DR. LUCIANA BORIO, FORMER DIRECTOR, NSC MEDICAL AND BIODEFENSE PREPAREDNESS: I think we need to leverage more technology that can support public health, efforts including contact tracing, isolation, we need to also leverage the power of the American people, where it is up to us to be able to counter this, our most valuable source.
CHRIS HAYES, MSNBC HOST: Dr. Luciana Borio, thank you so much. Appreciate it.
That is "ALL IN" for this evening. THE RACHEL MADDOW SHOW starts right now.
Good evening, Rachel.
RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Thanks, my friend. You are doing a fantastic job covering this story. It is an honor to go after you these nights, my friend.
HAYES: Thank you very much. You too.
MADDOW: Thanks to you at home for joining us this hour as well.
Let`s just jump right in. Here`s the headline, the front page of "The New York Times" right now: Coronavirus in New York, deluge of cases begins hitting hospitals. There are already critical shortages. A Bronx hospital is running out of ventilators. In Brooklyn, doctors are reusing masks. That`s the headline, and the sub-head tonight, of "The New York Times".
Here`s the lead, quote: For weeks, as the coronavirus has spread across the world, New York officials have warned that a surge of cases could overwhelm the state`s health care system, jeopardizing thousands of patients. Now, that surge has begun.
In a startlingly quick ascent, New York reported today the state was closing in on 8,000 positive tests which is about half the cases in the entire country. The number was ten times higher than what was reported earlier this week. New York has 10 times as many cases now as it did when we started this week.
And part of that is increased testing. The state says they processed 10,000 more coronavirus tests overnight last night. But regardless of whether it reflects increased testing or not, it`s giving us more information about what New York is coping with, and the state is now close to 8,000 known cases, with more than 1,200 people hospitalized, already.
There are not infinite beds to put people in in New York hospitals, as they bear the brunt of the first wave of this illness in the United States. And the hospitals in New York that already do not have enough beds, they also do not have the supplies they need to keep hospital workers and doctors and nurses from getting infected themselves, and they of course are the work force that we must keep alive and uninfected, and well enough to be working. As the hospitals fill up and spill over, first in New York. And then next, watch. It`s happening.
Quote, in the Bronx, doctors at Lincoln Medical and Mental Health Center say they only have a few remaining ventilators for patients who need them to breathe. In Brooklyn, doctors at Kings County Hospital Center say they are so low on supplies, that they are re-using masks for up to a week, slathering them with hand sanitizer between shifts.
Here`s New York City`s mayor today trying to make clear that this isn`t a future problem to worry about. This is what is happening now. And whatever happy talk you`re hearing from the federal government about how things are under control, and supplies are plentiful -- well, where those supplies are actually needed right now, they`re not here.
(BEGIN VIDEO CLIP)
MAYOR BILL DE BLASIO (D-NY): We don`t have masks. We don`t have ventilators. At the beginning of April, we will run out of basic medical supplies, because of the intense strain that`s being put already on our hospitals by this crisis. We literally will not have the things we need to save people`s lives.
I`m telling you in two weeks time or three weeks time, we will have nothing left and I have not gotten a hint of an answer from the federal government about when resupplies are coming. There`s no supplies moving. There`s no military mobilization.
We would know, I assure you, if we were receiving supplies, we`re not. We have not gotten a call saying here is your shipment, here`s when it is coming.
The president doesn`t act within days to maximize the use of the Defense Production Act to put every company that could produce a ventilator or surgical mask or any other necessary supply, put them on full 24/7 production and guarantee that those products get to the front line, get to where the need is greatest, if he doesn`t do that in the next few days, if he does not mobilize the United States military immediately, not only will hundreds die around the nation who didn`t need to die, thousands will die around the nation who didn`t need to die, people will die waiting to get into a hospital. People will die at a hospital because will is no equipment or there is no medical personnel who can help them in time.
(END VIDEO CLIP)
MADDOW: There`s no supplies moving. And we would know if we were receiving supplies. We are not receiving supplies.
Here`s the headline tonight in "The Wall Street Journal." Coronavirus cases strain New York City hospitals. Quote: We are getting pounded, swiftly rising number of patients. Sooner than expected. Leads to supply shortages.
"The Journal" reporting tonight that Maimonides Medical Center in Brooklyn has no more isolation space for coronavirus patients. They are full-up.
