Coronavirus outbreak TRANSCRIPT: 4/3/20, The Rachel Maddow Show

Guests: David Ho, James Black

RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Have a great weekend, my friend. Thank you.

And thanks to you at home for joining us this hour. Happy to have you with us this Friday night.

The United States has more than 273,000 confirmed cases of coronavirus. And that -- be mindful, that is with millions of Americans who would like to be tested, who have reason to be tested, but they are still unable to access testing.

Still, though, with millions of measures unable to access testing we`ve got 273,000 cases. And that is the largest in the world by far. The second largest number of cases in the world is in Italy, but they are way behind us. We`re 273,000, they are at basically 120,000.

If you are frustrated by your inability to get tested or the inability of a family member or acquaintance of yours to get tested, it`s an understandable frustration. There are literally frontline health care workers who have been seeing coronavirus patients in places like New York City who can`t get themselves tested. It`s just nuts.

But today at a White House meeting with oil executives, the president blurted out, you know what, I like it. Let`s test these guys. If anybody wants to be tested, we`ll test them.

And today at the White House, all those oil executives there to meet with the president got tested. Congratulations, gentleman, you`re lucky guys.

Three and hundred five people died of coronavirus in New York City in the past 24 hours, which means in America`s largest city today one person died from coronavirus every 4.7 minutes. There are nearly 12,000 people hospitalized in New York City now. We have been watching how that number has risen over the past two weeks.

How do people get to those hospitals? How do those patients arrive? Well, there`s one particularly worrying new data point from New York City today, which is that one in four EMS officers from the New York Fire Department is out sick.

And you know who EMS officers are, right? I mean, let`s say you are ill with suspected coronavirus. Your condition has deteriorated such that you are in fear for your life. You call 911 for an ambulance. Well, the fire department dispatches EMTs, EMS officers to come get you in an ambulance.

One in four EMS officers in the New York City Fire Department is out on sick leave. This is not some kind of labor action or something. They are out because they are ill. This is a 4,000 officer force at FDNY. Four thousand officers and about 1,000 of those 4,000 officers are out sick.

We talk about frontline health workers, needing to keep them alive and on the job, same thing for EMTs. FDNY, the New York Fire Department also tonight mourning the death of one of its leaders, FDNY Deputy Chief Inspector Syed Rahman is dead tonight from coronavirus, who is 59 years old, leaves behind his wife and their four sons. The governor of New York has been warning that New York is within a few days now of having every ventilator in the state in use, which will mean no more ventilators available to put new patients on and that can be a death sentence. You don`t go onto a ventilator early on in your disease progression. You go on the ventilator as a last ditch effort to keep you alive.

The governor says it is a matter of days before New York has every ventilator in the state occupied. He`s called for mutual aid from other states. If the federal government can`t or won`t coordinate the response, can`t or won`t coordinate the marshalling and allocation of resources nationwide, and the governor of New York says, please, can some other states provide equipment to New York now as New York approaches its apex patient load before any other state in the country does so.

The governor of New York has repeatedly promised, including here on the show last night, that if other states can bring equipment and personnel, actually, to New York now, he will personally ensure that New York will return the favor. New York will bring that equipment back and more when those other states approach their apex patient load in the weeks ahead.

Today was another day when doctors and nurses at a New York City hospital, this time Mt. Sinai, pulled together an ad hoc low tech protest outside their facility to beg for protective equipment so they can keep treating patients without themselves getting infected.

Today, New York City`s Mayor Bill De Blasio sort of gamely tried to institute a national draft for relief health care workers for New York, asking for health care workers to be called up from all over the country to come to New York, to help New York now, saying as the governor has been saying, that New York will repay the favor back to other states, back to other cities in the country when they hit their peak. If only New York can please get help now as they hit their peak first.

(BEGIN VIDEO CLIP)

MAYOR BILL DE BLASIO (D-NY): Look, if another country were attacking United States of America, if I told you that a country was attacking United States of America, attacking the largest city and simultaneously attacking Florida, attacking Louisiana, attacking Michigan, and thousands of Americans had died, and I said to you, do you think the military would be called up to fight that enemy, I know you`d say yes.

