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Ireland Gov. TRANSCRIPT: 4/16/20, The Rachel Maddow Show

Guests: Gretchen Whitmer, Joshua Sharfstein


Good evening, Rachel.

RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Thanks, my friend. Appreciate it.

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

The five largest coronavirus outbreaks in the world are number five, Germany, number four, France, number three is world is Italy, number two is Spain, and number one, of course, is the United States. But our epidemic is so huge, at this point, our epidemic is larger than all the other top five countries combined.

The United States as of tonight stands at 667,000 known cases of coronavirus. More than 32,000 of our fellow Americans have now died from coronavirus. And the toll has risen so staggeringly fast.

I mean, February 15th was two months ago, there were zero American deaths from coronavirus two months ago. Last month, March 15th, there were less than 100 deaths nationwide. Today, we`re over 32,000 Americans dead. It went from less than 100 a month ago, to more than 32,000 now, and no end in sight. One of the country`s in Europe that has done fairly well, relatively speaking, in terms of its epidemic, even with what else is going on in the continent is the nation of Ireland.

Ireland and the U.K. both got their first cases around the same time, but the U.K. was slow, like we were, to put in place policies designed to keep people apart, and to keep the virus from spreading. The U.K. government had some strange ideas about maybe it not being important to keep people apart from one another, and it not being important to slow the spread of the virus.

Because of their slowness, the U.K. now has the sixth largest outbreak on earth. Over 100,000 cases in the U.K. over 13,000 dead already. But their trajectory is terrible. Even as the other bad cases, the other bad epidemics in other parts of Europe start to come down the top science adviser to the U.K. government warned this week that the U.K. may end up having the worst epidemic in Europe, before it`s all over, because their trajectory is still up and up and up.

And that does seem pretty directly linked to how slow they were to start their stay-at-home orders, which is an ominous thing, given the fact that in our country, there are still places that have rising numbers of cases, particularly in farm country, in the middle of the country, where they don`t have stay-at-home orders even today. Even as all of those states start to see their numbers rise.

We know what happens when we do that. We know it from watching other countries deal with it. We know it from watching it happen in our own country. We`re making those mistakes now.

But in Ireland, as opposed to the U.K., they`ve got, you know, the U.K. has over 100,000 cases, Israel has less than 14,000 cases. The Irish people have suffered fewer than 500 deaths so far. And 486 is still terrible. But compared to their neighboring countries, they`re doing better. It`s because they moved quickly to keep people apart, to slow the spread of the virus.

You might remember Ireland literally canceling St. Patrick`s Day, canceling St. Patrick`s Day celebrations back in the middle of March. It seemed unimaginable until it happened. But now, in retrospect, it seems like it was of course the right thing to do, and Ireland probably saved thousands of lives and a huge escalation in the ultimate size of their epidemic, just by doing that.

Well, today, interesting development in Ireland. Today, Ireland`s chief medical officer announced some good news about what they`ve done so far in that country but also some very serious news about what they`re going to be doing moving ahead. The chief medical officer of Ireland today put out this statement.

Quote: The first task for Ireland was to suppress the virus in the population at large. We are increasingly confident that we are achieving this. All of our efforts now need to be on extinguishing COVID-19 in our community residential settings, including nursing homes.

I mentioned that Ireland has fewer than 500 deaths so far nationwide. The official death toll there as of today is 486 deaths, which is, as I said, you know, a tragedy for all 486 of those deaths, it is a good news statistic compared to other European countries, in compared to where the United States is, and is heading.

But the Irish government isn`t just looking at their death toll in aggregate. They are counting where people have been dying inside Ireland. And so the Irish government, also knows, an has announced, that of the 486 deaths, they`ve had nationwide, more than 250 of them are nursing home deaths, more than half of their national total.

And so, having had pretty good success, tackling big picture population- wide measures, to keep the epidemic overall as small as possible, they are keeping those measures in place, the Irish prime minister announcing the measures that they put in place to slow the spread of the virus, it will be in place until May, but they`re confident they`re having success and keeping it in place because they know that it`s working.

