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virus spread TRANSCRIPT: 3/25/20, The Rachel Maddow Show

Guests: Gabrielle Mayer, Diana Koelliker, George Latimer

ZEYNEP TUFEKCI, ASSOCIATE PROFESSOR, UNIVERSITY OF NORTH CAROLINA:  --  universal mask wearing, started social distancing early January. Taiwan,  which had gone through this, tried -- heard from mainland China that there  was transmission and they did the same thing, ramped up production, locked  down --  


TUFEKCI:  -- those are the countries that have it under control. We should  have been one of them. 

HAYES:  Zeynep Tufekci, who is one of my favorite writers on a variety of  topics --  

TUFEKCI:  Thank you.

HAYES:  -- thank you so much for your time tonight. 

TUFEKCI:  Thank you, Chris. 

HAYES:  That is "ALL IN" for this evening. 

THE RACHEL MADDOW SHOW starts right now. 

Good evening, Rachel. 

RACHEL MADDOW, MSNBC HOST:  Fantastic show tonight, Chris. Really one of  the best I have seen by anybody on this topic. One of your best. Thanks, my  friend. Much appreciated. 

HAYES:  Thank you. 

MADDOW:  And thanks to you at home for joining us this hour. 

I am not the world`s most squeamish person. I mean, I like being outdoors.  I don`t really mind bugs and stuff. I like to fish. 

Sometimes that means handling bait of various kinds, which bug some people.  It doesn`t really bug me. And I should also mention, if you`re lucky when  you`re fishing, the act of fishing also occasionally involves handling  fish, right? That also ughs some people out, but I like to fish, I don`t  mind it. 

That said, if I had to pick a few things that I would choose to avoid if I  could, because they made me feel ew, I would pick number one, eels, they  just, huh-uh, not going to do it, number two, spiders, basically they just,  ugh me out, not as bad when I was a little kid, but still, given the  option, spiders, no thank you.

I also don`t like needles. When I get blood drawn for anything, at the  doctor`s office, I always get a little oozy, I have to warn them I`m going  to turn green. 

But today, I learned something, I watched something, that for the first  time in my whole adult life, made me feel less woozy, less bad about  needles. Because today, I learned that in modern med schools, and nursing  schools, when they teach student doctors and student nurses how to draw  blood, they use a fake arm. That`s not like a wedge of baloney or some  unfired pottery, that`s, I`m sure it has a technical term, we`re going to  call it here, an arm simulator, it is an arm simulator that has fake- colored blood in it.

They use this device for teaching nurses in training, in this case, how to  do a blood draw, using a butterfly needle and a vacu-tainer. And even  though I`m super ughed out by needles, seeing a needle used to train a  medical professional or soon to be medical professional on a device that`s  meant to seem like a human arm, it just makes me feel less ughy about the  whole thing. It`s like the first time I looked at the needle like that  without turning green my entire life. 

The reason I learned today that this is how they do it, this is how they  train, is because this video was made of a training this past week, for  people who are not nursing students. Within the past few days, the surgeons  in training, the surgical residents at the medical school at the University  of Southern California, USC, all the surgical residents at medical school  at USC volunteered to basically stop out of their advanced surgical  training for now, to instead learn to be nurses. To instead at least learn  some of the skills that ICU nurses have to learn. 

Because right now, in our country, what we need is pretty specific.  Coronavirus is not causing a demand for lots of new surgeries. What  coronavirus is doing is putting a lot of people in the intensive care unit,  in the ICU, and so these high-flying surgical residents at USC volunteered  now, that what is needed right now, is what they will do, they will stop  their surgical training and train as critical care nurses for right now,  because that`s what`s needed. 

And USC apparently innovated this in a matter of days. But the surgical  residents all stood up and said, yes, I will do it, I will change my  training, I will learn this stuff instead, because all of our lives are  changing in this pandemic, and our country is going to need things from us  that it has not needed before. 

Luckily, for a green around the gills woos like me, this lesson in today`s  news comes with a machine that fakes being a human arm, so I don`t have to  pass out while reporting on it and also I feel like I got over my  squeamishness on this subject a little bit all together. Again, that`s a  story out of USC med school tonight. 

But there`s a lot more news like that today, in terms of people stepping up  and people asked to step up in very dramatic ways. We`re going to be  talking about some of those extraordinary efforts, over the course of this  hour. 