We cannot ask each city to try and somehow improvise while dealing with the greatest health care crisis in a century. We cannot ask each state to just go it alone when the only possible way of getting through this is with the full support of our federal government, our military, and the medical community of our entire country. I have called for today something unprecedented, a national enlistment effort, a national effort to bring all available medical personnel into the fight against the coronavirus.

(END VIDEO CLIP)

MADDOW: A national enlistment effort. The mayor of New York City.

Of course, no mayor of any American city is empowered to institute a national draft. No mayor can order the marshalling of a nationwide surge of American power and personnel to help in a crisis, even if it is a crisis that threatens to kill thousands, tens of thousands, maybe hundreds of thousands of Americans, mayors aren`t in a position to be able to do that. The only person who can marshal that kind of national resources is -- well, that person is the head of the federal government.

In year 2000, the country elected barely and arguably George W. Bush the president of the United States. In 2004, the country re-elected George W. Bush to be president of the United States.

You know how we got a charismatic young Democrat who only served a half term in the U.S. Senate and would be the nation`s first African-American president to be elected president in the United States of America in the election after those two? In part we got Barack Obama elected in 2008 because of this having gone so wrong in the presidency of George W. Bush. Because in 2005, on great American city drowned, this was George W. Bush looking down at it from 30,000 feet while the perspective on the ground at the time was one that would have led you to know that ultimately there would be nearly 2,000 Americans dead.

George W. Bush White House was just absolutely feckless and failed in the face of that disaster. The president had hired a handpicked head of FEMA away from his previous job, which was that he was the judges and steward commissioner for International Arabian Horse Association. Oh.

The day Katrina hit, Michael Brown sent an e-mail to another FEMA official that said, can I quit now? Can I come home? A few days into the disaster, he wrote to friends, quote, I`m trapped now, please rescue me, who`s the head of FEMA, as 2,000 Americans were dying. It was all hilarious.

Mostly, Mr. Brown blamed everybody else. He liked in particular to blame the governor of the state of Louisiana and the mayor of New Orleans, saying amid a backdrop of 2,000 dead and dying Americans, quote, if the mayor doesn`t have the resources to get the poor, elderly, disabled, those who cannot, out, or if he doesn`t have police capacity to enforce mandatory evacuation to make people leave, then you end up with the kind of situation we have right now in New Orleans.

But turns out the mayor -- the mayor didn`t seem to have the power to do what needed to be done. So, yes, what a terrible mayor. It must have been his fault.

That was the hallmark of the disastrous failure of the George W. Bush administration in hurricane Katrina. It wasn`t the storm itself alone, right? It was the storm and catastrophically failed response characterized by the federal government not doing it and wanting to blame state and local officials instead.

Here is a headline in the "Washington Post" on September 4th, 2005, almost a week into the full sprawl of that catastrophe. Many evacuated but thousands still waiting.

Here is the lead in that piece: tens of thousands spent a fifth day awaiting evacuation from this ruined city. As Bush administration officials blamed state and local authorities for what leader at all levels have called the failure of the country`s emergency management.

The federal response was just feckless and counter-productive and unfocused. They didn`t think it was their job. They were happy to blame lower level officials. And so, the federal government behaved accordingly.

The secretary of state at the time this was all unfolding was literally high-end shoe shipping in New York as New Orleans drowned. She ended up in New York tabloids for getting cursed out by somebody working in the shoe shop.

But Bush administration blaming local officials, and catastrophe of the response, those were not unrelated things, right? Blaming local officials was politically convenient. They particularly like to blame Democratic officials, for example, at the local and state level. But then failing to act, failing to do what the federal government was supposed to do, those were two sides of the same coin, because what happened in the George W. Bush, Katrina failure was a specific national technical kind of failure.

When they sent in FEMA, even if it was being run by Arabian horse guy, when they sent in FEMA, they invoked this -- you know, the National Emergencies Act. These things aren`t a semantic way of just alerting people to the fact something is a big problem. You don`t call something a national disaster, national emergency just to make it sound bad.

