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Chicago Mayor TRANSCRIPT: 4/8/20, The Rachel Maddow Show

Guests: Lori Lightfoot, Michael Mina

CHRIS HAYES, MSNBC HOST: 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. Much appreciated.

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

When Ireland elected their current prime minister back in 2017, he was a landmark choice for a bunch of reasons. At 38 years old, he was the youngest-ever Irish prime minister elected. He`s also an immigrant`s son, his mom was Irish born. But his dad came to Ireland from India.

He`s also openly gay, which was remarkable enough thing in Ireland, for us here in this country, it was all the more remarkable when Irish Prime Minister Leo Varadkar brought his partner to meet Mike Pence. Oh, mother, there was trembling. Oh, it was awkward.

But now, in the spring of 2020, something else about the trailblazing biography of Ireland`s young prime minister has been brought to the fore because this week, he has gone back to work as a doctor. The prime minister of Ireland went to medical school and worked as a doctor, as a general practice physician in Ireland for seven years, before he left the medical role and went into politics.

Now as Ireland confronts its coronavirus epidemic, they`re currently over 6,000 cases and over 200 deaths, the prime minister himself has re- registered on the medical roles with Ireland`s health service, and he is now spending one day a week working as a doctor, assessing suspected coronavirus patients in Ireland, while he still works as prime minister.

Ireland last month asked health professionals of all kinds who were not currently working in the country`s health service to please sign up and join the fight. The prime minister himself is now among them.

And that kind of volunteerism, among the, you know, the powerful and connected, but also among regular people, we have seen it all over, and it is heroic. In the U.K., the government`s request for ordinary citizens, to come forward, and volunteer to bolster the British national health system, to help health care workers prop up their NHS, the British government asked for 250,000 British citizens to volunteer in that effort.

They`ve now had 750,000 British citizens come forward, three quarters of a million people, regular citizen volunteers coming forward to help, and this is on top of the thousands of British health professionals who have volunteered to join the front lines again, as well. I didn`t realize it before the "Washington Post" pointed it out today, but that number of British civilian volunteers that came forward, that 750,000 strong cadre of accomplish volunteers, that`s four times the size of the entire British military.

The data modeling group at the University of Washington that`s been so influential with our government and in our country, they`ve been doing these models of when individual U.S. states are going to hit the peak of their outbreaks, how many deaths that`s going to mean, how many beds each state is going to need, by what date, that same modeling group at the University of Washington has just started doing the same kind of modeling estimates for European countries as well. And there is, in those models, and in those projections, some good news for some of the hardest hit European countries.

For Italy, which was hit so, so badly, and is still struggling in some ways, the modelers at University of Washington say that the first wave of the pandemic has peaked in Italy, at the national level. The peak is behind them. For Spain as well, quote, almost all regions of Spain are at or past the peak.

For France, quote, the model shows that France is just passing its peak. Now, French health officials said this week that they believe they haven`t peaked yet. But the numbers in France do show their curve at least flattening out and this University of Washington model shows that France will start to improve from here. That they are peaking now, and things will get better.

According to this modeling, the peak in Germany is still to come. But the good news, for these projections, for the nation of Germany, is that Germany has kept its epidemic there contained enough, they have slowed the spread enough, in Germany, that even though they are not expected to peak in terms of their apex number of cases, until the third week of April, quote, the model shows that Germany will have enough beds, and enough ICU beds, to meet demand, when they get to that peak.

So there is some good news, for European countries who have lots of cases. The bad news in this new modeling for European countries is for our dear friends in the U.K., you know, where three quarters of a million British citizens have come forward, volunteering to help, where there is such goodwill, and such desire to do the right thing, where the prime minister, Boris Johnson, with all of the controversy around him and his government, the whole country is pulling for him, he himself is in intensive care in a London hospital.

But in the U.K., the Johnson government was slow to put in place stay-at- home orders and to close schools and businesses. They had some sort of pseudo scientific ideas about maybe being fined if they did nothing and so, they were super slow to act and that meant that the virus kept spreading in the U.K., and they kept achieving more and more prevalence in that country`s population while the government couldn`t get it together to confront the real data and the real science and put in place the measures needed to protect the people so they are going to have a gigantic epidemic and they are going to have a gigantic death toll.