But as they are keeping that in place, they now have a new priority number one. They are now refocusing their entire national response to try to save the most lives now, by focusing on the place where the most lives are being lost now, by focusing on nursing homes. The prime minister announcing that the government will be providing to nursing homes additional funding, additional staffing, they`re also making nursing homes priority sites for coronavirus testing. Nursing home staff and patients will have priority access to testing above other population groups.

They are also, as a government, redeploying senior staff from the Irish medical service, to improve infectious disease control measures in nursing homes nationwide. And as of yesterday, they have announced terms of a new agreement, in which the government of Ireland is asking health workers who are currently working in hospitals and clinics, and other places in the Irish health service, they`re asking health professionals to please volunteer to start working in the nation`s nursing homes instead, even the privately-owned ones, where regular medical staff from the National Health Service wouldn`t usually work.

The government will pay the health workers salaries for working in nursing homes. The government has agreed to provide all of the PPE, all of the personal protective equipment those health workers will need to work in nursing home environments, and this new deal, just announced by the Irish government, is not just for doctors and nurse, although it is for them, the government is also asking for health care assistance and cleaning staff, and even catering staff to volunteer to do the same.

More than half of their deaths in their country from this epidemic are their elders, in nursing homes of all kinds, including those run by private businesses, and charities. But the government recognizes that that`s where they`re losing the most of their citizens, to this virus. And so, therefore, it has become priority one, for that national government, to surge resources, and staff and expertise into those facilities, to break existing rules about who works where, to take responsibility for paying the people who need to be in there to do it, to repurpose resources from other places, to get those places in the front of mind. To put those places in the bull`s eye in terms of where resources are being targeted and where the most energy is being expended, to try to save the most people who are at the most risk of dying. That`s what they are now doing in Ireland.

You know, we could do that. Just imagine. We could do that, too. And it would make just as much sense to do it here as it would there, as it would anywhere. Where are you losing the most lives? Where are you slated to lose the most lives, as this thing moves forward?

Focus there. It save the most lives. We could do that. I don`t think we`re going to do it, at the national level, not with this government. The Trump administration at this point is refusing to even monitor the situation in American nursing homes. Let`s alone provide them resources to fight this thing.

Hell, they`re not even giving them individualized guidance on how to fight coronavirus. They`re just letting nursing homes figure it out themselves. You know, good luck, and maybe not even that.

But I know some states are starting to try to take this seriously. So maybe individual states could try that Irish model. Maybe groups of counties could try this together. Maybe small consortiums of states could get together, and try this regionally. If that`s easier than individual states trying to do it on their own, or individual municipalities and counties trying to do it on their own, I don`t know how the economies of scale work here, whether this is easier to do on a smaller scale or a larger one.

But we`ve got try something, because it can`t just keep going like this. Nursing homes can`t be left to just do this on their own. Today, NBC News up dated its count on deaths in American nursing homes.

The NBC News count as of tonight finds that 5,670 Americans have died of coronavirus in nursing homes, that we know of. But that`s only based on data from 29 of the 50 states. There`s 21 states who didn`t provide any count to contribute to that number at all. And the number was still well over 5,000 dead.

NBC`s data indicates that in New York state alone, it appears that more than 2 percent of all residents in nursing homes have already been killed by this virus, more than 2 percent of New York residents in nursing homes, 2.3 percent appear to have already been killed by this thing.

How do you think that number`s going to go? How high do you think that number is going to go in your state? How good of a state is your job doing on this?

Today, the Pennsylvania state government started providing breakout data on deaths in nursing homes specifically. It`s the first time they divided up their data that way, and their numbers show that more than half the total deaths in the state of Pennsylvania from coronavirus have been in nursing homes so far, 52 percent of the state`s deaths, which is terrible. It`s astonishing.