But I also want to start tonight with something that I mentioned  tentatively, a couple of nights ago, on the show, as a potential sign of  good news. It`s again, good news is relative in this context, but what I  mentioned a couple of nights ago is the potential sign of good news now  looks like it is holding as good news. So I want to show you the data that  we just got today. As you know, it is the nation of Italy that has the  worst outbreak in the world right now. And hospitals in the northern part  of Italy are overwhelmed, and the death toll is still towering, it is 600  and 700 death still every day now. 

But this is a chart, it`s aggregated data from Italy`s ministry of health,  that shows the rate of increase in new cases in Italy, and you can see,  there are still an increasing number of new cases being reported each day,  but what this chart shows, that in recent days, the rate of increase is  slowing. We reported at the beginning of this week that for the first time  since Italy really spun out of control, the rate of increase in new cases  had dropped into the single digits, and that was true at the beginning of  this week, and it`s still true. Italy has now reported a rate of increase  in new cases that is in single digits for three straight days. 

And I know this is the thinnest of silver linings. But it`s pointing in the  right direction, right? It at least means that Italy`s measures to try to  slow the number of people, getting newly infected, to try to keep people  distant from one another, to try to slow down the rate at which these this  thing is spreading, these are the first signs those measures are working.  It is the first hope for Italy even as Italy is in the depths of it right  now. 

In New York, where experts have been screaming from the rooftops that the  New York trajectory is basically Italy minus two weeks time, in New York  today, Governor Andrew Cuomo cautiously announced that New York`s  skyrocketing hospitalization rate may also be showing the first signs of  slowing. 


GOV. ANDREW CUOMO (D), NEW YORK:  This is very interesting, because the  evidence suggests that the density control measures may be working. And  again, we`re doing this from projections. But look at this, because it`s  interesting. 

This past Sunday, the projection was that hospitalizations were doubling  every two days, OK? On Monday, the numbers suggested that the  hospitalizations were doubling every 3.4 days. On Tuesday, the projection  suggested that the hospitalizations were doubling every 4.7 days. Now, that  is almost too good to be true. But the theory is given the density that  we`re dealing with, it spreads very quickly, but if you reduce the density,  you can reduce the spread very quickly. 


MADDOW:  So on Sunday, hospitalizations in New York were doubling every two  days. Then the next day, they were projected to double every 3.4 days. And  then the next day, yesterday, they were projected to double every 4.7 days. 

That`s going in the right direction. That`s good, right? That may be a sign  that the measures New York is taking to keep people at home, to keep people  apart from one another, those measures may be slowing the number of people  getting newly infected, which is slowing the increase in the number of  people getting sick, which is slowing the increase and how fast people are  pouring into New York hospitals. 

It is good if that, that all of this is slowing. It means, it indicates  that maybe these stay-at-home orders, these work from home orders, these  shelter in place order, whatever you want to call them, it means they may  be working. But even still, even with that good news, that`s about the  doubling of New York hospitalization rates, the doubling, even with that  news from the governor -- I mean, New York hospitalizations are still  doubling less than every five days, which is terrible. 

I mean, as of tonight, we just got the latest numbers. As of tonight in New  York City, there are 3,750 people hospitalized in New York City, at least  840 people in intensive care beds. Again, those numbers just, we just got  those moments ago from New York City. 

So I`m just checking something right now -- 3,750 hospitalizations in New  York today. That number yesterday was 2,850. So, I mean -- yes, it`s better  if those kinds of hospitalization numbers are not doubling every two days,  and they`re instead doubling every four or five days. But still, doubling  these numbers, within the space of a week, is still an upsurge in  catastrophe, in New York, in terms of the capacity to continue to treat  people in New York hospitals. 

I mean, here`s the headline in "The New York Times" just posted tonight, an  apocalyptic coronavirus surge at a New York City hospital. Quote, in  several hours, on Tuesday, yesterday, Dr. Ashley Bray, performed chest  compressions at Elmhurst Hospital Center on a woman in her 80s, a man in  his 60s and a 38-year-old who reminded the doctor of her fiance. All had  tested positive for the coronavirus and all went into cardiac arrest. All  eventually died. 

Elmhurst, a 545-bed public hospital in Queens, New York, has begun  transferring patients not suffering from coronavirus to other facilities as  Elmhurst moves toward becoming one facility that is dedicated entirely to  the coronavirus outbreak. Doctors and nurses have struggled to make do with  a few dozen ventilators, calls over a loud speaker of team 700, the code  for when a patient is on the verge of death, comes several times a shift.  Some patients have died inside the emergency room while waiting for a bed. 

Quote: a refrigerated truck has been stationed outside to hold the bodies  of the dead. Over the past 24 hours, 13 people at Elmhurst died. It`s  apocalyptic says Dr. Bray. Dr. Bray is 27 years old. 