"The Journal" also reporting that Long Island Jewish Medical Center is now 90 percent full. Half the hospital`s intensive care patients right now are coronavirus patients. The hospital is adding ICU beds right now tonight, as fast as they can.
One doctor telling the paper, quote, we are getting pounding, I`ve been in ICU care for 15 years and this is the worst I`ve ever seen things. I`ve seen more cases in the last ten days of severe respiratory illness than we`ve seen in years. Quote, I`m very worried.
To try to slow down the rate of new infections, remember, intensive care demand lags new infections by about three weeks. After people get infected, three weeks later, that`s when those infections start to get reflected in emergency wards and intensive care wards.
To try to slow down the rate of new infections, to try to slow the demand on hospital and intensive care beds, New York and Illinois have now joined California as states that have full statewide stay at home orders. And announcing the first of the statewide orders last night, California Governor Gavin Newsom said that without changes to slow the rate of new infections in California, California expects that 56 percent of the state would be infected within the next eight weeks.
In a state as large as California, that means they`re saying more than 20 million people would be infected within the next eight weeks, unless the state radically changes direction. And so, a statewide stay at home order announced last night, instituted as of last night.
All the way across the country, in the great state of Louisiana, things are escalating quickly there as well. Louisiana has more than 500 reported cases now. And that gives that state one of the highest per capita infection rates anywhere in the country. The mayor of New Orleans tonight, instituted a stay at home order for the city. It`s along the lines of what is in place now statewide in California and New York and Illinois.
The Tulane health system in New Orleans is actually planning to shut down one emergency room in a New Orleans suburb so they can move all of the staff from that emergency room location, instead to a downtown New Orleans hospital where they`re experiencing a large surge in coronavirus patients. Louisiana`s governor, John Bel Edwards, now telling the White House that he believes his state may be only seven days away from its hospitals being out of capacity.
The White House released a transcript of his request for help, so we can see it in exact words, the governor saying, quote: My fear, based on modeling I`ve received today, is that in as early as seven days, we can start to exceed our capacity to deliver health care here. I`m asking for help in terms of surging our medical capacity. The governor then goes on to ask specifically if the V.A. hospital in New Orleans, federal facility, might be a place where patients from the regular city hospitals could be surged into, as the hospitals start to overflow.
In Oregon state, and in Washington state, the state`s governors there, Kate Brown and Jay Inslee respectively, they have now ordered a halt to all non- urgent medical and dental procedures statewide. Anything that requires protective gear for health care providers because that gear is so key to whether or not doctors and nurses and other health care workers stay alive to take care of the rest of us.
The Oregon Governor Kate Brown announcing that the state is actually rounding up protective equipment now, like masks and gloves, rounding that stuff up, collecting it, from contractors, and veterinarians, and anybody else who is not using it for human health care right now. Oregon is also one of several states that is building new capacity, new beds. Last night, we reported on King County in Washington, building a brand new 200-bed hospital that I`m tempted to call a field hospital, because they`re building it in a soccer field.
We reported on that last night, in King County, Washington, that is going up fast. One state south, in the great state of Oregon, they are also now building out a similar facility. A 250-bed hospital that they`re putting up on the grounds of the Oregon state fairgrounds. They are using a fairgrounds building that`s about 50,000 square feet, and they are converting it to hospital overflow. Frankly, states all over the country need to be doing things like this.
Here`s Salem, Oregon, today.
(BEGIN VIDEO CLIP)
BRENNA KELLY, REPORTER: We`re at the Jackman-Long Building, where the hospital will be set up. And when you look inside, this building is massive. It`s 48,000 square feet. And inside, there`s heating and electricity.
Governor Brown said this morning, the Oregon medical station will become a 250-bed emergency hospital. Right now, it`s unclear what level of care will be offered here. The governor said the emergency coordination center is working on identifying 1,000 temporary hospital beds across the state, to move patients to, who do not have COVID-19. We do not yet know whether this will be that overflow, or if it will be an emergency set up for critically ill coronavirus patients.
I spoke with one of the project managers, Chris Ingersoll (ph), who is working at the COVID-19 emergency coordination center. He says uniformed military members are helping set this up, so he doesn`t the community to be alarmed if they see them. They`re unloading hospital materials like beds and other supplies, like military equipment.
The questions like who will be staffing this hospital, and what level of equipment is here, we don`t yet know. Governor Brown said this morning, the hospital may be ready by Friday, but Ingersoll says he doesn`t think it will be operational then.