But honestly, it gives you a place to focus. It tells you where to work, right? It lets you know, clearly, where you need to start focusing, if you want to save the most lives. Look at -- look at the front web page of any local paper in any corner of the country. Just pick one, at random, any corner of the country that you please.

Look at the smallest paper you can find. If it is a daily paper, you will see the same story. Look for example at "The Times Tribune" from Scranton, Pennsylvania. News there today of one nursing home in Scranton called the Jewish Home of Eastern Pennsylvania, they`ve had 12 residents die in the past nine days.

Well, if the country wants to save lives, in the state of Pennsylvania, if the state wants to save lives, if the community around Scranton wants to save lives, hey, bull`s eye, there`s a place to start. Do the most work where you can do the most good.

We know there is a type of institution where most American deaths are coming from now. That`s where we need the most energy, the most innovation, the most resources, the most help. And don`t get mad at the nursing homes. Certainly don`t get depressed by the situation in the nursing homes and despair and decide nothing can be done.

We`re Americans. We`re American citizens, alive in the middle of this crisis. This is our pandemic. These are our lives. This is our responsibility.

When you know that the most numbers of Americans, the highest numbers of Americans are dying in the same type of institution everywhere, it means we need to focus on getting help into those institutions. It doesn`t mean that we write them off and say oh, yes, I guess everybody`s going to die there, not in our lifetime, no the in our country, not if we have anything to do with it.

We reported a few days ago on a soldier`s home in rural Louisiana. Do you remember the statistics about the highest death rate per capita in the whole country being in St. John Parish in Louisiana? St. John Parish, that county, having the highest per capita death rate from coronavirus in the country, that was driven by the fact that more than 40 residents had died in a single veterans home, in a town called Reserve, Louisiana, 44 dead.

Today, in "The Times-Picayune" newspaper, that veteran`s home is celebrating two things. Number one they have celebrating that they have had their first two day stretch without a death. They haven`t had a death in two days. Also, they think they might be able to get the rest of the residents in that home tested, sometime soon. Soon. That`s the other thing they`re celebrating.

I mean they`ve just been told they might get enough tests to test the other residents, in a home where 44 residents have already died. If you were in a living facility where 44 people had already died, you would think that you would be a priority for testing. Not only in St. John Parish. Not only in Louisiana. But in the country, right?

I mean, I`m glad they are getting those tests, but you can see how bad that is, right? If a facility is closing in on 4,000 deaths among its residents doesn`t qualify as a priority site for testing, everybody else in that facility for weeks, what are we doing in this country? What are we focusing on instead of that? Why aren`t we trying to keep the most people alive? Why aren`t we trying to save the most vulnerable?

Last night, "The New York Times" reported on a facility in Andover, New Jersey, where on Monday, this week, police got an anonymous tip about a body being stored in a shed outside a large nursing home in this small town. And when police turned up, they did not find a body at the shed, but they did go inside and they found 17 bodies filed up inside the facility. That facility has reportedly had 68 people die recently, including two of its nurses.

And the pace of death in that facility in New Jersey was more than the institution could keep up with, in terms of getting people into the morgue, getting people out of the morgue, and into funeral homes, they couldn`t handle the pace of the epidemic there, just ripping through that facility, of elderly and fragile people. There are still hundreds of older people living inside that facility, right now, as we speak.

And today, the local police chief, and the mayor of that small town in New Jersey talked to reporters about what has landed in their town, what on god`s earth they think that they might be able to do about it.


ERIC DANIELSON, CHIEF OF POLICE, ANDOVER, NEW JERSEY: Monday evening, we were -- or Monday afternoon, we had received an anonymous complaint regarding a body that had been in a shed. Upon coming here, to determine if that was true, the body had already been removed from the shed and placed back within the -- inside the facility. In order to help them, as they were being overcome with apparently, it would be by the numerous amount of bodies, we facilitated a transfer of 13 bodies from the facility.