The University of Washington`s model at least predicts that the U.K.`s death toll is going to peak later on this month, and they`re predicting that the U.K. will not have enough hospital beds or enough ICU beds to meet demand, by a lot. They`re predicting that the U.K. will be short by tens of thousands of ICU beds.

The Washington model is predicting that deaths in the U.K. will ultimately be more than Italy, and Spain and France combined.

The only other country facing an acutely negative projection in this model is Sweden of all places. The University of Washington model says that Sweden, too, will outpace its hospital beds and its ICU beds by the time of their peak, later on this month. And that is because Sweden, too, of all places, for its own idiosyncratic reasons, the Swedish government decided that they wouldn`t put in place stay-at-home orders, they wouldn`t close the school, they wouldn`t close businesses.

They decided they would wait it out and see how things went. Sweden`s government decided to assume things wouldn`t get that bad. And so, now, they, like the U.K., are facing the -- what feels like the inevitable overwhelming of their medical facilities, and thousands of deaths. Even as other European countries start to get this under control.

And I mean, from this distance, here in the United States, we tend to think of Sweden and Norway as kind of twin Scandinavian countries, they`re like Vermont and New Hampshire of northern Europe for us, they share that cold northern peninsula at the top of the world, we think of them sort of similar and having similar politics, but they have very different approaches to coronavirus. Norway put in place early stay-at-home orders and closed schools and businesses while Sweden didn`t.

And now, literally, at the same time this week, Norway has flattened its curve enough that they are starting to work on when it is going to end. They`re starting to work on when they`re going to repeal their anti- coronavirus policies, and open their economy and their society back up. That is happening right now in Norway.

While Sweden, sharing a long border with them, on the same chunk of land, in that northern part of the world, Sweden`s government just next door, this week, is scrambling to give themselves new powers, so they can put in place belatedly now policies that they hope will at least mitigate, at least slow down, what looks like a coming disaster.


UNIDENTIFIED MALE: We are seeing more and more patients coming in every day. And unfortunately, not a lot of patients are leaving the ICU, at least not alive. So it is pretty worrying. And we have several wards filled with COVID-19 patients, in the hospital, that are still not in need of intensive care. But there`s a big worry that many of them will arrive in intensive care soon.


MADDOW: That`s general surgeon who is working in Stockholm, Sweden, we see him expressing that worry there.

That statement from him is part of a collection of statements, from front line medical workers, that NBC News has been collecting from doctors and nurses and other health workers all over the world and all over this country.

This for example was a prediction that we got just a few days ago from Dr. Prakash Gatta, a surgeon at Multicare Tacoma General Hospital in Washington state. Watch.


DR. PRAKASH GATTA, SURGEON AT MULTICARE TACOMA GENERAL HOSPITAL: Here I am back to work, with COVID-19, just want to let the world know and my health care providers when you`re on the other side of this, you`re going to have a lot less anxiety, a lot less fear, and you`ll feel like you`re invincible because you can deal with this crisis, without anybody having to worry.

And for my patients out there, for the people with fear, know that no matter what happens, you can work from home, the lights are always on, babies are being born, bones are being set, this hospital, this profession, we`re in a league of our own. We`ll take care of you.


MADDOW: That was Dr. Prakash Gatta in Tacoma. He`s a surgeon in Tacoma, Washington, speaking just a few days ago.

Here he was yesterday in the operating room.


GATTA: This is Dr. Gatta, in the midst of all of the COVID craziness we`re still in the operating room taking care of really sick patients that really can`t wait, being very careful about conservations of PPE, reusing masks, in some occasions, gowns and sometimes not leaving the operating room to take a bathroom break, because we don`t want to waste our gowns.

The level of involvement of our staff is just incredible. Everyone is going beyond what they`ve ever been asked to do, and you don`t even have to ask them. I`m proud to work here.


MADDOW: I`m proud to work here.

Again, that`s Dr. Prakash Gatta, in Tacoma, Washington.

Here`s another you should see. By coincidence, it is another doctor Indian descent. Like I believe Dr. Gatta and like the Irish prime minister, this is Dr. Ajit Rai, who is an anesthesiologist who works in California but he is in New York now because he volunteered to come do time in a front line New York City hospital.


