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Kansas prisoners riot TRANSCRIPT: 4/10/20, The Rachel Maddow Show

Guests: Andy Slavitt, Ernest Patti

RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Thanks, my friend. Thanks for that.

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

I would like you to meet Dan Renzi. I think you are going to like him, I am quite sure you are going to want to know more about him.

Dan Renzi is a nurse. He lives in Kansas, except for right now, he lives in New York City because he came to New York City from Kansas to help.


DAN RENZI, KANSAS NURSE FIGHTING COVID-19 IN NEW YORK: Hi, it`s me, I`m back home, after another night of wild exciting coronavirus fun on the night shift in New York. When I was in nursing school, I was talking to some friends, and we were going around the group discussing why we all signed up to be a nurse.

And honestly, when I signed up for nursing school, I had these visions of myself working for a cosmetic dermatologist, or something, you know, I would go to work and the real housewives would come in, and they would get a little facial filler and a lot of gossip, and we would have fun.

And if you told me that just, not too many years after I graduated that I would be living in a hotel in New York, while I was, you know, putting bodies in body bags, because this mysterious virus was mowing down everyone`s grandparents, I did -- how do you process that? And I didn`t have to come, but at the same time I kind of did. If I don`t come, who will, you know?

But it does not make it any easier. Oh, and we got to call families, we got to call a family today, because, you know, families aren`t allowed in the room, they`re not allowed in the building, and, of course, you know, people know that it`s coming, that phone call, but it doesn`t make it any easier. Stay home, everybody, please.

You know, one of my jobs here at this hospital is I`m the guy who ties the toe tags on people, and gets them ready to be sent to the morgue. And they have me do this because I`m the biggest one on the floor and I can lift them easily in bed. So, I`ve been -- I`ve been looking at a lot of faces, and I keep seeing my parents, and if you could please, I`m 1,500 miles away from home, if you -- I can`t do anything about it here, so I`m just going to ask you guys a favor, if any of you see my parents out and about, just tell them, tell them to go home. You know, we do not go into the store.

My father retired ten years ago, and has watched TV every day since then, and now if the government has told him that he needs to stay home, suddenly, the man has hobbies, he`s got to leave and go at home and shouting the TV, oh, this is bull (EXPLETIVE DELETED).

But we`re busting our asses here, doing CPR on intubated patients, and my father`s driving around town. So, please, if you see him out, just tell him to go home, they do not need to be out. They can wait this out. This will be over.


MADDOW: This will be over.

On the last word, here after my show Lawrence O`Donnell has been featuring for a few nights now the 7:00 p.m. clap, the citywide cheers that New Yorkers are getting for health care, giving for health care workers every night, and sometimes those displays of gratitude come with a huge loud exclamation point when New York fighters joined outside the hospitals and they not only clapped they put the sirens on from the fire trucks to really make it impossible to miss, even for the health workers inside the hospitals.

But most nights, it is just night after night, New Yorkers cheering and clapping, and part of the reason I wanted you to see these dispatches from Dan Renzi, , who you may remember, you may recognize him, from MTV`s "The Real World" back in the `90s, you might remember him from then.

But part of the reason I wanted you to see these dispatches from him in his new life as a nurse who has come from Kansas to work in New York state, is because I feel we should all really see from the perspective of a health worker, in his case, from the perspective of a nurse, who wanted his nursing career to be a glamorous "Real Housewives" like drama, but instead came to New York to work the night shifts in Brooklyn and the Bronx to help, I feel like we should all see, not just what the cheering episodes for the health workers look like, to all of us, I feel like we should all see what those feel like to somebody who those cheers are for.


MADDOW: One of the hardest-hit hospitals in one of the hardest-hit places on earth right now has been Saint Barnabas Hospital in the Bronx where I would like you to meet somebody else. This is Ernie Patti. He`s an emergency room physician at Saint Barnabas.


DR. ERNEST PATTI, ST. BARNABAS HOSPITAL: The battle continues, the end of another shift. We still have a large number of people intubated down here. I believe there`s 13 intubated, and about five or six on CPAP.

A lot of people are still requiring high concentrations of oxygen. It doesn`t seem like it`s slowing down. Although we have had a little, I don`t want to use the Q word, but a little lull right now, which is good, because we`re able to catch up and get some patients upstairs to the ICU.