Quote: Across New York City, hospitals are beginning to confront the kind  of harrowing surge in cases that has overwhelmed health care systems in  China and Italy. According to a Federal Emergency Management Agency, a FEMA  briefing obtained by "The New York Times" tonight, all of the more than  1,800 intensive care units in New York City are expected to be full by  Friday. 

By Friday, that`s the day after tomorrow. One doctor at that same Elmhurst  hospital in Queens, New York, telling the city newspaper today, quote, it`s  a fairly dire situation. COVID-19 is completely taking over the hospital in  a way I`ve never really seen anything else do. It`s just a tidal wave. The  only beds we have been able to free up are people who have died. 

And yes, this is what is happening in New York now, because New York is  first in our country. But this is what we know happens even in places like  New York City, or Milan, in rich northern Italy, when the virus spreads  fast enough, unchecked enough. That so many people get, it and so many  people get sick, the numbers just swamp, even big modern capable health  care systems and big modern hospitals. 

This is how it goes. Everywhere it gets in a significant number and spreads  fast. New York, as Andrew Cuomo said yesterday, is the canary in the coal  mine, but New York is first. Other places where it is spreading,  particularly places where it is spreading unchecked, and there have not  been serious measures put in place, to slow down the spread of this virus,  it will happen there next. This news is apparently not arrived at the desk  of the Republican governor of Florida, Ron DeSantis.

Florida has a population of over 20 million people, and Florida has some  very worrying signs in terms of this epidemic both in terms of their  demographics as a state and the epidemiological markers that are signaling  that Florida may have a real problem on its hands. But still, as of today,  no stay-at-home order from Governor DeSantis. 

Why bother, right? I`m sure Florida will be fine. Why not just guess. Why  assume they`ll fine. Why try?

Even Idaho today finally issued a stay-at-home order. But in Florida,  population 20 million, dozens of deaths, and climbing, still in Florida,  whatever, no reason to have a stay-at-home order. 

Last night, we talked about the governor of Mississippi, announcing that  there would not be a statewide stay-at-home order in his state either  because he said Mississippi is not China. And while that is true,  Mississippi is not a gigantic country in Asia, Mississippi is sandwiched  between Louisiana, which has what is probably the fastest-growing epidemic  in the country, maybe in the world, and Alabama, where Birmingham, Alabama  hospitals are already screaming from the rooftops for help, in terms of the  numbers of patients they`ve already got in their intensive care units and  on ventilators. 

Mississippi right in between Louisiana and Alabama. But today, the governor  of Mississippi, Tate Reeves, decided that he would break new ground in this  pandemic. Not only did he announce there would not be a stay-at-home order  statewide in Mississippi but the governor of Mississippi today did  something brand new. He issued his own executive order that overrides and  overturns any actions that have been taken by cities and towns in his  state, even as he is refusing to act statewide. 

So, take, for example, the beautiful city of Tupelo, Mississippi. Birth  place of Elvis Presley, right? World famous. 

On Saturday, the mayor of Tupelo, Mississippi, ordered a stay-at-home order  for that city. He banned gatherings of more than ten people. He ordered  nonessential businesses to shut in Tupelo. 

That was this weekend. The mayor issued that order in Tupelo. On Tuesday,  yesterday, the city council in Tupelo met and in a unanimous bipartisan  vote, they voted to affirm and ratify those rules that the mayor had put in  place in Tupelo. 

But today, the governor of Mississippi superseded that. Today, the governor  of Mississippi said Tupelo and any other city or town in the state can`t do  anything like that. Only his rules apply. And his rules are no stay-at-home  order, and restaurants can still do dine-in service for limited numbers of  people, lots of cities and towns around Mississippi had shut down  restaurants so that they were only takeout and delivery, and the governor  says no, restaurants will be allowed to stay open as long as they`re only  servicing limited numbers of people for dine-in service. 

The government`s executive order says it`s OK, yes, nonessential business  do have to shut down but his executive order declared that basically all  businesses in Mississippi are pretty essential, including, quote, offices.  Per the governor`s executive order today, any office is an essential  business, and therefore can`t be ordered closed. 

Cities and towns around Mississippi have been ordering non -- real  nonessential businesses to close down, including some that are housed in  offices, but the governor of Mississippi overrode that today, and said, no,  you can`t have those rules. The mayor of Tupelo did a Facebook live event  today in which he tried to explain the about-face to his city after he and  the city council had unanimously taken these decisions to protect the  people of that city, and the governor came in and said, no, you have undo  all of that. 

Here`s what he said. 