DR. AJIT RAI, CALIFORNIA ANESTHESIOLOGIST, VOLUNTEERING IN NYC HOSPITAL: Here in New York, we are in full blown crisis mode and the city is sinking, so although first responders, and myself, I`m just one person, but I believe that we can still be a life vest for an overburdened health system to help it remain afloat, and what has been so surprising to me is that the resource depletion I`m seeing here in one the wealthiest cities in the world reminds me a lot about the limitations I experienced when I was providing medical care for war-wounded refugees in the Middle East, working for Doctors Without Borders.

And you know, everyone in the country is so fixated on PPE shortages and ventilator shortages, but none of that even matters if you don`t have the medical personnel to turn those machines on. So, for doctors and nurses around the country who are just waiting, time is now when we need you. Some clinicians believe that because of their specialty, they may not be able to contribute to the care of critically ill patients, but the truth is, at a time like this, anyone and everyone with medical training has value. We are seeing a disproportionate amount of disease and death in one region. So, for me, it just didn`t feel right to sit back and watch it happen.


MADDOW: Again, that`s an anesthesiologist who works in California but he has come to New York to work at a front line New York City hospital.

Here is just one more I want you to see. This is from a working paramedic in the New York Fire Department, FDNY.


ANTHONY ALMOJERA, VICE PRESIDENT OF FDNY EMS OFFICERS` UNION: It`s been, it`s been a crazy week. The call volume is 6,500 or better. Last night, it was 6,900 again.

There`s been a lot of people dying. I`m getting phone calls from crews who are going four, five, six arrests in the tour, cardiac arrests, people dying, knowing they`re trying to work out. This Sunday, I did 12 cardiac arrests in a 16-hour tour. It`s a suspected that most of them are COVID- related as the patients tell us that they have similar signs and symptoms of what is going on.

The sick leave of the FDNY EMS is about 20 to 25 percent. That`s people who have contracted the virus and they`re out sick. Thankfully, some of those people are starting to come back in.

But we do have a lot of members who are really sick with it. We have two members who are intubated. We have about seven or eight members who are in the ICU. And a whole bunch of them are in quarantine. Roughly about 700 people of the fire department are being monitored for this.

So, it`s a serious virus and we`re out there on the front lines battling it. The governor today said that he thinks it is going to reach its peak, and I hope he`s right, you know, he`s doing a pretty good job giving it to us straight. But out here in the streets, it`s nothing but ambulance sirens.


MADDOW: The paramedics, the doctors, it`s not just the amount of work that is being put on them, it`s the risk to them at the same time. It`s just impossible to ask what we are asking of them, and yet we are.

In New York, over the last 24 hours, they started transferring some critical coronavirus patients out of one hospital, in Queens. Out of Jamaica hospital medical center in Queens, because there were so many patients on ventilators at that one hospital, they were worried about being able to sustain the supply of oxygen necessary to keep feeding those ventilators. Worried about their oxygen supply, they distributed these critical ill ventilated patients to Upstate, to Albany and other New York City hospitals, and to New York harbor, on to the U.S. Navy hospital ship, the Comfort.

New York`s case load is roughly at 150,000 confirmed cases which means that New York state alone has more positive cases than any country on earth, other than the United States. Here`s a look at, New York`s numbers right now, though, which are horrible, but they may tell the story of a crisis that is starting to slow down, in its acceleration.

First, let`s look at the bad news first. This is the death rate in New York, the daily death toll. This is the number of new deaths reported each day over the past couple of weeks. And you can see how it rose and rose and rose and rose, there was a little dip where the numbers went down from 630, down below 600 for a couple of day, people got very hopeful those death numbers would start to fall consistently but no, now, they are higher than ever.

You can see it in chart form here. It is bad. The daily death toll is bad. Yesterday was a new record death toll anywhere in the United States. Today was worse than that record. But death, of course, is the end of the story when it comes to any patients` progression.

Is there reason to hope in other numbers that lead up to that final death toll? Well, look, here`s the numbers for the last couple of weeks for new hospitalizations reported each day in New York. These are the raw numbers.

And again, you can see them going up and up and sort of tipping around, up and down and up and down and over the last couple of days, you can see the recent numbers are lower. Those are the raw numbers. Now let`s again put them on a chart.