Let`s hope we reached that plateau at some point soon, where we flatten the curve. I`m hopeful.


MADDOW: When he says we`ve got five or six patients on CPAP, what that means is that Saint Barnabas in the Bronx is one of the places that has basically MacGyvered a response to the huge number of patients who simultaneously need mechanical systems to breathe, as coronavirus attacks the lungs. What Dr. Patti is describing there is that most of the patients they`ve got are on traditional ventilators but they`ve also started repurposing CPAP machines, machines for people with sleep apnea, basically into a make-do clinical solution for critically ill coronavirus patients.

So we`re going to be speaking with Dr. Patti in just a moment, about that hope that you just saw him talking about there, about what he and his colleagues are going through, this many weeks into it, at a capacity-filled hospital.

But part of the reason I wanted you to get a chance to meet him tonight is because of this next tape that I`m -- next piece of tape that I`m going to show you that we got from Dr. Patti today at Saint Barnabas. Because with more than 18,000 Americans now dead from this, with 2,056 Americans dying just in the past day, which means just in the past day, one American died from coronavirus every 42 seconds, with that many Americans dead, it is one thing to clap for health care workers and nurses and doctors, and we should, and it is one thing to hear them explain the kind of work they`re doing and how hard they`re working and what exactly it is that they`re doing.

But it`s only if we put a camera that one of their hands that we can actually see from their perspective what it is really like when they`re doing this work and we should see it particularly from these hospitals that have been pushed to capacity, because what they have got is what every other hospital in the country should see, as all of the cities and states that aren`t this far up the curve yet, start to approach those kind of apexes.

So I`m going to do something that kind of breaks the cable news production rules a little bit. But I just want you to watch this. It`s not super long. It`s about 40 seconds long.

The reason this breaks the cable news production rules is because this piece of tape I`m going to show you is something where there is no dialogue. And there is nobody narrating it. I`m not going to narrate it. I`m going to shut up.

But this is worth seeing. This is St. Barnabas in the Bronx. What it is like to be in this clinical environment with multiple patients being mechanically kept alive. This is what it was like for the nearly 2,000 Americans, for the 2,000 Americans who fought this thing in the hospital until they died today. This is what it is like now, tonight, for tens of thousands of Americans, who are fighting for their lives in hospitals right now as we speak.

This is rare to see, unless you give the doctor the camera, and let them show you from their own perspective, that this is just a glimpse from one hospital, of the working environment for the health care workers, who are trying to save Americans, who are trying to cling to life, with coronavirus.

Like I said, this is only 40 seconds. I will shut up. Just watch. Turn your sound on but just watch.


MADDOW: If you know somebody who says screw these stay-at-home orders, somebody says it`s all just a big overreaction, sit them down, turn the sound on, show them that.

The emergency room doctor who shot that, we`re going to be speaking with him in just a minute, we`re super grateful that he shot that video for us, we`re grateful for him and all his colleagues.


MADDOW: That`s St. Barnabas, St. Barnabas lost one of is doctors in the last couple of days, a trauma surgeon, Dr. Ronald Verrier. Dr. Verrier was born and raised in Haiti. He was the father of three children.

He worked as a trauma surgeon at St. Barnabas, fighting coronavirus like all doctors a health care worker like all health care workers are trying to keep coronavirus patients alive. He himself became infected with coronavirus. He died today at the age of 59.

Front line health worker know that their lives are at stake while they are doing this work, and yet, remarkably, this far into it, with all of the support that we as a country are trying to give them, it`s not enough. We are still seeing hospital staff have to literally protest to try to get themselves protective equipment, to try to get enough staff, relief staff, on board to share the burden in hospitals that have crippling numbers of cases.

This, for example, was today. This is Wyckoff Hospital Brooklyn today.


SHERYL POWELL: We need more nurses at the hospital. The nurses are working short. The nurses are working stressed. The nurses are working hard.

I want my nurses to know that we love them. We respect them, the respiratory therapists, the physical therapists, the doctors. They`re all working hard for the patients, for this community at this time.

At the end of the day, the nurses have tears in their eyes and the taste of death in their mouth. These nurses need relief. They need help.