JASON SHELTON, MAYOR OF TUPELO, MS:  So pursuant to the governor`s order,  some of the things that we did to protect the health and public safety of  our citizens is no longer going to be in effect. There`s nothing we can do  about that locally. 


MADDOW:  The Jackson Free Press today reporting that thanks to the  Mississippi governor, overriding cities and towns, who took action to  protect themselves, quote, as of press time, the Jackson Free Press has  referred reports from businesses in the Jackson, Mississippi, area, that  have, businesses in the Jackson area, that have as of today`s executive  order, scuttled plans for work from home, and instead, ordered their  employees back to work on-site. 

So businesses in and around the capital of Mississippi were putting in  plans to have their employees working from home, a stay at home effort, to  try to keep this disease in check in Mississippi.

But now, with the governor saying any local rule like that is null and  void, on his orders, those employers are instead telling their employees to  come back to work on-site. 

I will just say this, to the people of Mississippi -- you should know that  your government is breaking new ground when it comes to the coronavirus  pandemic. The governor of your state today has pioneered a whole new kind  of response to the coronavirus pandemic in which he is legally blocking  towns and cities in your state from doing a better job than he is at  keeping you alive. He is undoing public health measures and insisting that  the state will not have them. 

Meanwhile, in many more places on earth, this is a "ask not what your  country can do for you" moment, but an "ask what you can do for your  country" kind of moment. In the U.K., where the response was slow and small  until they just now started to panic at how behind they are, we mentioned  last night that the government in the U.K. put out a call for 250,000  regular citizen volunteers, just regular British citizens, to please come  forward, and volunteer to three to try to bolster the National Health  Service as the NHS comes under what is expected to be an absolute assault  in terms of the numbers of sick people and the numbers of people needing  intensive care treatment in Britain. 

The British government asked for 250,000 volunteers yesterday. In 24 hours,  405,000 people came forward to volunteer. As of tonight, now more than half  a million British citizens have volunteered. In New York, Governor Cuomo  has asked health care providers to volunteer to support the New York health  system too and they have been coming forward by the tens of thousands. 


CUOMO:  God bless them. 40,000 people have signed up as a surge health care  force, 2,000 physicians, anesthesiologists, emergency room technicians,  nurse practitioners, physician assistants, nurse anesthetists, respiratory,  RNs, LPNs, 40,000 people have signed up. That is a very -- that`s a big,  big deal. 

You have to have staff when the existing staff gets ill, or by the way just  can`t work the hours that we`re going to need people could be working. So  that`s very good. 

We ask for mental health professionals to voluntary sign up to provide  online mental health services. Six thousand mental health professionals  agreed to volunteer to provide mental health services for people who need  it. How beautiful is that? 

You can call that hot line. You can schedule an appointment, with the  mental health professional, totally free, to talk to them, about what  you`re feeling and what stress you`re feeling. 

And again, God bless the 6,000 mental health professionals who are doing  this, 100 percent, free. On top of whatever they have to do in the normal  practice. 


MADDOW:  God bless them indeed. 

So states, countries are asking a lot of people right now, to come forward,  and volunteer and do what they can. I mentioned at the top of this hour,  the University of Southern California, the USC surgical residents, who have  now all volunteered to be trained in ICU nursing methods, so that they can  help out with the kinds of things they`re going to be needing in ICU wards  more than their surgical needs are going to be needed in this crisis. 

In New York, medical students at NYU just got this stark request for their  service as well. Quote: We ask for your help. The medical school and the  university have agreed to permit early graduation for students who agree to  begin working as an intern now. This is consistent with the national  discussion regarding the early graduation of eligible medical students so  they can join the health care work force prior to the typical July 1  starting date. We are writing to ask you to consider this option. 

We will permit students in the class of 2020 to graduate early, if they met  all graduation requirements, and voluntarily work as an MD in our internal  medicine or emergency medicine departments beginning in April. 

Please note that you don`t have to be going into the fields of internal  medicine or emergency medicine to join our physicians in the fight against  COVID-19. 

These are medical students at NYU, being asked to stop med school now, in  their final year, months before they would have graduated, to instead  graduate now, and answer the call to service, to come help. 

Joining us now is Gabrielle Mayer. She is one of the students at NYU`s  medical school, who has volunteered to graduate early and begin working as  a doctor early to help New York hospitals respond to the surge in  coronavirus cases. 

Gaby, it`s really good to have you here. Thanks for your time tonight. 


MADDOW:  So tell us how this came together. It`s my sense that this effort  to release fourth year NYU med school students got under way all pretty  quickly. It was a surprise when it happened? 