Again, these are the new hospitalization number, each day, in New York. You can see the lower numbers right now, recently, is that cause for hope?

Now, let`s look at newly-reported cases. Newly-reported coronavirus cases in New York, this is the rate of increase each day, and newly reported cases of coronavirus. Again, you don`t want to get too hung up on any small set of data but what we are looking at here is a daily rate of increase, that is getting smaller.

We`ve now had four straight days, in which the daily increase in the number of cases in New York is below 10 percent. It is in the single digits. That`s the day by day numbers. Here`s what that looks like on a chart.

To a layman like me, that looks like reason to hope. The pace at which New York City`s new cases are increasing, starting to slow, it looks like hope to me, but you know what? Dashed hopes are the last thing we need right now, and so, in just a few minutes, we`re going to talk to an epidemiologist to get his take on whether there is really reason to be hopeful in these New York numbers, these numbers in the worst epidemic that we`ve got in our country.

But, you know, separate and apart from what`s going on in New York and whether New York is hitting an inflection point, just absorbing the day`s news today, there are some other clear promising signs in the U.S., among states that took it very seriously and acted very quickly. Just as we`re seeing some good news out of some European countries who are past the worst of it, in some American states, things are going better than they might have.

Last night, we reported on California, sending ventilators to New York and New Jersey and Illinois. Today, California sent more. Fifty ventilators flown out today to D.C. and also to Maryland and also to Nevada.

Earlier this week, we saw Washington and Oregon also start sending out their ventilators to other states. Their ventilators that it turns out they don`t need yet because they`ve done a good job so far keeping their curve low, keeping people at home, slowing new cases.

Today, Washington state also gave back an Army field hospital that had been set to open this week, staffed by uniformed army personnel.

Governor Jay Inslee in Washington state, today, saying quote: I`m incredibly appreciative of the men and women of the 627th Army Hospital Center out of Fort Carson, Colorado. These soldiers uprooted their lives to help Washingtonians when we needed them most. Since then, it has become apparent that other states need them more than we do. It is only right that we release this capability so those states have the tools necessary to help end this nationwide fight that we are all battling together.

Unequivocally that is hopeful news, positive news. And another one of the Western states that has sort of grabbed the curve early and decisively and bent it forcefully down and they are doing better than they otherwise would have, and better than they prepared for. But now, we are in this situation as a country, where, you know, we`ve got some places doing better, and some places really not. We`ve got some places in the country where they are still furiously building out new hospital capacity.

For example, the mayor of the great city of Chicago is going to join us in a couple of minutes tonight, in part to talk about the hand over fist effort in Chicago, to get enough beds built there, right? We`ve got that happening at the same time that these other places that went big and fast in their response, and you know, they`re able to lessen some of the capacity they expected to use. For the first time, we hit this landmark moment today where one of those places is about to turn back in their build out excess hospital capacity so it can move to somewhere elsewhere it is more needed.

There really are some bright spots in the American story. Some places that acted quickly and decisively. But the big picture for us is still very bad. I mean, the story overall of coronavirus in the world now, remains the massive size of America`s epidemic. The national level, federal failure, of the U.S. to handle this responsively and the way it has therefore run away with us as a country.

There are currently more than 425,000 cases in the United States. That`s bigger than the other three largest epidemics on Earth combined. More than 14,500 Americans have died. One thousand nine hundred and sixteen of them have died in the last day, which means one American is dying on average every 45 seconds from coronavirus.

And still, it`s this patchwork response. Still there are U.S. states that don`t think it`s a big deal and haven`t had any national instruction to take it any more seriously, so they`re not.

The Arkansas governor, Asa Hutchison, now insisting that not only will there be no statewide stay-at-home order in Arkansas, he is overtly blocking any county or city in Arkansas from initiating their own measures to slow the virus, he is stopping them from doing so, if they want to. In Arkansas, they have already hit about a thousand cases, they are already about to hit a thousand case, maybe they want to see how high they can go.

In Iowa, they`re already over a thousand cases, over 20 percent of whom are health workers. Iowa medical board begging Governor Kim Reynolds for a statewide stay-at-home order, but Iowa`s governor is refusing that, too, because OK, sure, why not.