And what is clear right now is that setting up the Oregon medical station is a direct measure to flatten the curve and slow the spread of COVID-19.
(END VIDEO CLIP)
MADDOW: So they`re calling it the Oregon medical station. Oregon is building this capacity right now. They say they want a thousand beds that they need to get in very short order across that state. They`re using military resources to get 250 beds up and running right now. Again, they`re calling it the Oregon Medical Station. But they`re building it at the Oregon state fairgrounds.
In Washington state, they want even more surplus beds. They want 3,000 beds in Washington state. They have already been buying and leasing hotels and motels. Yesterday, they started standing up a hospital on a soccer field. We`re actually going to talk with the King County commissioner over the course of this hour, to talk about how his county, how he`s been able to basically get so on the ball about that stuff, and get that stuff in motion, bet those beds in use, while the rest of the country has lagged so far behind.
In Chicago, the commissioner of public health said today that they -- the city has assigned its first contract for hospital overflow and quarantine beds in Chicago. Now the commissioner did not announce what that first contracted facility is for Chicago. But they say they`re looking at empty schools and dormitories, and even convents. And Chicago is expecting to stand up thousands of beds again to try to keep Chicago hospitals from being overwhelmed.
In California, the governor says they will be trying to add tens of thousands of beds. The governor there signed an executive order last week that allows the state to commandeer, to take over medical facilities and hotels and he signed that executive order last week, he now says the process of doing that is under way.
(BEGIN VIDEO CLIP)
GOV. GAVIN NEWSOM (D), CALIFORNIA: Today, we just secured a very large hospital in northern California, Seton. It`s now part of our portfolio, and we`re going to populate that hospital, as an example to meet the moment. Tomorrow, we`ll announce a hospital in southern California. That`s 750 beds, those two hospitals combined. We start to stack this, 750 here.
The motels that we`re currently and hotels that we`re currently negotiating with, we start stacking those master leases, for those hotels. We`re working, I had very, positive conversations with the leaders of two of the finest public university systems in the world, UC and California State University System, we`re working with those systems to identify appropriate dormitories to help us with the surge. We start stacking those numbers.
(END VIDEO CLIP)
MADDOW: California, Washington, Oregon, the city of Chicago, Louisiana asking to please use the V.A. facility, which makes sense, probably, in the short run, except the V.A. has done almost no testing of veterans already in its care, and the numbers they`re showing early on from the few tests this very done show that the V.A. is going to have their very own serious charge with their own patient load, particularly given that they have so many older patients.
In terms of the happy talk we`ve had on this front from the federal government, there is no sign that the Navy hospital ships that the president made such a big deal of, the Comfort and the Mercy, there`s no sign that they`ll be anywhere on-site helping out anywhere in the country for weeks yet. The president said when he announced that those ships would be put into action against the COVID-19 epidemic. He said one of those ships would be operational in New York harbor by next week. That`s nonsense. It will not be there next week.
The army is talking about deploying a combat support hospital and a field hospital, potentially to New York, and also to Seattle, that would certainly be a help, as we understand it, a combat support hospital typically has about 250 beds, including about 50 ICU beds. A field hospital is much smaller, less than 100 beds, but a field hospital can also support ICU bed, including with ventilators.
So that`s not a lot of capacity that the army is talking about, one combat support hospital, one field hospital, if they`re only talking about deploying one of each of those, that`s not much, but every little bit will help. It would be helpful in particular if they`re able to move those fast.
Again, it looks like tonight, New York is already getting the first blast in terms of hospital capacity. There is talk in New York about potentially converting the gigantic Javits Center, the Javits Convention Center, into bed space, to hospital overflow space. They`re also talking about potentially using Madison Square Garden, or the student dorms at NYU, New York University.
And it is presumed that the U.S. military will help with setting those up, or with converting those spaces into hospital overflow, but with New York hospitals already filling up tonight, just talking about the prospect of doing that, at some point, is late already. And I mean the lodestar, the thing that New York officials believe they are heading for, is something akin to the situation in northern Italy which experts say epidemiologically speaking is about ten days to two weeks ahead of where the United States is in terms of its increase in cases.
And about the same distance ahead of New York City in terms of a hospital influx.
(BEGIN VIDEO CLIP)
REPORTER: This is the main hospital in Bergamo in Lombardi province. It`s one of the most advanced hospitals in Europe. But it`s the most hard-hit hospitals in all of Italy. The town is the center of the epidemic here.