MAYER:  Yes, and no. We`ve heard of things like this being done in other  countries, or at least being entertained in other country, and  understanding the increasing severity of the pandemic on New York City`s  health care system, I think it was something that had crossed a lot of  people`s mines. 

We also heard some public tell from both Governor Cuomo`s office s well as  Mayor De Blasio`s office that they were considering speaking to medical  schools about. We heard nothing officially from our own administration  until yesterday evening when we received the email that you read allowed on  air. 

MADDOW:  So, tell me what goes into a decision about whether or not to say  yes for this request to help. What do you -- what you are weighing? What --  how hard of a decision is this? And do you know how many of your fellow  students have said yes? 

MAYER:  So I do know, the number seems to be right now, it might change,  around 69, of somewhere around 120 of us, have agreed voluntarily to enter  the hospital as the interns, in a matter of weeks. As far as the decision  making process -- go ahead. 


MADDOW:  Please, go ahead, I`m sorry. You have the floor. 

MAYER:  OK, as far as the decision-making process, it was both an easy and  I think at times a challenging one. I think things that go into it that are  more fixture (ph) to my skill set, do I have the skill set that feels  useful and helpful in a hospital. I think at this point, I finished all  clinical rotations, and had a block of free time, leading up to graduation,  and so, I did feel and still feel very confident that I have a skill set  that is going to be useful for patient care, acting as an intern on the  floor. 

Other things to consider are the need for the health care system. And I  think that`s been the biggest motivator. I`m someone who is interested in  helping people, and helping patients as well as the health care officials  fighting COVID and that made this choice a lot more straightforward for me. 

MADDOW:  Are you are worried about the reports that we`ve already got from  all over New York, from rich hospitals and less rich hospital, from hard  hit hospitals, and hospitals that haven`t yet got there, that the personal  protective equipment for health care workers, for doctors and nurses and  other people working directly with patients isn`t sufficient to protect you  guys properly from the patients who you`re -- the infectious patients  you`re going to be in contact with? 

MAYER:  Absolutely. I think I`ve been on the ground doing some grassroots  PPE sourcing efforts, alongside medical students across New York City  institutions, and so, it`s certainly been on my mind for the past week or  so. I think that hearing the response from the hospital, I know that they  are actively sourcing PPE both for us, specifically, was mentioned in one  of their emails to us, that this is something that they`re putting  concerted effort toward is making sure we all have PPE, but also to make  sure that they catch up with the increased need in all of the hospitals. 

And they`ve already instituted several policies to change the usage of PPEs  and diminished access usage. And so, yes, of course, it`s a concern but I  also know that there`s been a lot of responsiveness from the hospital  systems themselves to figure out a way to meet the need and that`s making  me more confident that I will be protected going into the hospital. 

MADDOW:  Gabrielle Mayer, fourth year student at NYU Grossman School of  Medicine, volunteered to graduate early, to help her city respond to the  surge in coronavirus cases. 

Gaby, thank you for joining us tonight. Thank you for doing this. We`ll  check back in with you hopefully in the days ahead as you start this new  part of your life. Thank you. 

MAYER:  I`ll keep you posted. Thank you. 

MADDOW:  All right, much more ahead tonight. Stay with us. 


MADDOW:  There are two ways of testing to find out, to see if you`ve been  exposed to the novel coronavirus. The first is to test for the presence of  the virus. That`s generally with a swab of your nose or throat. That`s kind  of the test that is so hard to come by in this country. That`s the test  that actually tests for the virus, for the antigen itself. 

The second way is to test your blood for antibodies to the virus. So if  you`ve got the virus, and your body fought it off, your body made and used  coronavirus antibodies in that fight. And with a relatively simple cheap  quick blood test, doctors can tell whether you have those antibodies, and  therefore whether or not you`ve been exposed. 

Today, the U.K. said they would try to go ahead with antibody testing of  the British population on a mass scale. They said they`ve already ordered  3.5 million antibody tests and they`re in the process of ordering millions  more. 

The advantage to antibody testing, as I mentioned is in part speed and  ease. Compared to the kinds of tests that look for the virus itself,  antibody testing is quick, relatively easy and relatively cheap. It  therefore does have the possibility of being used on a mass scale, which  could be helpful. It could reveal how far the virus has spread through a  particular community and it could potentially reveal whether people who  have recovered from the virus might be immune to it, at least for a while.  That might be very important in terms of thinking about people to relieve  overworked health workers or to restart parts of the economy. 