It was overwhelming, I think, for the people that were inside, the staff. The staff was overwhelmed by the number of bodies that were becoming deceased.

MAYOR MICHAEL LENSAK, ANDOVER, NEW JERSEY: What we`re doing is asking the state to step up and help us out in any way we can, because we don`t have the staff to be able to come in and do anything with them. I mean our township, we have 12 police officers, and a town staff of maybe a dozen people. So, none of them are medically trained to go in and assist.

I give kudos to our volunteer EMS squad that came in and removed 13 bodies, the other day, to assist. There are 17 bodies, they were left -- they kept four bodies in the facility, that`s what they`re capable of handling, but the overflow was taken to Newton hospital.

DANIELSON: We`re on understanding that they`re understaffed. We would like to get them some help staffing-wise. We understand there are more additional resources needed in the sense of PPE.

Again, as the mayor indicated before, PPE was dropped off yesterday by the county officer of emergency management, so we want to help facilitate in any way we can more additional PPE. We will gladly accept donations of PPE at our police stations and make sure they get to the facility and in order to help the staff members who are truly, again, like nurses at hospitals, it`s the same type of atmosphere here, working the front lines with this pandemic.


MADDOW: They got a tip about at least one body being put out by the shed outside. The police showed up, and ended up hauling 13 bodies, they left four more behind, they just took the overflow bodies, they had apparently been 68 deaths at that facility already, and the way, and this is happening right now, in the United States of America, and the way we are dealing with this as a country, is to hope that Good Samaritans with spare PPE, maybe you work at an auto paint shop, and you`ve got a respirator you could loan us.

Regular, the hope -- the way we`re dealing with this, is that we`re hoping that regular citizens with spare PPE might be able to drop off some spare materials they have on hand, at the local county office. And then the local cops will then try to drop that stuff off at the door, or maybe they will bring it the next time they get called about the bodies stacking up there again?

I mean, this is where -- this is the kind of facility where Americans are dying in huge numbers. And that one`s in New Jersey. But it`s all over the country. I mean, in Massachusetts today, Belmont, Massachusetts, a facility considered to be a very well-run facility, a five-star facility, they had reported 13 deaths as of Saturday. As of today, there are 27, right?

You can be a poorly-run facility, you can be a well-run facility. That is ultimately going to make a difference, but even in well-run facilities, Americans are dying in huge numbers in concentrated places that we can see and identify and help if we choose.

I mean, where we are counting the deaths in nursing homes, it turns out that nursing home deaths are often the majority of people who are dying in a particular region or a particular state. Mostly, though, we`re just not counting them.

The federal government is not tracking this. And if the federal government isn`t tracking this, then, you know, the state or even local communities are going to have to figure out a way to help these places, to get medical staff in there. Not all a-lot of medical facilities have a lot of medical staff. But they need them now. They need medical staff added to the regular roda of people who they`ve got working in those facilities.

They need medical help. They need protocols for how to handle this right and supplies to be able to fulfill those protocols. They need priority and regular access to testing. They need to be visible and connected to the larger health care response that we are seeing in the hospitals, but that we are not seeing in these places.

When the police chief there, from that town, where they have had 68 dead, where they had to come in and haul out 14 bodies of overflow from the morgue this week, because they got an anonymous tip about bodies stacking up, when that police chief said that these people are just as much on the front line of this pandemic as the nurses and the doctors who are we are applauding every night from our window sills, that`s exactly right, except they, in some cases, are dealing with more death, with less equipment, with less training, and with no visibility, and no help.

I mean, the federal government should be doing this. They`re not. We can`t wait for them to start doing it while we let this many Americans die every day. And some places are trying.

The Democratic congressman who represents that part of New Jersey, or that facility is, where we just heard from the mayor and the police chief, he says that when he heard, when he got a call in his office, asking that facility to please source body bags, he says he asked FEMA, he called FEMA, to inquire about please, maybe sending in some national guard medics to that facility. That`s an option. FEMA does not seem to have reacted to that request. But that request was reportedly made.