Those are technocratic things, technocratic decisions that are supposed to set things in motion. When you declare something, a national disaster, national emergency, that is a means of declaring and setting in motion that the federal government will coordinate the response to the crisis. It`s literally in the statute, right, that the president thereby puts the federal government in charge to, quote, coordinate all disaster relief assistance provided by federal agencies, private organizations and state and local governments, to provide technical and advisory assistance to affected state and local governments and on and on.

But it`s the federal government that coordinates the response. That is what you are declaring you will do when you declare something a federal emergency, a federal disaster. Yes, local officials and state officials are in charge of their own problems in general on a day to day basis. But in cases where it is beyond their means to do so, then a disaster, an emergency is declared.

When that is declared at the federal level, as President Trump did for coronavirus on March 13th, that means something specific. It means the president has invoked the statutes that explicitly declare the federal government will coordinate disaster relief assistance. But once you have declared that, you actually have to do it.

In Katrina, the Bush administration ultimately did figure that out way too late, after they fired the Arabian horse association guy, heck of a job and all the rest. Ultimately they brought in U.S. army general, General Russel Honore, who was just on with Chris the last hour, they brought him in to actually take charge and start to clean up what had been a failed, feckless, federal mess.

But by the time General Honore came in and started to get things in shape, for the 2,000 Americans who died in that disaster, it was too late. And no, that wasn`t the only reason we got President Obama as the successor to Republican President George Walker Bush. I mean, George W. Bush was a bad president and his presidency was full of very terrible things.

In Katrina, that course and desperate technical failure to take federal responsibility for a national disaster was just a different kind of bad. You know how people say you had one job. Well, I mean, it`s a president`s job to declare a national disaster, a national emergency. But then by definition it is the president`s job to get the federal government to run the response to that emergency. That`s why you declare it. That`s the whole point.

If you are a president who has declared a national emergency, you thereby accept national responsibility to run the response to it. That`s your one job from that point forward and it`s nobody else`s job. Nobody has the power you have to declare these things and put it in place and thereby put the federal government in charge of coordinating things. That`s it.

When President Trump signed the national emergency declaration for coronavirus on March 13th, he had been, you know, downplaying the severity of this. He had been telling these weird tales about coronavirus saying America would soon have zero cases and it would go away on its own and it was all a hoax by the Democrats designed to make him look bad.

But don`t pay attention to what he says, watch what he does. I mean, whatever he had said about it -- nevertheless, on that date, by declaring that federal emergency, he put the federal government in charge of the response, and then he didn`t actually do the work. And so, now, we are in the part where he is blaming the states, right? His statement on twitter now that the states should have been stocked up.

And the administration today changing the definition of the federal stockpile of emergency supplies that that they are making up now that it`s never supposed to be stuff that goes to the states to bolster what they need in a national emergency even though that`s always been what it is. I mean, claiming the federal role -- the federal role here is just to play back-up, because it`s really the states that are responsible for responding to a national disaster and so therefore everything that`s going wrong is the state`s fault.

You know, it`s the same, blame the governors, blame the mayor strategy that worked out so great for George W. Bush White House during Katrina. And as of today, the American death toll for coronavirus is more than triple already what the death toll was on Katrina. It may be 100 times the death toll from Katrina by high summer.

But the type of failure is the same at core. Again, you can get really focused on the president`s demeanor and the president`s mendacity. Yes, the president has lied about this crisis, lied about the virus. He has said terribly ignorant and dangerous and damaging things about it. His public presentations in terms of how he has handled this are just astonishingly bad.

But ignore what he says. Look at what he has done. Still, no nationwide stay-at-home order. No widespread access to tests, still. No national quarter-mastering for procurement and allocation of critical medical supplies. No real use of the Defense Production Act to compel the production of supplies, despite the fact he keeps saying it. It`s not happening.

I mean, to the contrary, he`s actually been using FEMA to undercut the ability of states to procure materials on their own. He`s having FEMA bid against the states or claim state`s shipments of their own material they have arranged to purchase on the open market while still telling states it`s their responsibility to get their own supplies and now saying that the federal stockpile is something for us, not for the states. Yeah, heck of a job.