We`re asking the governor, the president, whoever can help us, to send us some staff as soon as possible. We are doing the best we can with what we have. And we want everybody to know we will continue to do the best we can with what we have, but we need help, and we need relief, as soon as possible.

JOHANNA GONZALEZ: We also have staff bringing cleaning supplies from our homes, to clean our computers, to clean our chairs, to clean the stretchers, to clean the vital sign machines that the patients are using and this is a big problem. We`re a hospital, that we`re trying to control infection control, how is it that we`re bringing our own cleaning supplies to supply for the hospital? And that is one of my big concerns.


MADDOW: Nurses at one Brooklyn hospital they say, they are saying they are bringing in their own cleaning supplies from home to try to do infection control as they are seeing coronavirus patients.

I will also tell you, if you look, can we drop the lower third, can we drop that breaking news banner, I don`t know if we can with the remote control room, can you see what that nurse is wearing, can you see the dates written on her gown? We believe that is in terms of that gown being reused, because of the extent to which they have to reuse all of their gear, including their gowns. So they are labeled with sharpie to let you know what days they`ve been used.

And this is -- this is not, this is not only happening in New York. We`re starting to see signs of real crisis, for example, in Michigan hospitals. Nurses in Michigan hospitals have staged sit-ins and protests in the last few days, to try to draw attention, not just to the need for protective equipment, but to how understaffed they are for the volume of seriously ill and dying patients that they are seeing all at once in a flood.

And the headlines in the Michigan papers are stark, running out of body bags, people dying in the hallway. Coronavirus has Michigan hospital workers at a breaking point.

This one from "The Detroit News", inside Sinai Grace war zone, we started to run out of body bags.

Detroit today opened the first beds at its convention center, to try to take some of the strain off of their over-run hospitals. The first 25 beds opened at the convention center in Detroit today, they hope to have 250 beds operational by the end of the week. I will tell you, while this is happening, the Michigan Republican Party is nevertheless attacking the state`s governor for being too tough on this coronavirus thing, demanding that the stay at home nonsense should be lifted.

There`s just no reason for it. Call the governor, they are literally addressing the public, telling the public to call the governor of Michigan to call the governor and complain to stay at home and try to slow the spread of the virus. Michigan is fine. Why do we need this stupid stay-at- home order. Complain about the governor.

That`s the Michigan Republican Party. How they are approaching this.

Yes. I mean, Michigan is fine. They are running out of body bags because, what, it`s spring, they haven`t been conserving then, they have been wasteful with their body bags? But honestly, things are bad in a lot of places.

The Indiana governor today announced that they are over 300 deaths and over 6,000 cases, but they don`t know how many more cases they`re going to be able to track because they don`t know how many more tests they are going to be able to do because they are out of swabs. There aren`t enough swabs to do more testing. They have run out of them. So they`re now experimenting with how they might be able to maybe MacGyver some more of those.

Today, from on board the USS John C. Stennis, the military posted this video of sailors cutting and sewing and rigging homemade masks for use on board that aircraft carrier. I think the military might have thought of this as a kind of, you know, heart-warming, everybody`s pitching in kind of thing, but it also shows that even the United States Navy does not have adequate supplies to provide masks for active duty sailors currently deployed on aircraft carriers, so they really are making them themselves, in craft shops, on board ship.

The Navy says they`re making 30 a day right now on board the Stennis, they hope to be up to 50 a day by next week. I should tell you, at full tilt, the Stennis can have 6,000 sailors on it at a time.

If you`re looking for a snap shot of how the epidemic is shaping up where you live, or if I know you, where your parents live, or your grandparents live, and you`re worried about them, we`re going to post a link tonight at Maddow Blog, to this map, which is not being put out by any government agency. But I think it, I think this is a particularly helpful map. It is made by a company called Topos. It`s a company that does mapping and artificial intelligence stuff, founded by a couple of data geek professors who teach at UPenn and Cooper Union.

In general, what we are finding is that in the absence of good national clearinghouse of statistics and the epidemic, people are good at wrangling data from sources we can get, are trying to make the data easy to visualize, easy to access and therefore easy to use for decision-making. So, for example, this is the Topos map that shows the number of cases on a county by county map in the country, places with a high number of cases in dark red, and they also map a moderate number of cases, they map those in a lighter color of red.