It turns out the Brits are not the only ones getting ready to deploy  antibody testing at large scale. A county in Colorado is going to try  antibody testing, that entire county, for free. And it comes out of an  unusual set of circumstances in San Miguel County, Colorado. Two biotech  executives happened to own a home in the ritzy ski town of Telluride,  Colorado, and they decided to offer antibody testing to all of the roughly  8,000 residents of Telluride and the surrounding county of San Miguel for  free. 

The county now plans on testing everyone, regardless of any symptoms or any  known contact with anyone who has the coronavirus. San Miguel County says  they have already tested all of the first responders of the county and  their families, that was 645 tests, and now, they`re going to start testing  everyone else. They`re going to roll it out in phases and try to get to  every single person in the county. 

And when do you that, when you approach it that way, when you test an  entire community, you end up providing individual people with individually  interesting data, people find out if they`ve got antibodies to the virus,  but you may also see things in the data that couldn`t have been apparent  through any other approach. 

In Iceland, for example, they`ve tried large-scale testing in that small  island nation. That thus far has shown not just who had the virus, so they  could be isolated, to stop it from spreading any further, but also, that  Iceland mass testing program, showed that half of the people who tested  positive were asymptomatic, which ends up being a very big piece of  information, not just about Iceland but about this virus. I wonder what  this new round of testing in this one county in Colorado will show us about  it here in Colorado. 

Joining us now is Dr. Diana Koelliker. She`s deputy medical officer for San  Miguel County, Colorado. She is coordinating this countywide effort for  antibody testing. 

Dr. Koelliker, thanks very much for joining us. 

Let me ask you, if I explained that right or if I got anything wrong about  what you guys are doing in San Miguel County? 

DR. DIANA KOELLIKER, DEPUTY MEDICAL OFFICER, SAN MIGUEL COUNTY, CO:  Hi,  Rachel. You got it exactly correct. We are -- you covered all of the bases  and we`re super excited to be able to offer this to the members of our  county. 

MADDOW:  Can you describe for us how the antibody test is administered, how  long it takes to get results, and how confident you are in the antibody  test that you are going to be using? 

KOELLIKER:  Sure. The antibody test is specifically a test for IGG  antibody, so the type of antibody that is produced usually about eight to  ten days after infection. This test is a blood test, a serum test, that has  a relatively short turn-around time, less than a couple of days, is our  plan, and as you said earlier, it really allows us to do mass testing, and  gives us a better idea of the prevalence of the virus in our county. 

Currently, we have been able to do some of the nasal swab tests, about 150,  in the past few weeks, and 100 of those were done with our state CDPHE, our  state public health facilitated with the National Guard. Unfortunately, out  of those 150 tests, we had one positive, but we`ve only had 24 results, and  so, the testing not only has it been unavailable, but it`s really been  really woefully inadequate as far as the time it takes to get those results  back. 

This blood testing in contrast, we`re hoping to be able to test everybody  in our county, once, and then again, 14 days later, so that we can really  see who has seen the virus, who has created antibodies, and perhaps is  immune to it, and who hasn`t had any evidence in their bloodstream of  having made any antibodies. It`s going to help us make some decisions  moving forward. 

MADDOW:  And from what I understand, there`s between 8,000 and 9,000 people  in the county, I know you guys do want this to be universal, and it`s free  to everybody, to get tested, but you`re asking for two blood test, right,  14 days apart, and obviously, this is unusual, this is not the kind of  testing regime that is in place anywhere else in the country. 

How do people in the county feel about it? Do you think you are going to  get people mostly wanting to participate, are there people who don`t want  be to a part of it? 

KOELLIKER:  You know, I think there probably are opinions all over the map.  I do think that our community has definitely stepped up and has been very  cooperative in our shelter in place orders, that we placed last week. And  they`re observing the social distancing rules that help us to stop or slow  the transmission of this virus.

And I think people are anxious to have some answers. I think we have not  been able to provide them with a good estimation of how much prevalence we  have in our counties. So I think people will be happy to be able to get  that information. I think it`s going to allay some fears, if we have really  a good understanding of how much COVID is here in San Miguel County. 

And a lot of the responses that I`ve gotten from people is that they are  thankful that we have this opportunity, and they`re encouraging, you know,  their friends and neighbors, to participate, because I really feel like the  best information is going to come if everybody really does participate and  it gives us an idea of where we are, and it will help us, you know, moving  forward, as we perhaps start to be able to consider loosening some of these  restrictions that are there for a very good reason. But once we have some  information, some data, I think we can reconsider those at a later date. 

MADDOW:  Yes, fascinating, essentially pilot project, for the country, and  in a community that is uniquely positioned to be able to do this. 