In Kansas, the Democratic governor there, Laura Kelly, did institute a statewide stay-at-home order and a ban on large gatherings. Today, Republicans in the Kansas state legislature overturned the ban on large gatherings. Apparently, because they want Kansans gathering tonight in large numbers right now?

I mean not, Republicans in every state don`t have their heads screwed on the same way about this. You`re seeing that in Kansas. You`re seeing stuff like what we`ve seen from the Republican governors in Iowa and Arkansas. I get it.

But for example, Maryland`s Republican governor, Larry Hogan, is going the opposite direction. Today, he, for example, formed a multi-agency strike force, to try to help out the dozens of nursing home and long-term care facilities in Maryland that have coronavirus cases already. Maryland has a stay-at-home order. Maryland has asked for ventilators from other states.

Maryland is now acting as best it can to try to approach the devastating problem in these congregate living facilities that are so vulnerable to this virus. That seems good. Because nursing homes have been hit so hard everywhere in the country, there out to be national guidance, and national effort and assistance here, for those incredibly critical vulnerable populations in facilities, but this federal government doesn`t do that. The Trump administration doesn`t do things like that.

I mean they`re also ought to be a national testing plan but this administration doesn`t do that either. The "Washington Post" today with a devastating report on how every state is doing for themselves as it comes to testing and even now, even three months into this thing.

There ought to be national guidance on how to limit the spread of the virus through stay at home policies and social distancing, but states are still making that up as they go, too, with no federal direction, including some states just deciding to not do it at all. Because the White House hasn`t told them they should.

But here`s what all that looks like in the end for us. I have one more thing to show you here. Here`s what this looks like.

This animated graphic I`m about to show you was produced by the BBC. And they are using data here from Johns Hopkins University. And what you`re going to see here is a graphic that shows the progression of how the coronavirus pandemic spread throughout the world.

This thing is only about 40 seconds. It is worth watching the whole thing. I particularly want you to watch when the part of the bottom of your screen, the part that shows the time frame that we`re in, I want you to particularly watch when it gets to the very beginning of March.

OK? Let`s start it. So as you can see, by late January, China was dealing with an explosive outbreak. But even as that country started to grapple with tens of thousands of cases, the rest of the world remained largely unscathed.

By late February, however, there`s South Korea, there`s Italy, there`s Iran, all reporting thousands of cases, and now, here, watch what happens, at the beginning of March. Look at the speed at which the U.S. epidemic starts to take off.

By the end of March, we have surpassed everyone, and from that point on, cases in the U.S. continue to grow with astonishing speed, by the thousands, and then by the tens of thousands, and nobody is even close. That, that is the proof in the pudding. That is the data that shows a failed national response. The worst failed national response on earth, right?

How our response is an international disaster, because of the way our unchecked, unmitigated spread of the virus, now dominates the pandemic worldwide, and dominates the human prevalence of this virus on earth.

I mean, patch work, late, denialist, fantasists, uncoordinated, inept, unscientific, confusion in national policy leads to this, leads to a run- away disaster. I mean, we do have to build on the few places that have been getting it right in our country and learn from them. And we need to support the places that are being overrun.

But at half a million cases now in our country, and nearly 2,000 American deaths, every day now, this has run off with us.


MADDOW: There have been a few real gut punch to flash points that will be remembered when the early history of the coronavirus, and how it ripped through this country is finally written. There was the nursing home in Kirkland, in Washington state, where we learned that two-thirds of the residents were sick, and ultimately 35 people died.

The town of New Rochelle in New York, where the outbreak was so fierce and moved so fast, that officials sealed off the town into a one-mile containment zone.

More recently, there`s the USS Theodore Roosevelt, the nuclear powered aircraft carrier where the virus ravaged the ship`s sailors turned sitting ducks stuck on board while their CO desperately asked the Navy for help.

Kirkland, New Rochelle, USS TR, those are big ones. But in terms of simple math, they may all be dwarfed by an outbreak you may not have heard about at all at the Cook County Jail in Chicago, which is now officially being described as the nation`s largest-known source of coronavirus infections.

Quote, it started small, on March 23, two inmates in the sprawling Cook County jail, one of the nation`s largest, were placed in isolation cells after testing positive for the coronavirus virus. In a little over two weeks, the virus exploded behind bars infecting more than 350 people. And even those numbers probably grossly underestimate the scope of the infection, because quote, the vast majority of the jail`s 4,500 inmates have still not been tested.