But it`s also just a feckless nothingness of the response. The U.S. epidemic is worse than any other epidemic on earth now, in part because our response was slow. Delay in this case equals death. Slowness equals death. This turns out to be crucial.

If you act fast to contain the spread of the virus, you will reduce the number of people who will ultimately get it, the number of people who get sick and the number of people who die and the rate at which your health system is at risk of collapse.

If we had had a national stay-at-home order when Northern California figured out that they better do that in the San Francisco Bay area, if we had had federal public leadership, federal national health disaster leadership, that was as forward thinking as San Francisco Bay Area, when they put in place their stay-at-home order, we`d be in a place now where our president would be saying what the California governor is saying now, which is that the rate of infection might have been slowed enough in California that California might not end up having so many sick people at the same time that the hospitals get overwhelmed there. They might have successfully avoided that horrific prospect. We could have had that.

Instead, Dr. Tony Fauci is on TV as of last night saying I don`t understand why a national stay-at-home order isn`t happening. I don`t understand why we`re not doing that. We really should be doing that. We don`t have that.

And now, New York is closing in on 3,000 dead already, a death rate that is doubling every three days. And everywhere else in the country it`s the same, numbers rise unabated.

Alabama and Missouri decided on stay-at-home orders just today. They are among multiple states where it has been all you can eat, free transmission at in the wild rates for the virus for all of these weeks because these are the kinds of governors who think the White House is in charge. If the White House isn`t telling them what to do, that means they should do nothing. Literally there are 2100 plus cases in Missouri and the governor this has just been letting it spread unabated for now planning to maybe work on it later.

The new stay-at-home order just put into effect today -- just announced today in Missouri isn`t going to go into effect until Monday. So, even as the Missouri governor finally concedes, OK, maybe I`ll do something, still you can enjoy a full weekend of Missouri`s epidemic feeding itself as widely as possible ensuring the number of infected people in Missouri as high as possible, thus ensuring the number of ill people as high as possible as sick as possible with as many sick simultaneously as you can muster as a public policy matter.

Having some stay-at-home orders in some places and some states and having it still be do whatever you want in some states is insane. It was insane from the beginning, it`s absolutely insane this far into it. We have the worst coronavirus outbreak in the world.

We`ve already got more than 7,000 dead Americans. We don`t have a treatment. We don`t have a vaccine. We don`t have a cure. It`s going to be a long time before we have any of those things. We don`t really have testing in this country on any widespread basis.

The only thing we`ve got to try to stop this virus is to keep people from giving it to each other to reduce the numbers of people who get infected who get sick at once so our health care systems don`t collapse. That`s all we`ve got. We`ve got the biggest epidemic on earth, more than 7,000 people dead and still -- still millions of Americans live in places where there aren`t stay-at-home orders.

It is insane that there remains no federal policy in this regard. Having a patchwork policy here, having some states where it`s stay-at-home and some places not, it`s like having a pool where there`s one section in the pool where it`s OK to pee. It`s like having an airplane where one place can smoke and everything also is nonsmoking despite what they are going to smell like when they got off the plane.

I mean, Dr. Fauci at least is saying, let`s have a national stay-at-home order. Why don`t we have one yet?

The surgeon general is going on the "Today" show and saying, I think we should have a national stay-at-home order. Can I just tell people we do even if we don`t?

Why is that alone not just fixed tonight? It would take ten words at the podium, could save thousands of lives. A cat-4 hurricane hitting a major American city, blowing up levees and flooding the whole darn thing and killing 2,000 people while Americans climbed under the rooftops to beg for help -- yes, that`s a national disaster. So yes, we can all see and we could see at the time that the national government, the federal government should be running the response.

And the George W. Bush administration tried to play it off like it wasn`t their problem. Ultimately, they figured it out and they put somebody in charge who could handle the operational concerns of that disaster, who could handle the logistics. But they didn`t figure it out quickly enough. They didn`t figure it out quickly enough to save 2,000 Americans and not quickly enough to consign the George W. Bush presidency to worst of list for the rest of American history.