This isn`t a ward. This is a waiting room. Wherever you go, people are on gurneys and corridors and meeting rooms, they`re everywhere. All the medical staff urged other nations to see what`s happening, and lock their nations down, right now, or face this.
UNIDENTIFIED MALE: Well, I would suggest just to shut down to stop all of the outbreak, and not come into this kind of situation. It is very, very difficult to manage.
REPORTER: Can I ask you personally what it`s been like?
UNIDENTIFIED MALE: I have never felt so stressed in my life. I`m an intensivist and I`m quite used to intense moments, and choices, and people are critical, and will die without any treatment, and you make a difference. But when you`re over to this point, you realize that you are not enough, and maybe all -- we are 100 anesthetists here, we are doing our best, but maybe it is not enough.
UNIDENTIFIED FEMALE: We are performing the test kits for the swab to detect coronavirus.
REPORTER: The problem facing health services across the world is that when the infection curve goes up, it rockets, and all of the resources, all of the testing, all of the supplies, are used up instantly, multiple hospitals all at once.
(END VIDEO CLIP)
MADDOW: Italy reported its largest single day death toll today, 627 people died in the last 24 hours. And even as Italy struggles and struggles and tries to keep up, China just set up a team of experts who just went through their coronavirus catastrophe to try to advise and help out with the situation in northern Italy.
The vice president of the Chinese Red Cross on that visit to northern Italy said that from what he can observe, what Italy is doing to try to slow the rate of new infections, which are frankly the kinds of measures we are just lackadaisically starting in a few states in this country, the Chinese officials who just went through this in their own country, are visiting Italy and they say what Italy is doing is not nearly strict enough to make enough of a difference.
Quote: Here in Milan, he said, the hardest hit area by COVID-19, the lockdown measures are very lax. I can see public transport is still running. People are still moving around. Having gatherings in hotels and they are not wearing masks.
Quote, I don`t know what people here are thinking. We really have to stop our usual economic activities and our usual human interactions. We have to stay at home and make every effort to save lives. It is worth putting every cost we have into saving lives.
Again, that`s what the head of the Chinese Red Cross is telling northern Italy about how well they`re doing in their nationwide lockdown effort. Their nationwide lockdown effort in Italy is effectively the same kind of stay at home order that only three U.S. states have thus far adopted, and those three only in the last 24 hours.
So here we go. There was some more happy talk from the White House today about how plentiful our national supply of ventilators is, saying there is no problem there, and also how plentiful the supply of masks and personal protective equipment is. There`s tons of that stuff.
There`s murmuring from the White House that there will maybe be some additional manufacturing of those things, but we`ll see. Let`s hope so.
I mean, those things do eventually start getting manufactured in greater numbers because the federal government decides to do something about it, let`s hope all of those things come with a time machine, too, to turn the back the clock on the last three months that have been wasted while the White House was saying this was a hoax.
I don`t know if the federal government is ever going to get it together. But as of now, with the first hospitals in America reporting that they are all filled up, we are out of time waiting for the federal government to get it together. The best-run state, the clearest-eyed leaders in the best-run states, right now are just going on their own. They have to be now.
And if your state isn`t, you should not hope that there will be some kind of federal response that will step up to fix things, when things start to get dark in your state over the next few weeks. States, we have learned, have to go on their own.
Yes, we need a national manufacturer and mandate for ventilators. We need that. We need a national manufacturing mandate and a national coordination effort for the distribution of protective equipment for health care providers and the other crucial supplies they`re already running out of and rationing and unsafely reusing.
And, yes, weeks ago, we needed a national effort to get millions of coronavirus tests in the field. We`ve needed all of these things from the federal government. The federal government is failing at all of these things.
And that is lamentable and I lament it, but it`s not stopping the virus, right? It`s not stopping these things from moving forward. It`s not stopping the influx at our hospitals from starting as of today.
So lament it all you want, but if you`re a state official, the lesson is go. Go now.
(BEGIN VIDEO CLIP)
REPORTER: Do you want the president to use the Defense Protection Act to ramp up production of medical supplies.
GOV. ANDREW CUOMO (D), NEW YORK: Look, I`m -- if I had a New York state Defense Production Act, I would use it, Jessie. I don`t have it.