The dry tinder situation at the Cook County jail has led to urgent calls to get the prisoners out of there. It has also drawn pleas from the Americans who are locked up there right now themselves, handwritten sign, you can see propped up in the cell window, it says, quote, help, we matter, too.

In the community at large, in the great city of Chicago, there are very worrying signs in the data about their outbreak, and its contours. African- American residents are dying at nearly six times the rate of white residents in Chicago. African-Americans make up about 30 percent of Chicago`s population, but 68 percent of Chicago`s deaths from coronavirus.

And there`s this warning sign from the city`s hospitals. Parts of Chicago are already, already running low on intensive care beds. They have some of the lowest numbers of available ICU beds in the whole state.

And it`s not for lack of trying. This is time lapse footage of the largest convention center in North America, Chicago`s McCormick Convention Center, being converted into a 3,000 bed field hospital, for coronavirus patients in Chicago.

And more field hospitals are coming as the Army Corps of Engineers is working to convert and reopen shuttered hospitals to care for COVID-19 patients. But it is an open question right now. Is Chicago this great American city, up to what they are about to hit, in terms of their apex patient load? And what can the rest of the nation do to help? As they face it?

I have the person to ask, the only person to ask.

Joining us now for the interview, I`m honored to say, is the mayor of the great city of Chicago, Lori Lightfoot.

Madam Mayor, I know how precious your time is right now. Thank you for making time to be with us tonight.


MADDOW: Let me first ask, that is a brief look of some of the things going on in Cook County and in Chicago. Let me ask you if I said anything there that struck you as wrong or wrong-headed?

LIGHTFOOT: No, it`s a -- I think the landscape that you portrayed is accurate but I will say in answer to your question, we are, and we have been, and we will be up to the task.

It`s daunting. There is no question about it. But we`ve got a great team on the ground. We`ve got really historic cooperation among all levels of government.

And we`ve got a plan that we`ve been executing on now, for over a month. And it`s starting to show results. I`m happy to describe that.


LIGHTFOOT: Go ahead.

MADDOW: Yes, I was going to say, I would love to hear about that plan, and I -- the thing that I have learned in recent day, as part of the reason I wanted to talk to you tonight is, I am concerned to see the -- that heading into this, Chicago had such a low proportion of ICU beds available relative to its population and its other hospital beds. I know that`s been part of what you`ve been trying to address.

LIGHTFOOT: Yes, we`ve been looking at the ICU bed vacancy and availability literally every day. So, we are looking at the ICU number overall. We`re also looking at the ICU beds occupied either by COVID, diagnosed patients, or patients under investigation for having COVID.

And we`ve been really hovering now for about two weeks, between about 75 percent and 77 percent. We`ve seen a slight uptick, in a number of COVID beds occupied, that`s about, in the low 40s, but we feel like, particularly with the other resources that we brought online, whether it is the McCormick Place field hospital that you`ve identified, or the other thing that we`ve done is we stood up about 2,600 hotel beds, so that people that don`t need acute care, but still need either quarantining, or isolation, and can`t go back to their homes, they now have a place to go as well.

So all of those things working together, we believe will help us meet the surge that we`re anticipating.

MADDOW: In terms of the staffing levels, one of the things that we`ve seen in New York, and now increasingly in New Jersey, we`ve seen some reference to it in other hard-hit places including parts of Georgia, and Louisiana, is that even when the supplies are there, even when the beds are there, there is concern about whether the staff is there.


MADDOW: Both because the staff is working flat-out because they themselves are at very high risk of infection, but also because the patient loads are just bigger than the health care worker corps, that stands in a normal time, could handle. Do you anticipate that Chicago will essentially be trying to draft people from other parts of the country, or to bring back recently-retired personnel, to come join the front lines?

LIGHTFOOT: We already have. We put out that all call several weeks ago, and particularly for the McCormick Place, the alternate care facility, we are taking health care workers from a nearby county, who have been furloughed, and bringing them on.

It`s the senior medical leadership there are both retired, but also furloughed, executives from other health care systems, that have been working now, for I guess two weeks, really setting up what the staffing model is going to be, and then recruiting in a way that doesn`t deplete or cannibalize existing hospital and health care workers, but bringing everybody in.