Here`s a map that, from, also from the Topos database that looks very different, highlights different parts of the country, and this shows the rate of increase of new cases in individual counties in the country. So, you see those dark red blocks all over the country, those are counties that have a high rate of increase of new cases of the virus, places where the epidemic is really taking off. You can see it`s everywhere.

And you can zoom in, say to a place like Alabama, which looks pretty red- hot on this map and once you`re in Alabama, you can look county by county, to see what the rate of increase is, in new cases, and county by county, to see where the epidemic is growing fast. You can do this where you live, you can do this where your parents or grandparents live.

Again, this is the Topos map. If you want to go directly to check this out online, it`s And again, everyone is trying to do their own data visualization tools because the U.S. government is putting out basically nothing useful. But this at least as of today is the handiest thing I`ve seen so far to figure out basically what parts of country ought to be freaking out a little bit more than they are.

The other, one of the other tools I have found, to try to do that, as the government puts out no useful information, is to look at news coverage, literally, just the free press coverage, of what`s going on in nursing homes. Tonight, NBC News has this fairly terrifying report in which they`ve gone state to state, to try to figure out what the death toll from coronavirus has been in American nursing homes so far.

Obviously from what we know about the virus, it is particularly dangerous for people who are older, or who have underlying health conditions, and the way that we prevent people from getting it is by keeping them distant from one another, and nursing homes are a perfect storm, in terms of the virus being able to spread and the virus zeroing in on the people least able to fight it off.

NBC News tonight finds more than 2,400 nursing homes in 36 states that are contending with known coronavirus cases inside their facilities. NBC News tonight is documenting more than 2,200 Americans dead in nursing homes already.

But the most astonishing thing about this new reporting, from NBC news, is that as this national epidemic rips through nursing homes all over the country, and in cities and rural areas and suburbs and red states and blue states, everywhere, with the most vulnerable populations in those facilities, both for getting it and for being unable to survive it, as coronavirus just rips through American nursing homes, it`s freaking NBC News that is doing the tracking of those cases and deaths nationwide.

It is NBC News doing it as a journalistic project which is great but the reason they`re having to do it is because there is no federal effort whatsoever to track that data, let alone to do anything about it.

The federal government is not only not responding to the particular vulnerabilities of nursing homes, where, thousands have died and have a bull`s eye on them, the federal government is not even looking, they`re not even counting it. There isn`t federal data on, it and they`re not trying for it. I mean, this will be the deadliest swath of this virus, through our elders, in nursing homes and long-term care facilities. And so far, the federal government literally is pretend it`s not happening. Let alone doing anything about it.

It is not supposed to be that way and it does not have to be that way. And that story is next.


MADDOW: Page one today in the great state of Louisiana, veterans home hit hard, 25 have died at a facility in reserve, Louisiana, many have not been tested for the virus.

Here`s Indiana today, 24 dead, after coronavirus outbreak, at long-term care facility. Here`s Virginia, one long-term care facility in Virginia, reaching a grim milestone today, with 40 deaths at that one facility.

Here`s Alabama, also new today, testing reveals 36 cases at one nursing home in Alabama. That also yields this gut-wrenching headline. She did not deserve this, nurse at Alabama nursing home dies from COVID-19.

Here`s New Jersey. Three nursing homes in the town of Elizabeth, New Jersey, alone, have lost 45 residents to the COVID-19 outbreak.

Here`s North Carolina. Second veteran dies amid COVID-19 outbreak at Rowan County veterans home.

Here is another, 19 cases, at a nursing home in the great state of Oregon.

There`s a different headline from Louisiana today. Coronavirus outbreak at Louisville -- excuse me, here`s -- excuse me, Kentucky, here`s a Kentucky headline today, coronavirus outbreak at Louisville nursing home infects 29 people, killing five.

Choose your state. Choose your newspaper. Choose your local TV station. You will find at least one story like this, wherever you look.

It is ubiquitous local news everywhere in the country. But that`s how it`s being treated, local stories. That just happened to be happening everywhere at the same time. Coronavirus hitting nursing home, veterans home, long- term care facilities and hitting them hard.