So what I`m saying is I`ll pay businesses more, I`ll start a new, I`ll fund a new business, if you can make these products. I`m trying to make these products.
If you were in this, this line of work, you know, we need masks, if you`re making clothing, figure out if you can make masks, I`ll fund it. So I`m doing everything I can to increase the production.
(END VIDEO CLIP)
MADDOW: If you`re making clothing, figure out if you can make masks, for nurses, and New York state will pay you, I mean that`s where we`re at. That`s where we`re at.
Lots of expert help lined up tonight to help us get through the news. Do stay with us.
MADDOW: Within the last few minutes, the president has just declared New York state a federal major disaster. This is something that was sought by both of New York`s senators, Chuck Schumer and Kirsten Gillibrand, the expectation that this federal major, the disaster declaration, will open up more lines of money and aid for New York, as the state struggles already with the initial large influx of hospital patients and intensive care patients.
Tonight in Washington state, Governor Jay Inslee is also asking the president to declare a federal major disaster in his state as well. Again, to help them deal with the spiraling crisis of the coronavirus epidemic. The governor`s request comes as King County Washington, which includes Seattle, now reports a total of 793 confirmed cases, that`s up 100 from yesterday. King County is also now confirming 67 deaths, and seven deaths confirmed in the past 24 hours.
Regardless of what the federal government ends up offering, a hard-hit community like King County, Washington, local officials there have not been waiting around for help. Chief among the early identified needs in King County is having enough room in the hospitals there, preserving hospital beds, so sick people can be safely isolated, and so that everybody who needs care can get it.
Way back on March 2nd, the King County executive, a man named Dow Constantine, announced that the county would plan to buy a motel to convert it into a facility where people could be isolated. The county looked at properties that fit certain criteria, like having hard surfaces that could be easily and repeatedly cleaned and wanted facilities with separate HVAC systems in each room. The county ended up purchasing a motel with 85 beds.
And as of last weekend, county officials announced they are leasing another motel in the city of Issaquah to house and isolate more people. And two days ago, King County started building their latest facility on a soccer field in the city of Shoreline, which will be ultimately 200 beds. King County estimates they will still need about 3,000 more beds and looking for more facilities to use for isolation, quarantine, recovery, hospital overflow.
King County, Washington, is not just talking about what could be done. They are doing it. They`re not waiting around for the cavalry. They are doing everything they can. And they are doing it themselves.
And their efforts have come with some local friction, some Not In My Backyard objections. But the King County executive Dow Constantine has defended how aggressively the county has been working, and a statement that caught our eye and I have been holding on to it ever since.
He said, quote: Epidemiologists tell us that left unmitigated, the number of people with this infection roughly doubles every five to seven days, possibly quicker during this period in the disease`s evolution. That fact underscores the urgency with which we are implementing these community mitigation measures, as well as purchasing, citing, and setting up places for people to recover, and to isolate themselves so they don`t inadvertently infect their families or others in the community. We must take time to be sure to get this right. But we must also act with urgency and leave no one behind.
Again, that was earlier this month, I`m willing to bet, he feels the same way now. But let`s ask him.
Joining us now is Dow Constantine. He`s King County executive.
Sir, thanks very much for being here tonight. I appreciate you making the time.
DOW CONSTANTINE (D), KING COUNTY EXECUTIVE, WASHINGTON: Thanks for having me, Rachel.
MADDOW: So, as -- I understand that you have one motel open that you`ve convert to this kind of use and another that you`re about to open. You`ve got this hospital under construction. Tell me about the sense of urgency. Tell me about what you think would happen in King County if you weren`t building out that additional capacity.
CONSTANTINE: Well, what you just showed happening in Italy is what we are looking to avoid. What we`ve been working hard for more than a month to avoid, which is hospital overcrowding, hospitals having to turn people away, the people who need that acute hospital care and not being able to get it.
So we`re pushing for 3,000 units for people to be outside of the hospital, still recuperating or being isolated. or getting an appropriate level of care while we keep the few hospital beds available for the folks who really need them.
MADDOW: How difficult is it to get these facilities up and running? I know some of them, you`re building from scratch, literally popping them up in fields, but in other places you`re taking existing facilities and repurposing them. As other communities around the country look at what you`re doing, and trying to figure out how they can replicate it, what can you tell them about how hard, how expensive this is, and how much time it takes?