So whether you`re retired, whether you`re close to graduation, we are looking for everybody in between those two extremes, to come and help work in Chicago. So, we have been issuing that call now for some time.

MADDOW: Madam Mayor, let me also ask you about the racial disparities that are evident in a lot of cities --


MADDOW: -- every place that is reporting racial data is reporting racial disparities in terms of African-Americans in particular having a higher infection rate and a higher death rate. The numbers in Chicago are just incredibly stark. I know you talked about this, and how concerning this is, and how upsetting it is, and just breath taking to see these disparities.

What`s your plan to try to get to the bottom of why it is, and how to address it?

LIGHTFOOT: Well, we have a sense of why it is. We`ve been talking for some years now and more recently since I`ve been mayor, talking about the income health care, life expectancy disparities that are really plaguing black and brown communities all over Chicago.

So, we know that, for example, the rate of diabetes, heart disease, upper respiratory illnesses, all of those things are exponentially magnified throughout black and brown community, and this virus attacks those underlying conditions with a vengeance. So while it is absolutely shocking and it is, I think I`ve had some of my roughest days as mayor once I learned what these disparities are. The fact that black folks are dying seven times the rate of any other demographic, that`s a hard thing to even wrap your mind around.

But what we`re doing is this. Number one, we`re making sure that we`re being very public about the data. We need people to know this. There is a myth in black Chicago that black folks can`t get coronavirus. And we are doing everything that we can to disabuse people of that notion.

Number two, we are putting together what we`re calling a racial equity rapid response team. So, it`s a combination of health care worker, public health, street outreach, and local stakeholders, in a hyper-local focus, to make sure that we are going deep into communities, we`re reaching people where they are, connecting them up with resources, doing aggressive check well-being calls, and visits, so that we understand the magnitude of the impact, and then we give people themselves tools to help them, social distance, tools to help them get access to health care and other things that we know are necessary to really address this hideous disparity among black and brown communities in Chicago.

MADDOW: Chicago Mayor Lori Lightfoot, you have a bear of an epidemic on your hands, in your city. I have incredible faith in you, from everything that I know of you and from watching you lead in this time, your city is lucky to have you. Please keep us apprised. Please let us know what you need the country to know about how things are going in Chicago in these coming days.

LIGHTFOOT: I appreciate it, thank you, Rachel. Take care of yourself.

MADDOW: All right. Much more -- I will do. You too, Mayor.

All right. Much more to get to tonight. Stay with us.



MAUREEN MUECKE, ALABAMA PHYSICIAN: This is Dr. Maureen Muecke. I am at work right now, started at 8:00, I`m doing a 24-hour shift. As you can see the helicopter is behind me, we had a patient who came in for shortness of breath, no fever, and he went downhill big time, and we are having to transfer him out.

We had one patient in the hospital with COVID-19 and one in isolation that is waiting for the results.

We are a small rural hospital. We have no ventilators. And we`re seeing already the infiltration finally of the virus into the rural areas of Alabama. So we`ll just see how it goes, and we`ll keep our fingers crossed and keep doing the best we can for the community and the surrounding communities.

The surrounding communities now are also seeing an increased number of COVID-19 cases. So we`re probably going to be seeing many, many more in the next few weeks here.


MADDOW: That is Dr. Maureen Muecke, an emergency medicine doctor in Evergreen, Alabama.

The coronavirus epidemic has been raging in New York, and in New Jersey, and in Chicago, and other dense urban place, but it really is spreading in America`s rural areas, too. It is in three out of four American hospitals now. It`s in two-thirds of America`s rural counties.

About 140 miles northeast of Dr. Muecke`s E.R., in Evergreen, we`ve got something else today from Alabama, from East Alabama Medical Center. This shows the hospital staff at East Alabama Medical Center celebrating their first coronavirus patient who improved enough that he could be taken off a ventilator.

It`s a 48-year-old man. He had been in the ICU for more than two weeks. And he`s off the vent. And that is -- that is great news. It`s amazing footage.

But he is the first, and so far, the only patient they have had at East Alabama Medical Center who has gone on to a ventilator, and lived and been able to come off it. He`s number one.