They were late enough that they consigned him to that. But this failure, this national disaster, again, has already cost more than triple the deaths of Katrina, it will cost 100 times the deaths of Katrina by this summer on the White House`s own estimates if they don`t learn that belated lesson now. And I`m not complaining about it because I enjoy saying things about the president doing poorly. Boy, do I wish the president was doing better.

Mr. President, there are only things you can do here. But the most important thing that you can do is put somebody in charge. You know, you`ll love it, because whoever you pick, you can blame that person at the end when there are still 100,000 or 200,000 dead Americans piled up in the nation`s funeral homes and crematoriums and cemeteries.

Pick somebody you`re looking forward to scapegoating and blaming and saying it was all their fault from the beginning. I think we could take that as a country if putting somebody in charge, who is actually in charge, might also mean we`ll keep the numbers that low. Because as long as we don`t have a federal response that is being run by anyone, there`s no guarantee that the numbers will stay within that massive range you`re talking about. The sky is the limit in terms of what it can be.

Just go back and look at what George W. Bush did belatedly with Army General Russel Honore. Put an overall command and control officer in place who can, number one, announce, on your authority, binding national policy and firm national guidance to governors and mayors.

Number two, who can federalize on your authority all needed supplies and resources and facilities needed to test, trace, isolate, triage, treat, and ultimately bury coronavirus victims.

Three, pick something on your authority massive production, procurement, purchasing, maintenance, allocation, distribution and redistribution system for those critical resources. It`s going to be a huge effort. You may want to get your son-in-law out of the way here. You may want to create a disaster response command within the U.S. military to do this, which would be a huge deal.

That said, if you are uncomfortable being commander in chief of such an effort, because you don`t want to be that clearly responsible for it when you ultimately want to blame the person you put in charge, then pick something else and don`t call it combatant command. But you are going to need to organize transportation system to move critical resources around the country. You`re going to have to aggressively use and not just cite Defense Production Act. And you`re going to have to have someone very good moving very quickly to address the death trap conditions that exist right now in senior and congregant living facilities of all kinds, including nursing homes and long term care facilities and veterans homes and, yes, jails and prisons.

You`re going to need to well and truly let an experienced operations manager take the lead and fix this now. It is too late already but now is better than never. Now is better than next week. Yesterday would have been better than today. But we`ll take what we can get.

We can`t call it too late. We have to still believe we can save some lives. Just do it already. Whatever you need to tell yourself to do it, just do it.

(COMMERCIAL BREAK)

MADDOW: This far into it, we still don`t have a national stay-at-home order, which means it`s up to each of our 50 states to make their own call on that. Even today, even now, at this hour, there are still nine states that have no stay-at-home orders -- Wyoming, Utah, Oklahoma, South Carolina, Iowa, Arkansas, Nebraska, and the Dakotas. Still nothing. They figure they will deal with it later.

That`s not just a problem for those individual stays, that may be a problem for all of us. Today, we call it the legendary aids researcher Dr. David Ho who is now working on a cure for the coronavirus to ask him if he has anything else to share with us about how we should be thinking about fighting this virus before we have a cure.

The revelation of Dr. David Ho`s HIV research almost a quarter century ago was about timing. You can`t wait until the patient is really sick. If you wait to treat HIV, Dr. Ho learned and taught the world. If you wait until the person is sick, by then, the virus has been replicating and replicating and replicating, and tiring out the immune system and becoming increasingly invincible inside the body which makes it basically impossible to defeat.

Dr. David Ho`s revelation in the AIDS crisis was that you have to hit the virus hard right at the beginning as soon as you know the patient is infected to keep the virus from replicating out of control and becoming a harder to fight enemy.

Today, Dr. Ho told us that once again he`s thinking about timing, specifically the timing of all these stay-at-home orders that are still being issued piecemeal here and there across the country. Dr. Ho today sent these elegant little graphs to demonstrate what happens when different localities shelter in place sequentially, one after the other, only when the virus gets demonstrably bad in their particular place, versus what happens when everybody everywhere shelters in place simultaneously and immediately.