CONSTANTINE: Well, as you know, we already had a housing crisis here in Central Puget Sound, so we are trying a yes and approach, if there`s a vacant motel or hotel, we`ll get it, if there is an open field, and we can get a large tent, we`ll take that. We`re putting up modular units on government-owned property around the region.
We`re even converting an old shelter that we`ve already been using, into space for folks to move out into respite from the hospitals.
MADDOW: In terms of the extent for which you are serving as a model for the country and I`m not sure why there isn`t more national attention to what you`re doing, I think it needs to happen all around the country, I guess I wonder if you -- if you imagine you were speaking to other public officials right now who feel what you`re doing is too hard or beyond what they think their jobs are about, do you have any words of encouragement for them about how this is doable or what they should do, who they should talk to, to make it more doable, particularly if it seems like an insurmountable task.
CONSTANTINE: Well, you know, Rachel, you were talking about this earlier. The federal government has rendered itself incapable of really rising to the occasion in the sport of national emergency. So, we are left here at the state and local level to do what we can to provide for the people and one thing we need to do to save lives is to maintain that hospital space. So whether you have to borrow the money, whether you have to upset some people in neighborhoods, you have to get that space set up to get the people out of hospitals, to allow the hospitals the space to care for those who most need it.
I went to our Harborview Medical Center, a public health hospital, last week, with Major Jenny Durkan of Seattle, and we saw the folks there on ventilators. It is truly harrowing. And to think that we might not have the space for them to be admitted, or there might not be enough ventilators for the people who need them is terrifying. So faced with that, we`re going to do everything within our powers, as a local government, including borrowing up to $100 million from ourselves, to set up the space we need to save lives.
MADDOW: Dow Constantine, King County executive. I really appreciate you joining us tonight. And I know that the last thing you want to do is lots of national media interviews but I hope more people call to you get the word out about what you`re doing because it is a real model for the country. Thanks for being here.
CONSTANTINE: Thank you, Rachel.
MADDOW: All right. So we are all depending on health care workers in this current crisis. It turns out they are also depending on us and letting us know it. That story is next. Stay with us.
MADDOW: Do you have a sewing machine? Do you know how to sew? Are you good with your sewing machine? Maybe by any chance you live in the Seattle area?
Providence Hospital in Renton, Washington, is looking for anyone with a, quote, willing heart and the ability to sew to help protect care-givers on the front lines of the coronavirus pandemic. The hospital is literally signing up people who can sew at providence.org, for what they`re calling the 100 million masks challenge. They are asking for the community to help create medical-grade masks for health care workers who are desperate now for protective equipment so they can keep doing their jobs.
This is not the way that American health care workers are supposed to be getting personal protective equipment, but this is what we`ve got.
How about any of you out there in Oklahoma? Anybody out there in Oklahoma with a sewing machine and good set of hands? The Stillwater Medical Center in Oklahoma is also looking for people to sew masks, if you go to buttoncounter.com and search for face masks, you will find a tutorial of exactly what they`re looking for, in that case, in Oklahoma, they`re looking for masks to be warn by the worried well, so people will start buying up the medical ones so actual medical workers can use those.
Last night, we reported that the president of Mass General, Massachusetts General Hospital in Boston, was broadly appealing for anybody who has a 3D printer to try to help out as well, asking for people with 3d printers to start printing medical-grade masks. Well, update to that, this morning, on the "Today" show, the president of that hospital said he heard from over 100 individuals and companies offering to help.
Mass General is also giving out this email, that you see on the screen, firstname.lastname@example.org, for those with expertise who want to work with their researchers on that project.
Everybody out there, hospitals need help from regular civilians who didn`t know we knew how to do this stuff.
You may have seen pictures of E.R. workers and their masks and gowns along with the hashtag, get me PPE, get me personal protective equipment, drawing attention to the desperate need for basic equipment like masks and gowns and gloves. And that campaign was started by somebody on the front lines of that effort. An E.R. doctor in Portland, Oregon, who saw the need, who experienced it herself, who decided, well, let`s just try, it let`s just ask the world for help.
Joining us now is that doctor, Esther Choo, an E.R. doctor, an associate professor at the health and science university in Portland.
Doctor, thank you very much for joining us. I really appreciate it.
DR. ESTHER CHOO, HEALTH AND SCIENCE UNIVERSITY ASSOCIATE PROFESSOR: Thanks for having me on, Rachel.