Dr. Diana Koelliker, San Miguel County medical officer, thank you so much  for your time tonight. Good luck. Keep us apprise as you guy start rolling  this out through the rest of the county. I really appreciate it. 

KOELLIKER:  Thanks, Rachel. We appreciate your time. 

MADDOW:  All right. Well, we will have much more ahead here. Stay with us. 


MADDOW:  Here`s how the "Washington Post" headlines the situation tonight.  Quote: Scramble for medical equipment descends into chaos as U.S. states  and hospitals compete for rare supplies. A mad scramble for masks, gowns,  and ventilators is pitting states against each other, and driving up  prices. 

Hospitals are requesting donations of masks and gloves from construction  companies, nail salons, tattoo parlors, they`re considering using  ventilators designed for large animals, because they cannot find the kind  made for people. 

Illinois Governor J.B. Pritzker said that in conversations with ventilator  maker, one company, quote, told me I was competing with FEMA to get  ventilators. I called another manufacturer of ventilators and he pointed  out that I would be competing with countries other than the United States.  I better put in as big of an order as possible in order to put myself  higher on the list of priority. 

State officials and health care leaders are begging the federal government  to use a wartime law to bring order and ensure the U.S. has the gear it  needs to battle the coronavirus but so far, the Trump administration has  declined. 

The president has talked about using a wartime law to try to bring order,  and try to impose the power of the federal government to try to organize,  mandate, and meaningfully distribute the medical supply chain in this  country. He`s talked about it. So far hasn`t done it. 

And when the federal government is acting on trying to provide medical  supplies, it doesn`t seem to be doing a particularly good job of it. State  officials today telling ABC News, that what little they are getting from  the federal stockpile in terms of supplies includes a bunch of old and  expired equipment. 

New York City says they`ve gotten 78,000 of the 2.2 million N95 masks they  asked for from the feds, again 78,000 of the 2.2 million they asked for.  The city health department says many of the ones they did get are expired.  Of course, they`ll take them. But that`s not ideal. 

The Oregon governor`s office says they received 10 percent of the N95 and  gowns and gloves and face shields and goggles and that they requested, and,  quote, what we are receiving are well past expiration dates and wouldn`t be  suitable for surgical settings. But hey in the words of one Pennsylvania  health official, quote, a mask is better than no mask. 

That`s where we are right now. The need to nationalize the medical  equipment supply chain, to put the power of the federal government to make  the supply chain of this stuff better, to rationalize it, to make order out  of the chaos, to get enough supplies and quality supplies to where they are  needed and to have the states stop competing against each other and driving  these bidding wars. 

This is not an abstract concept anymore. Why isn`t this happening? 

Connecticut Senator Chris Murphy tweeting this afternoon, quote: Just off  the phone with the president of one of Connecticut`s busiest hospitals.  They have enough tests to last three days. And their supplier just called,  the next shipment isn`t coming. President Trump -- federalize the medical  equipment supply chain. Lives are at stake. 

Hospitals in hard-hit areas are already reporting they are days away from  running out of key supplies, at a time when the number of COVID-19 cases in  this country is just skyrocketing. 

We`re going to go live, to one of the first epicenters of the outbreak in  this country, a place that took some of the earliest steps to fight it, and  a place that may just now be starting to reap the benefit of having taken  those early measures. That story is next. 


MADDOW:  The first known coronavirus cluster in the eastern United States  popped up in Westchester County just north of New York City, in the town of  New Rochelle. Of New York`s first 11 cases, ten of them were in New  Rochelle. It began when a single local resident, a lawyer who worked in  Manhattan, commuted in and out of Manhattan, contracted the virus and seems  to have passed it on to his own family members and they passed it on to  others. 

Within a week of the first case of COVID-19 being discovered in New  Rochelle, within a week the number of known cases spiked to over 100. That  led Governor Andrew Cuomo to announce on March 10th, the establishment of  an unprecedented one-mile containment zone in New Rochelle. 

Schools, places of worship, all major gathering spots were closed and the  National Guard was sent in to deliver food and also to clean the area. It  was the first effort of its kind in the U.S. to try to slow the spread of  the virus by keeping people in their homes and keeping people from going  out. 

That decision in New Rochelle to institute those early distancing measures  maybe appears to have started paying off. The latest numbers from New  Rochelle show that two weeks after the measures were put in place, the  spread in the city is starting to slow. 

And it`s a bit of a controlled experiment here because while New Rochelle  was subjected to those measures on March 10th, the rest of Westchester  County only instituted similar measures last week, when those measures went  into effect statewide, and the county as a whole, the number of cases  continues to rise unabated in a way that we are no longer seeing in New  Rochelle specifically, apparently because New Rochelle specifically acted  and it made a difference. These rules appear to make a difference. 