The difference is time. See how much sooner the epidemic is over for everyone if everyone everywhere shelters in place at once as soon as the virus begins to spread anywhere? That`s the case he is making, and he is in a position to know.

The question, of course, now we`re already in this far, can we still make these kind of decisions? What can we do about it now?

Joining us now is Dr. David Ho. He`s the scientific director and CEO of the Aaron Diamond AIDS Research Center.

Dr. Ho, thank you so much for being with us. I know you`re busy. I really appreciate you taking the time.

DR. DAVID HO, CEO, AARON DIAMOND AIDS RESEARCH CENTER: Good to be with you, Rachel.

MADDOW: Let me ask you, first, if I explained the basics of those graphs correctly. Could you just -- could you just tell us in your own words what these mean and why you wanted us to see these today?

HO: Well, as you know, the U.S. has been hit hard now with a quarter of the global case load. And New York is surpassing Hubei and New York City is surpassing Wuhan in terms of case load. Of course New York along with the West Coast were hit first in the U.S. and -- but we have since observed the epidemic sweeping inward toward Middle America. And now, we see a second wave hitting Detroit, New Orleans, Chicago, Florida. And we`re likely to see successive waves hitting the rest of the country.

And it`s time that we be proactive rather than be reactive. Regions have not implemented shelter in place orders ought to. I think the lesson is very, very clear already for the past two months. No place will be magically spared. The virus will spare no one in its way. The graph that you show, if we say the red line in the sequential models represents California, we know it`s the first one to be hit but California is the one first to implement the draconian measures to mitigate against the outbreak and begin to flatten the curve.

But its neighbors, for example, Nevada and Arizona implemented the shelter in place order much later. It will be hit with the next wave. And that wave would not be flattened out until a much later time point. Similarly one could say their neighbors, Idaho and Utah, hypothetically would implement the measures even later.

So you could see that we would just be hit with successive waves. And the point where everyone brings the epidemic curve to an extremely low level is much later, and the areas under each curve would be much larger.

Now, if you were to do this simultaneously now and ask each state to endure together in synchrony, that would bring everything under control much faster. And if you think about the areas under the curve, each one would be much smaller. That`s telling us the human casualties would be lower and the economic loss overall would be smaller, because the ending point would occur much earlier.

So we could take this type of thinking, instead of thinking about state to state, we could extend it to the world, country by country. And shouldn`t the whole world endure foggy together? And, in fact, if -- hindsight is 20/20 -- just imagine shelter in place in January when the epidemic wasn`t epically bad, we would now be looking at very tight control and maybe the possibility of extinction for this virus in the human population.

Now, that would have very prescient to make that call back in late January. But surely now after watching the epidemic go through Europe and much of the world, we should not be making the same mistake now. We need to act.

And this -- not just for the whole country but for the whole world. We need global leadership that is not very apparent right now.

MADDOW: Dr. Ho, let me just ask you to kind of turn the telescope the other way around. And I know you`re talking about this need, as you elegantly put it, to endure together in synchrony.

Thinking about the individual states that have recalcitrant, the individual leaders that don`t see an imperative to do this, isn`t it also fair to say looking at it from the perspective of their state, that each day they wait to put in place a stay-at-home order, they are consigning more people who live in that state to get sick, to get infected, get sick, and ultimately to die.

HO: Absolutely. We know once community spread occurs, in each region there will be exponential growth. That growth rate could be doubling every couple of days or few days depending on the region. And you know within a few weeks, that could mean an order of magnitude difference in terms of case load.

And once you reach that level, it`s much, much harder to flatten the curve. And there should be enough lessons now from China, from Korea, from Iran, western Europe and, of course, in the hardest hit regions of U.S. the other regions should not be making the same mistake. We need to act together now.

MADDOW: Dr. David Ho, scientific director and CEO of the Aaron Diamond AIDS Center -- Dr. Ho, it`s an honor to have you here any time you can be here. Thank you for talking to us about this idea. Thanks for being with us tonight.

HO: Thank you, Rachel.