In Los Angeles, this week, the L.A. County public health director went so far to say it would be quote, perfectly appropriate for families to take their elderly loved ones out of nursing home, just bring them home if you can because the homes are just that dangerous right now.

Currently, there is no national response even trying to address this part of the crisis. There`s no coordinated national effort. This is a problem that is everywhere. And this is the most vulnerable patients in the country.

As NBC News reports tonight, the federal government isn`t even tracking cases in nursing home, let alone doing anything about this part of the problem. Every state is on their own.

And yes, states are, some of them, trying, at the state level, to do something. In Maryland, and in Virginia, the governors in those two states have made pact to work together, each though one is a Democrat and one is a Republican. In those two states, they have now started multi-agency task forces specifically for nursing homes, task forces that can intervene, that can come in to help, that can help with things like testing, that can help with things like supplies, help with things like infection control. Help with things like treatment.

And that`s encouraging. That seems like a good model. It`s Larry Hogan in Maryland who ordered it first. It`s now Northam in Virginia who ordered as well.

Those two states willing to work together. Those two states trying it. And maybe other governors would follow suit. That would be good. But that`s two states out of 50, when it comes to the absence of any federal response.

Ultimately, there has toing something bigger here. More than 2,000 Americans already dead in these kinds of facilities and it is poised to kill thousands more Americans in these facilities and we can`t just let that happen, right?

We are at a critical point right now when it comes to this part of American life. We`re past the point of prevention, of keeping it out of these facilities. In thousands of these facilities, it`s already there. And once it`s in there, it is so dangerous to these populations.

Now is the time when there needs to be help. There does need to be invention. We cannot sit back and let it happen. We will lose too many thousands of Americans.

There has to be an effort to stop it. And I know apparently the federal government isn`t interested in doing this. But they have to. Honestly, they have to.

During the Obama administration, Andy Slavitt served at the head of Centers for Medicare and Medicaid Services, overseeing health care coverage for 100 million Americas. He`s also overseeing the type of healthcare coverage that most people use to pay for their stays in nursing homes and long term care facilities.

President Obama picked Mr. Slavitt as after Slavitt helped to repair the broken rollout of the Obama care website.

Andy Slavitt knows what it means to approach the overwhelming, the seemingly impossible and to try to fix it anyway.

And so we called him tonight because he is the person I decided I would like to talk to, at least to talk to first about what I find to be a middle of the night sit up and worry about it issue.

Joining us now, Andy Slavitt, former head of the Centers for Medicare and Medicaid Services. The host of the new podcast, "In the Bubble".

Mr. Slavitt, thanks for making time to be here tonight. Thanks for your expertise.

ANDY SLAVITT, FORMER ADMINISTRATOR OF CENTERS FOR MEDICARE AND MEDICAID SERVICES: Thank you, Rachel. Thank you for your focus on this really incredible, important story.

MADDOW: Well, let me ask you if there`s anything that I have said about it -- you can probably tell I feel emotional about it, like I`m head up about it. And it has literally been keeping me up.

In the way I have been talking about it as a layman observing these things, am I saying anything that strikes you as wrong or feels like the wrong approach to this as a problem?

SLAVITT: The only thing strange is you`re almost the only one saying it. There -- let`s step back a second. There`s 1.5 million Americans living in nursing homes today. There`s about 15,000 nursing homes in the country. Many of them are quite small.

And think about who these folks are. People over 80 today were born at or around the Great Depression. Many of them served in the Korean War. They have lived through so much in this country.

And the promise that Medicare and Medicaid in our country owes to these people is a dignified life, a healthy life, and a peaceful existence to their last days. Sadly, this is not what`s happening.

The time to have dealt with this, of course, is a few years ago, not in the middle of a crisis. And in 2016, in fact, President Obama created regulations that we put through that were wholesale meant to address complete nursing home infection control, nursing home safety, overuse of antipsychotics, all these things.

But sadly in 2017, the Trump administration got rid of those regulations and just said that they were not going to enforce them. That`s turned out to be, I think, the root of a lot of the challenge here.

MADDOW: Andy, in terms of trying to get our hands around this and not giving up on this and not deciding this is too hard to do -- I mean, it really does feel like an impossible problem because it feels like, as you said, a lot of these facilities are small. They`re everywhere. There`s nothing uniform in terms of the way care is provided or the way they are overseen.