As "The New York Times" reported today, the rural epidemic in America is exploding. This week, the case rate in rural areas was more than double what it was six days earlier. Governors of rural states who think it is not coming there are wrong. There is a rural coronavirus epidemic just taking off. This is a 50-state problem.

It means as this moves into -- it moves into in significant quantity, to places that have rural hospitals, that may not be well-equipped, that may not have good transfer facilities in terms of dealing with large numbers of patient, all coping with the exact same illness, there`s a whole new circle of head -- circle of hell ahead for us in this country in terms of how we strain our health care resources. That is ahead in terms of rural America.

But right now, in the first hit, worst-hit places in America, there have been some tentative glimmers of hope that maybe the epidemic in the country`s worst hit spots may be leveling off. We talked about some of that data at the top of the show tonight. It looks from a layman`s perspective like it is reason to hope but let`s talk to an expert. Let`s talk to an epidemiologist about whether or not things are getting better in the worst hit places in the country. That`s next.


MADDOW: Joining us now, Dr. Michael Mina, assistant professor of epidemiology at Harvard School of Public Health.

Dr. Mina, thank you so much for making time to be with us tonight. I`ve been really looking forward to the chance to talk with you.


MADDOW: So I was hoping you can help us get some perspective on the numbers that we`re seeing out of the worst-hit place in the country, out of New York. I`m conscious of the fact I`m just a layman looking at these things and that I have my own emotional investment in wanting things to get better.

But when you look at these numbers that we have been talking about tonight that show what might be the start of a decrease in new hospitalizations in New York, do you think we`re looking too hard for a glimmer of hope there or do you see that as significant?

MINA: I see this as significant. Certainly, it matches the expectation that`s we have. So the real sort of stay-at-home type of social distancing really began to take shape in New York City in particular in the last -- in the last couple of weeks and really in the last week in New York City. And so, we anticipated this would be the week, two to three weeks after that that we`d really start to see the benefits of those social distancing efforts start to take shape, and I think that that`s exactly what you`re seeing here.

We`re seeing because usually there is this two-week lag between when those distance -- social distancing measures occur and when we actually see the effects of them and that`s really where we are now. So, I think this is a glimmer of hope and not just an aberration at the moment.

MADDOW: Is it an even more direct measure of the effect of social distancing policies to look at the increases from day to day in new cases? I mean, New York has also started to be in single digits day after day in terms of the percentage of increase from day to day in new cases. Presumably that`s an even more direct metric for counting essentially the effect of the interventionist policies that you`re describing.

MINA: That`s exactly right. So looking at the change from day to day, this is a very -- this is a good trend to see and I think that we can -- we can take hope that this is a real trend. There are a lot of things that could be changing that might also be playing into those types of trends, changing -- changes in test practices and things along those lines, but in general, I think the slope downward fits what we`re expecting, and it is suggestive that the social distancing measures that really are being held on to I think pretty well in metropolitan areas in particular, I think that we are seeing the benefits of those play out.

MADDOW: So even as we are seeing positive trends in hospitalization and in new case numbers, which is the two graphs we just showed, the death numbers are as bad as ever, literally. I mean, New York hit a record number of -- record number of deaths in 24 hours yesterday and then beat that number today.

Does it make sense that the outbreak could be slowing? That those other positive measures that you described could be evident even while deaths are still going up so steady?

MINA: Absolutely. This is, unfortunately, another expected type of data to see. So deaths tend to lag more than new cases. So the numbers of new cases entering in, if you stop people from interacting, you`ll see the fruits of those labors play out a couple weeks later. But death often takes two, three, four, maybe more weeks before it occurs after somebody becomes infected.

So, unfortunately, there was an exponential increase in cases before the social distancing measures took place and we`re going to potentially continue seeing those increased cases that were happening in transmission events, we`re going to see the end result of a lot of those, which is death happening three or four weeks after those events occurred and that`s why I think we might still continue to see increasing numbers of deaths this week and maybe even into next week.

MADDOW: Dr. Michael Mina, your perspective is invaluable. Thank you. Dr. Mina of Harvard School of Public Health -- really appreciate your time tonight, sir.

MINA: Absolutely.

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


MADDOW: Thank you for being with us tonight. That`s going to do it for us for this evening but I`ll see you again tomorrow night.


Good evening, Lawrence.

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