MADDOW: All right. We`ve got much more to come this Friday night. Stay with us.

(COMMERCIAL BREAK)

MADDOW: This is from "The Atlanta Journal Constitution" in Georgia today. Quote: On March 2nd, a month before Georgia Governor Brian Kemp issued a statewide stay-at-home order, two top state officials received a warning about dangers posed by people who did not display symptoms of the coronavirus. A professor at George Tech who advises governments on how to deal with public health catastrophes sent this e-mail to senior members of Brian Kemp`s administration way back March 2nd. It said in part, quote, there is a strong chance a person could be infected by asymptomatic but could still infect others.

That was received by Georgia`s public health commissioner and director of Georgia`s emergency management agency a month ago, explicitly giving them an early heads up about how people who are asymptomatic can nevertheless still have the virus and still spread it to other people. Again, that was March 2nd, more than a month ago.

This, however, was the governor of Georgia talking about the recent revelation he just had about the asymptomatic spread of the coronavirus two days ago.

(BEGIN VIDEO CLIP)

GOV. BRIAN KEMP (R-GA): The CDC has announced that individuals can be infected and begin to spread coronavirus earlier than previously thought, even if they have no symptoms. From a public health standpoint, this is a revelation and a game changer. Those individuals could have been infecting people before they felt bad but we didn`t know that until the last 24 hours.

(END VIDEO CLIP)

MADDOW: We didn`t know that until the last -- who knew that. This -- between March 2nd and Wednesday when the governor was speaking there, Georgia went without a statewide stay-at-home order all that time. The number of coronavirus cases and coronavirus deaths rose steeply in Georgia. And while a couple of real public health catastrophes started to take root in that great state. Right now, "AJC" reports there are 58 senior care facilities in Georgia that have confirmed coronavirus outbreaks, 58 in the state.

The "AJC" reporting that the outbreaks are so severe in two facilities that those facilities are, quote, struggling to properly function. One of those struggling facilities is in Albany, Georgia, which is a small rural city -- small rural community of about 75,000 people. In that Albany senior care facility 35 residents have tested positive, seven have died just since March 15th.

Albany, Georgia, is facing one of the most acute and deadly coronavirus outbreaks in the country, apparently stemming from a number of funerals attended by people a few weeks ago. That outbreak in Albany, Georgia, has been buckling the moderate little health system in that rural part of the state. That area of southwest Georgia has just one health system, called Phoebe Putney. That hospital has 38 ICU beds. By Wednesday last week, every single ICU bed was full with coronavirus patients. Staff at that hospital burned through a six-month symptom pile of supplies in less than a week.

The head of that hospital season now telling "AJC", quote, what we were not prepared for were the sheer numbers. An ER doctor from that hospital who`s on the front lines of one of the most acute coronavirus in the country joins us next.

Stay with us.

(COMMERCIAL BREAK)

MADDOW: While New York battles away alone in an apocalyptic fight against coronavirus with 12,000 people in New York hospitals and ventilators on pace to be 100 percent in use in New York within days, well, that continues to unfold at scale in New York. Albany, Georgia, is the story of what the other front lines on this fight will be like because every small city, every rural community can see itself in Albany, Georgia.

And in the Albany, Georgia, a community of 75,000 people in the southwest corner of that great state, their one hospital, Phoebe Putney memorial, is the front line of their front line, and the emergency room at phoebe is the tip of the spear.

Dr. James Black is the medical director of emergency services at Phoebe Putney Memorial Hospital. Dr. Black served in the Navy as a flight surgeon. He`s also a native son of Albany, Georgia. He was born in the hospital where he now runs the emergency room, meaning Dr. Black is not just treating patients at the hospital. He is treating a lot of people who he knows.

(BEGIN VIDEO CLIP)

DR. JAMES BLACK, PHOEBE MEDICAL DIRECTOR OF EMERGENCY SERVICES: When you`re taking care of people you don`t know, you have a more objective view than people you have known for, you know, 40-plus years. We went from if it happens to when it happens. We never thought we would be one of the early places to see such a dramatic rise. The number of patients that are positive and symptomatic and really sick has been very eye-opening.