MADDOW: It does feel ridiculous for people with sewing machines and people with 3D printers to be activated here. It only feels slightly more ridiculous than construction companies and contractors being asked to donate their masks, as well. But the campaign that you started and the way that it`s resonated around the country, with doctors and nurses, health care providers everywhere, saying yes, the shortage is real, it is starting to seem like this stuff isn`t far-fetched.
CHOO: Yes, I mean this really feels to me like some sort of dystopian novel, where regular processes have completely broken down and we are doing these really surreal things like dropping by the Home Depot on the way it a shift or asking our friends and neighbors to sew basic medical equipment, for us, so that we can have some semblance of being safe when we go in to take care of these patients, but that`s where we are.
And I`ll tell you, speaking from health care providers I`m talking to, this is one thing we`re fixated on because it is the first layer of protection as we simply go in and see people and take care of them. We`re already thinking ahead to if the supply does not come through, if we`re not really able to reproduce medical-grade equipment, through these kind of MacGyver ways, we`re thinking ahead to the hard decisions we have to make. I mean, can we continue to ask this entire work force to go into rooms where they`re not adequately protected knowing that they are going to be exposed to patients with COVID-19, get sick themselves, and then not be available to take care of hundreds or thousands of other patients. There are some really tough ethical decisions we will have to make at some point.
MADDOW: I mentioned earlier in the show, and I used sort of harsh language, I said that it`s -- there`s been quite a bit of happy talk, from the White House, from the federal government, in terms of the availability of these kinds of equipment. We have seen the president and the vice president say that there is tens of millions of masks on order, and that there`s going to be a mental supply, not only of masks and protective equipment but also of complex equipment like ventilators.
It`s frustrating to me just as an observer to see the distance between what the White House is talking about, and what providers like yourself are describing, in terms of the ground reality. But I have to ask you over these past couple of weeks, does it feel like anything is getting any better in terms of supplies of this kind of stuff?
CHOO: I really want to be positive, you know, I want to give people hope, I am listening, and watching all of the news that you`re talking about, and I`m hearing some positive messages, and I think on the ground, we would love to see those things. I will say hospital administrator, public health officials are working very hard and trying to be very creative, doing the kind of public campaigns that you`re talking about.
On the ground, we`re not seeing the -- we`re not really seeing the delivery of items that we`re hearing from our country`s administration, so I haven`t unfortunately seen it yet. We`re waiting and we`re optimistic. And then in the meantime, we will do what we can with what we have.
And I also want to say, face masks, gowns, gloves, respirators, ventilator machines, I mean, these are the kinds of things that we`ve been talking about. They represent one part of many, many different types of resources that we are going to run short on. And something we haven`t really talked a lot about is we`re right now facing a national shortage of albuterol inhalers. You know, those are the first line treatments for people like wheezing and shortness of breath, asthma exacerbation, the kind of things that get worst when you have a respiratory viral illness like COVID-19.
So, as we get over this first hurdle, if we get over this first hurdle of things like face masks we will then be talking about the vital medications that we have a shortage of, we`re going to be talking about how much supply do we have of these experimental therapies that we`re using to treat COVID- 19, and then on and on, to rooms and ventilators, other advanced ICU equipment, and then how we sustain the work force, and not just doctors and nurses, respiratory therapist, pharmacist, the complex team that you need in every hospital to take care of very, very sick patients.
So this issue of we`re lacking fill in the blank, it starts here with basic things like face masks and gloves, this conversation is not going to end, it will just be the next shortage du jour for a while I believe.
MADDOW: No, we need a war-sized national response to address these things each in turn, all of them. It`s remarkable.
Dr. Esther Choo, associate professor health and science in Portland, Oregon, Doctor, I would like to have you come back and talk us to in coming days as things start to evolve in Portland. We`d love to have you come back with us again.
CHOO: Any time. Thank you, Rachel.
MADDOW: OK, more ahead. Stay with us.
MADDOW: I know we ought to be getting used to this kind of thing by now but I`m not.
(BEGIN VIDEO CLIP)
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: This has been prescribed for many years for people to combat malaria, which was a big problem and it was effective and a strong drug.
REPORTER: It was effective against SARS?
TRUMP: It was very -- as I understand that, is that a correct statement? It was fairly effective with SARS.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES, NATIONAL INSTITUTES OF HEALTH: John, you got to be careful when you say fairly effective. It was never done in a clinical trial that compare to anything.