It feels like an overwhelming problem in terms of how you would -- even when you think about it the level of one facility, when we first learned about that facility in Kirkland, Washington, that had a whole bunch of people positive and we learned ultimately a whole bunch of people would die there. It wasn`t for a lack of caring or a lack of trying that things went so badly.

Do you feel at all -- that there is a constructive way to approach it, that there is something, for example, that something has powerful as the federal government could do that would make a meaningful difference?

SLAVITT: This is not impossible. With people`s lives on the line, you cannot go in with the attitude this is impossible.

If I were there, there`s three things I would do immediately. The first thing I would do is I would test and get resources to every nursing home in the country because we know right now that the nurses and the staff, many of them are infected. We don`t know which ones. Many of them don`t want to show up.

So, over the next seven days, I would commit to testing every single one of them and getting gear to every single one of them. The federal government absolutely has the power to do that.

The second thing I would do is I would help them. We`re in the middle of a crisis. I would get them resources. I would go to Congress. I would give them resources to retro fit some of their facilities. Hospitals are not taking nursing home patients right now many times because they`d prefer to have them die in nursing home. I would get money for infection control.

I would get resources for telemedicine for doctors to come in and talk to patients. I would get the CDC to issue guidelines so I could bring in hospice nurses because there are going to be folks who do not make it through this, and I don`t want people in this state to be dying alone.

The third thing I`d do is something you talk about really repeatedly and it`s the most critical thing, and I think it extends to everything this administration is not doing right. Transparency. I would have a Monday morning, Tuesday morning, Wednesday morning, Thursday morning, and Friday morning phone call with the nursing home operators of this country. We would publish a dashboard around the country of infection control record, of where there were infections, of how many people were infected, of deaths.

And the way this will get fixed -- and this is not to embarrass anybody. But the way this will get fixed is there are nursing homes that are doing it right. And the nursing homes that are doing it right can give guidance to the nursing homes that are doing it wrong. We don`t have enough time to go back to the drawing board and create new regulations.

But in the middle of a crisis, I`d get them on the phone, we`d be sharing best practices. We would be publishing them, and we would be slowly taking down infection rates. And for those that couldn`t do it, we would be moving people into facilities that could.

MADDOW: Andy Slavitt, former head of Medicare and Medicaid Services under President Obama, as I mentioned, host of the new podcast "In the Bubble", that three-part strategy is incredibly practical and both ambitious and overdue and necessary. I hope a lot of people are listening to that tonight to give us hope about this crisis, but also I hope people can do something like this are listening to you too.

If they won`t do it at the federal government, every state should start doing this themselves. Andy, thank you so much.

SLAVITT: Thank you, Rachel.

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



UNIDENTIFIED MALE: They`ve broken everything that can be broken except the bars because you can`t break the bars. Windows, microwaves. They`ve trashed the officers` station where they do their work. The computers are broken. The cameras have been taken down. It`s just like mayhem.


MADDOW: It`s just like mayhem.

That is a prisoner at the Lansing correctional facility in Kansas just outside Kansas City, Kansas, describing in real time an uprising, a disturbance at that prison yesterday. The incident apparently started mid- afternoon around 3:00 p.m. it lasted for more than eight hours. Aerial footage of the prison showed stuff being thrown out of the windows in cellblock C. Officials say there was widespread damage throughout the whole facility.

Again, the situation lasted until about 11:00 p.m. last night and then tactical teams when in that cellblock. They used tear gas. Two prisoners were ultimately treated for minor injuries.

So far, at least officials in Kansas say they have not been able to confirm what caused that disturbance at the prison, but that young man, that prisoner you just heard from talking to the local news station, KSHB, he called in to say that what prisoners were angry about was the handling of coronavirus cases at that prison. So far, 12 prisoners and 16 staff members at Lansing correctional facility have tested positive for coronavirus and prisoners are reportedly upset about how it`s being handled and the fact they don`t feel like they can protect themselves from getting infected.

It`s also worth noting the cellblock where that uprising took place is just a few hundred yards from the infirmary where people who are sick with the virus are being held and treated.