(END VIDEO CLIP)

MADDOW: Joining us now is Dr. James Black. He`s the medical director of emergency services at Phoebe Putney Health System in Albany, Georgia.

Dr. Black, thank you for taking the time tonight. I know there are a million demands on you. I really appreciate you being with us.

BLACK: Thank you for having us.

MADDOW: We`ve been following closely about the story of your community and hospital and how taxed you`ve been and how many cases you`ve coped with, how many people have been buried. Let me start by asking how you are doing and how you and your family have been holding up over the grind of these few weeks.

BLACKWELL: It`s been tough. I haven`t seen my family, obviously. But I keep in touch with them every day and we know this something we have to go through until we see the end of it.

MADDOW: Can you tell our audience and tell me what we should understand about why Albany has been hit so hard? We`ve seen very interesting reporting that a couple of, you know, totally innocent honorable community events a couple of funerals that had a large number of people may have been sort of super spreader experiences in the community where a lot of people got infected all at once.

What`s your understanding of the sort of the trajectory of the epidemic in your community and what your case load has been like over time over the last couple weeks?

BLACKWELL: Well, the public health department, their epidemiologist studies have shown us are they`re surmising that it did begin on a certain day with couple funerals. You know, what -- one of the things, we`re kind of geographically isolated, and you would normally isolated and would protect you or make you one of the late communities to see such a rise but in contrast, we were one of the early ones.

We have been preparing for cases of coronavirus. We knew we would not be spared. But we certainly did not expect to be one of the early communities to get hit and it`s been a dramatic increase in the trajectory is still up. We would certainly like to see even a stable number of cases but every day, we see more and more and we can`t quite see where the end of where the flattening of it may occur.

MADDOW: You have finite resources obviously, single hospital in the community. I know the National Guard has come in to provide help. I know you`ve been able to try to tap other resources to create more ICU beds where things didn`t exist before. I imagine your emergency department, you must have made significant accommodations to deal with as what you`re describing a still increasing -- still increasing case load.

How much more flex do you have? How much more can you expand as your case load keeps going up?

BLACK: That`s a very good question. We made accommodations both in the emergency department, and throughout the health system and we`ve gotten help from the community and also from our neighboring hospitals to off load the numbers, but there will be a point at which we will not be able to flex more and expand more, but we keep finding ways to create more and secure beds and more ways to help transfer patients in order for them to get the care we would like to provide here, but we`ve been at capacity.

And as for as supplies are, we have a team that their only job throughout the day is to try to source materials. Early on, we were fairly successful. As this gone in more communities, it`s become much more difficult to source those materials but to their credit, we have yet to run out of anything that`s essential. They always manage to find a way.

MADDOW: Dr. James Black, medical director of emergency services at Phoebe Putney Health System in Albany, Georgia, managing, helping to manage one of the most acute epidemics in the country and perhaps in the world. Sir, thank you for the work you`re doing. Good luck. Stay well.

BLACK: Thank you so much. You, too.

MADDOW: All right. We`ll be right back.

(COMMERCIAL BREAK)

MADDOW: The record for the largest ever attendance at a soccer game was set in 1950. Nearly 200,000 people crammed in to Rio de Janeiro`s Maracana Stadium for a World Cup match. Those little dots of people, 200,000 of them.

To this day, Maracana is still the largest stadium in Brazil. In this picture from space, Maracana is that thing that looks like a lifesaver in the upper left hand side of your screen. Now, that facility is being converted into a hospital.

Same thing in Germany. Tomorrow, that country`s largest soccer stadium will open as a hospital.

This is the largest exhibition complex in all of Spain, in Madrid. Now, it is a 5,500-bed hospital.

In this country, in Chicago, they have converted McCormick Place, the largest convention center in North America, into a hospital with 3,000 beds and only took them five days to do it.

If it is big enough to be seen from space, it is a hospital now. And that is true all over the globe.

That`s going to do it for us tonight. We will see you again on Monday.

Now it`s time "THE LAST WORD" where Ali Velshi is in for Lawrence tonight.

Good evening, Ali.

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