(END VIDEO CLIP)
MADDOW: You got to be very careful when you say fairly effective.
President Trump today again just flat out wrong in public about this malaria drug that has gotten stuck in his mind quite some distance from the fact.
Yesterday, President Trump proclaimed that that drug had been approved as a coronavirus treatment and would be available almost immediately for use. Within moments, the FDA had to clean that up because that is not true at all. It is not at all approved for coronavirus treatment.
But the president loves saying things like, you know, there`s a drug we`ve got. It`s very effective. It approved already. Everybody is going to get it.
He loves saying things like that because that would be a lovely thing to tell people, unless of course, that`s not true and telling people a fairytale like that is cruel and harmful and needlessly diverting and wildly irresponsible from anyone in any leadership role. It wildly responsible if someone said that to you from a barstool if we could go to bars anymore, but to get from the presidential podium, nevertheless, he keeps doing it.
In the weeks leading up to now, we repeatedly heard claims from the president that the virus was well-contained, that it was well under control, that it was going to disappear -- remember that? Like a miracle, he said, it was going to disappear.
In terms of material tangible promises, President Trump claimed we would have 1.4 million tests available this week. Of course, we`ve seen nowhere near that. We`ve got about a tenth of that.
Last week, Trump announced that Google was developing a website to help people decide if they needed testing and where to go to get it. It was going to be very quickly done he said unlike websites of the past.
Turns out, of course, that that website is still in the early stages of development and currently only being tested in one part of California and it`s not even really working just for that.
President Trump announced this week that the navy was sending two medical ships, one to New York City, one to the West Coast to help treat patients. He said the ships would be launched over the next week or so depending on need.
Wrong. That was also wrong as NBC`s Courtney Kube puts it. Quote, it`s anybody`s guess when those ships will come in. One of those ships is currently undergoing maintenance. It has no medical personnel on board. The other one is also undergoing maintenance and it lacks a medical crew all together. Remember the president said it will be there next week. It won`t be there next week.
The president has claimed that the government has, quote, massive amounts of ventilators. Maybe in normal times, I guess, you might say but in a crisis like this the government`s stockpile of ventilators will not be nearly enough to satisfy the demand. We need literally tens of thousands more than we have.
He has said similar things about face masks and other protective equipment for health workers and told a grown up of nurses this past week that the government ordered 500 million N95 respirator masks. He declined to mention the order will take 18 months to fill, if we`re lucky. Millions of masks. Don`t worry.
Nurses, what are you worrying about? Millions of masks are coming. Wait a year and a half before you might.
I mean, there`s a -- there`s a clear pattern here in this crisis of the president promising stuff he knows America would love to hear but it`s not true. And even stuff that he`s saying that he will do, that the federal government will do, he`s not doing. And so the specific way in which the president is failing now is clear. We have said from the very beginning, watch what they do, not what they say. That`s very, very, very relevant here.
And I say this not to vent my outrage or anything. I`m over that frankly at this point. I`m just saying it because I feel like we should inoculate ourselves against the harmful impact of these on going pulse promises and false statements by the president by recognizing when he`s talking about the coronavirus epidemic more often than not, he is lying. Even when he`s talking about what he has done or what he will do, he`s consistently lying and giving you happy talk that is stuff that the federal government isn`t actually doing.
And it`s making people around the country count on the fact the federal government is doing that stuff when they`re not. I mean, there may be people in the federal government who are saying that are true, but this daily briefings from the White House are litany of things from the president that would be awesome if they were true, if they were happening but they`re not.
And so, the sooner we come to terms with that, I think the better for all of us. If it were up to me and it`s not, I would stop putting those briefings on live TV. Not out of spite but because it`s misinformation. If the president does end up saying anything true, you can run it as tape. But if he keeps lying like he has been every day on stuff this important, we should -- all of us should stop broadcasting it. Honestly, it`s going to cost lives.
MADDOW: Before we go tonight, I want to tell you about a member of the MSNBC family who died yesterday of coronavirus. The thing you should know about Larry, about Larry Edgeworth, is that he was a hoot, he was a ton of fun and he was really good at his job.
He spent 25 years at NBC News. It was always a really good sign if you got sent into the field or to a remote location somewhere and Larry was on the team. He was super charismatic, super talented, very respected by his co- workers. He`s survived by his wife and his two sons and mourned by all of us who are lucky enough to work with him.
That will do it for us tonight. See you again on Monday.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. END