Joining us now is Westchester County executive, George Latimer. 

Mr. Latimer, thanks very much for being with us. 

Let me start by asking if I got anything wrong there, or if I said anything  that seems wrong-headed to you about the situation in your county and with  New Rochelle. 

GEORGE LATIMER, WESTCHESTER COUNTY EXECUTIVE:  No, I think, Rachel, you  really summarized it very well. It`s still a story in progress, but we`re  encouraged by what we`ve seen so far. 

MADDOW:  I do know that the number of cases in your county continue to rise  but you do have what appears to be a success story in New Rochelle where  the numbers, the rise each day really seems to have almost come to a halt.  Is there something specific about what New Rochelle did, which is not being  done statewide and therefore in the rest of the county right now? Is there  something else we should be learning with public policy from New Rochelle`s  experience?

LATIMER:  Well, I think the shutdown that happened in New Rochelle and  credit Governor Cuomo for advancing this, in a one-mile radius in the north  end of New Rochelle, was really seen as very severe at the time but it  jarred people into realizing that this was a very serious contagion that  was moving around rapidly. And as you point, in the first really few days,  we jumped to hundred cases in New Rochelle.

Over the last two weeks, in that vicinity, we`ve done just about the same  number of cases, slightly more. In the last three days, we`ve just had  three cases. I don`t know what the trim lines will show in the future. This  is a very hard thing to predict. But what we saw in shutting down the  schools, a couple of country clubs in that area, houses of worship, the  religious services were shut down in both Christian and Jewish faiths, in  that area, it stopped people from congregating and it stopped people from  spreading the virus so quickly. 

The fact that there`s still is a spread is there, but certainly, as we look  at overall in Westchester County, we`ve tested with more cases per capita  than any other county in the country, but we`re hoping that what we`re  watching is the beginning of what we hope is the flattening of the curve  that will save us in the long run, if it`s -- if it`s accurate and if it`s  across the board. 

MADDOW:  In terms of the large number of cases that you`ve done per capita  in your county and the large number of cases you`ve had, I know that you  asked for volunteers to come forward to help health care workers, help  support the health care system in your county. I understand quite a number  of people have come forward and some started to be deployed to work with  the Department of Health. What are you asking people to do as volunteers?  How is that going? 

LATIMER:  Well, so far in making this general, calling all nurses, calling  all doctors and other people who have experience in the health care field,  we`ve gotten over 120 responses, 90 plus nurses, 20 or so doctors, and we  know that when we hit the surge and Governor Cuomo indicated that we expect  New York to be on the front end of the surge, possibly in the next two  weeks, maybe less, maybe slightly or more. We`re going to need all the  nurses we can get. We`re going to need all the doctors we can get.

We`ve taken a facility in Westchester County that we use for basketball  tournaments and sporting events and exhibits, and we`re prepared to turn it  into an additional temporary hospital for overflow to buttress the 3,000  hospital beds that we normally have in Westchester and trying to get the  service personnel that can -- that can administer this, along with the  physical spaces essential. 

Your earlier story about having the PPEs is essential as well, all of the  equipment that we need, and, of course, we need ventilators. We need things  that we and the local government can`t provide but I think this is an  example of being prepared in advance and if we can do the right things,  hopefully we can keep this from peaking at the highest possible levels, and  save ourselves some of the tragedy we`ve seen in Europe and in Asia. 

MADDOW:  George Latimer, Westchester County executive, sir, I know this a  trying time. Thanks for making time to help us understand it. And I really  appreciate it. Thank you. 

LATIMER:  Thank you, Rachel. 

MADDOW:  All right. We`ll be right back. Stay with us. 


MADDOW:  That`s going to do it for us tonight. 

Two things to watch for tomorrow. We`re going to get the numbers on how  many Americans have filed on unemployment claim in the past week. For  reference, just to get your head around what to expect there, the worst  that has ever been before including in the great recession was on the order  of about 700,000 unemployment claims over the course of a week. That`s the  record for the worst. 

Experts are projecting that the number we`re going to get tomorrow is  likely to be well into the millions. That will happen tomorrow. 

Tomorrow night on this show, I`ll tell you we`re going to be joined by  Lieutenant General Todd Semonite, who is the commander of the U.S. Army  Corps of Engineers. I really hope that you`ll join us for that. I`m looking  forward to that interview. 

But now, it`s time for "THE LAST WORD WITH LAWRENCE O`DONNELL". 

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