Kansas` Governor Laura Kelly said today that the investigation into what caused that disturbance is ongoing. She said she would promise transparency into the state`s handling of the matter. But this, of course, comes at a time when Governor Kelly already has her hands full, including in some ways she probably shouldn`t have to deal with.

Governor Kelly in Kansas is a Democrat. She`s issued a stay-at-home order for the stay. She ordered a ban on large gatherings. But then this week, a group of Republican legislators overturned her order against large gatherings because apparently they want residents of Kansas having large gatherings right now.

Yesterday in response, Governor Kelly actually filed a lawsuit calling on the state Supreme Court to push back that effort by Republican lawmakers and settle this issue quickly, very quickly, especially given this weekend`s Easter holiday and the prospect of crowded Easter services on Sunday morning.


GOV. LAURA KELLY (D-KS): This is not a normal disagreement about policy or politics. The actions of the Republican legislative leaders jeopardize both the health and safety of Kansans. We do not have time to play political games during a pandemic.

I`m confident that the Supreme Court will take up this matter and adjudicate it quickly. I will not stand by where lives are in jeopardy, and I will not allow the rule of law or the Constitution to be trampled on during an emergency. I took an oath to uphold the Constitution and laws of this state. It is a promise I made to each of you.

We will get through this together. We will continue to flatten the curve, and we will beat this terrible disease. Please remember stay home. Stay safe. Save lives.


MADDOW: Today, we learned that the Kansas state Supreme Court will, in fact, take this up quickly. They`re going to hold an emergency session tomorrow morning on the matter.

Again, this is the Democratic governor putting in place a ban against large gatherings and Republican lawmakers saying they have overturned it, and it`s no longer in effect. The hearing in the state Supreme Court is scheduled for 9:00 a.m. tomorrow morning, Saturday morning, which is an unusual time frame. But the urgency is there for a reason. The court is making arrangements to allow the public to view those arguments maybe through a livestream on their website. In any case, it`s tomorrow morning, 9:00 a.m. I will tell you I have already cleared my calendar, but that wasn`t hard.

Watch this space.



PATTI: Well, the battle continues, the end of another shift. We still have a large number of people intubated down here. I believe there`s 13 intubated and about five or six on CPAP. A lot of people are still requiring high concentrations of oxygen. It doesn`t seem like it`s slowing down.


MADDOW: Dr. Ernest Patti is senior emergency medicine physician at St. Barnabas hospital in the Bronx, which means he`s the senior emergency medicine physician at one of the hardest-hit hospitals and one of the hardest-hit boroughs in the hardest hit city in America, which happens to be the worst epidemic on earth.

Here`s a third-year resident at that same hospital, at St. Barnabas.


ANGELO MASCIA, 3RD YEAR RESIDENT IN BRONX HOSPITAL: In the past two weeks, I`ve probably seen as much death as I`ve seen in the past three years. It`s bad. I feel like at this point everybody we intubate, it`s terminal.

Like I don`t -- it almost feels futile. The worst case scenario is not having a vent because then you`re playing god and deciding who lives and who dies. I don`t know anybody who can do that and sleep at night.


MADDOW: I don`t know how anybody can do that and sleep at night. I don`t know how anybody can do any of this and sleep at night.

Even by New York City`s standards, the community that St. Barnabas serves, the Bronx, is just getting hammered. A study published by NYU found that across New York City, quote, to date, the Bronx has seen the highest rate of deaths per capita from the virus, which is really something for the good Americans who live in the Bronx. It must be utterly transformative for say, say, the senior emergency medicine physician who`s in charge of keeping people alive when they turned up in extremis at St. Barnabas Hospital.

Joining us now is Dr. Ernest Patti, who`s the senior emergency medicine physician at St. Barnabas.

Dr. Patti, I know you`ve just gotten off work. I really appreciate you taking time to talk with us. Thank you.

PATTI: Thank you for having me, Rachel. I appreciate it. Thank you.

MADDOW: I want to start by expressing my condolences. I know you and the team at St. Barnabas lost a colleague from coronavirus, Dr. Ronald Verrier, trauma surgeon, father of three. I`ve been reading about him tonight. I imagine that must make going to work even harder now.

PATTI: It makes it very hard to go to work. It really does. When it hits home like that. I mean when we lose any patient, it really bothers us.

But when you lose somebody that you`ve worked with side by side -- Dr. Verrier has even cared for my own family members, my uncle, my daughter. I mean, it`s -- and he`s a dear friend. It hits very close to him. Thank you.

MADDOW: Dr. Patti, you sent us footage today that was very affecting, not because you showed us anything that was particularly gory or particularly narrative. You just gave us a point of view video showing what it`s like in the clinical context to be among lots of patients who are -- who need mechanical assistance to breathe. What it`s like to be a health worker in that environment, the sounds of that, the machines, the beeping, the struggling of the patients. It`s something that we who aren`t health care providers almost never see.

I wanted to ask you, though, I know St. Barnabas is not exactly a sleepy hospital under normal circumstances. I know you see something like 1,200 trauma patients a year.

How does what you`re doing now compare to what you normally see? How abnormal is your day in the life right now compared to a busy day in the time before coronavirus?

PATTI: I have to say probably two of the things that struck me the most right from the beginning, Rachel, were having to -- when you walked into the department, the level of noise and the level of assault on your senses was just -- increased it seemed like a hundredfold. The number of machines that were beeping and alarming and making noise and trying to catch our attention was much greater than I`ve ever experienced in the past. And those would be the ventilators because we had so many of them in the emergency department. We were basically running our own ICU down there, and we still are. Tonight when I left, we were still running an ICU.

The other thing is having to wear PPE or personal protective equipment like this for the entire day, nonstop because I can tell you today, I was actually performing an intubation on a very, very sick person who was COVID positive. And what struck me as I was going in to do the procedure was, I thought to myself, I always say a little quick prayer, and I thought to myself, I hope this PPE protects me as well because this guy, I know, is suffering so badly and is definitely infected. And I don`t want to get sick because I need to come back here and work again and help more people.

So those two feelings running through your head, and the other thing that bothers me as well is not being able to have family by the bedside when we work as hard as we are. Many times during normal resuscitations, families are present, and they can see the level of commitment and dedication that we put into each one of our resuscitations.

Here, the patients are alone. They don`t know us. They can`t really even see our faces because we`re all covered with these masks and face shields and gowns and PPE. It really -- it makes it very hard for both the physician and the caregiver as well as the patient. It`s -- it`s unbelievable.

MADDOW: Dr. Patti, I can`t tell you how much we appreciate what you do. I`m hoping -- I`m putting another ask on you on top of everything else you`re doing. But I`m hoping in coming days, you`ll come back to us.

We played tape from you earlier in the hour. You were talking about the hope, that you`re hoping that the numbers are going to start to go down, that things are going to start evening out in terms of the patient load. We would love to talk to you in coming days as these proceeds in your hospital and as you and your colleagues fight this fight for us.

PATTI: I really appreciate that. I`d welcome chatting with you because let me tell you. Sometimes being able to express what goes through your head -- I mean I can tell you when I drive home from work every night, I`m constantly talking to myself, to whoever the creator is, looking for answers. And it`s tough to get them sometimes.

And -- but I just want to remind you and all the viewers out there that this is a team effort. I work in emergency medicine. It`s a team sport. It`s not just one individual.

I could not do what I do without the contributions of everyone that works in this hospital. Everybody contributes so much to help us get our job done, and, you know, I have to applaud all of them. It`s an amazing team that I work with.

MADDOW: All right. And we all do. Dr. Ernest Patti, senior emergency medicine physician at St. Barnabas hospital in the Bronx. I`m going to call you next week, sir. I hope you`ll be able to come back. Thank you.

PATTI: Thank you, Rachel. Stay healthy. Thank you.

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


  MADDOW: Behold the Edgewood Congregation Church, in Cranston, Rhode Island. Services cancelled. God is making house calls.

This is from Athens, Tennessee. Folks, it`s OK if the church is empty on Easter, the tomb was empty, too. Not a bad point.

And this is the Journey of the Faith Church in Maryland. Jesus rode an ass into Jerusalem. Keep yours at home.

Truer words. Happy Easter, everyone. It`s still Easter with everything else. Stay inside.

That does it for us tonight. We will see you again on Monday.

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

Good evening, Ali.

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