In New York state, New York`s governor, Andrew Cuomo, has this week started to announce every day the number of deaths specifically in nursing homes when he announces the total state death toll. He goes out of his way to say how many of those were in nursing homes. He is starting to get more and more pointed questions about nursing home death tolls and which facilities need the most help.

Maryland and Virginia, the governors in those two state, one Democrat, and one Republican, have formed state task forces, joined forces there, in those two adjoining states, to form these multi-agency task forces, including the national guard to go into nursing homes to try to assess crisis situations, to try to prioritize supplies into those facilities, to try to organize help.

The mayor of Seattle this week, Seattle has been so hard-hit. This week, asked firefighters to take over testing in nursing homes, which is one way of making sure that nursing homes are priority testing sites. Firefighters had tested first responders in Seattle as priority testing targets and now she`s asking firefighters to please target nursing homes.

In the great state of Michigan, which has the third largest number of cases in the country, the governor of Michigan just in the past day, signed a state-wide executive order that directs nursing homes in Michigan to start reporting any COVID cases among staff or patients to the health department, to create separate housing, for residents with coronavirus, to provide PPE to all employees who are working with any coronavirus patients, to send any medically unstable patient to the hospital. Her executive order covers a number of things that nursing homes need to do better and that they need help with, in order to stop the tide of death through these facilities where more Americans are dying than in any other place. And that at least is a start.

We`ll talk with Michigan Governor Gretchen Whitmer next. Stay with us.



REPORTER: Every day, we report on the numbers of cases and deaths here. Each number represents a member of our community who has died. There`s no secret that the city of Detroit has been hit hard.

These containers with the words, short and long-term refrigeration rental on the side of them, can be seen in the parking lot here at Sinai Grace Hospital Tuesday. Our cameras there, as crews placed what staff members, tell me are bodies inside these refrigerated containers from inside the hospital.


MADDOW: That`s a local news report from one hospital in Detroit, Michigan, this week.

Hospitals across Detroit have been struggling, with the flood of coronavirus patient, there has been staffing concern, there`s been PPE concerns. Overflow facilities have been set up in Detroit.

Michigan has over 29,000 confirmed cases. Today, the state passed 2,000 deaths. That gives Michigan the grim distinction of having the third highest death toll in the country after New York and New Jersey.

Given that, it is -- surreal is not the right word, but close, it`s remarkable, at least, that this was the scene yesterday outside the Michigan state capital, Confederate flag-waving, Trump 2020 flag-waving people out on the street and ultimately blocking traffic in protest of the Michigan governor having a stay-at-home order in place.

These protesters demanding that the governor just rip the lid off, open it back up, let folks get back to business as usual, why all this overreacting? It`s only more than 2,000 dead and counting.

Tonight, in Michigan, Republican state lawmakers are trying to force an end to the governor`s declaration of the state of emergency. And also four sheriffs in northern Michigan now say they will not strictly enforce the governor`s order to try to limit the spread of coronavirus.

Between the scale of the outbreak in Michigan, which is quite significant, and the political pressure there, and Donald Trump tonight telling states, basically, it`s up to you guys, do whatever you want, who am I to say, how -- how does Michigan specifically get through this crisis?

If you were the governor of Michigan, how would you proceed through this minefield?

Joining us now for the interview, I`m pleased to say, is Michigan Governor Gretchen Whitmer.

Governor Whitmer, I know you have so much on your plate right now. Thank you so much for taking time to talk with us.

GOV. GRETCHEN WHITMER (D-MI): Yes, glad to be with you, Rachel.

MADDOW: So, I mentioned that your state is it in pretty dire straits in terms of the scale of your epidemic. You have gone over 2,000 deaths. You have the third highest death toll in the country.

Can you just give our viewers a sense of where you think you are in terms of your position on the curve, and what you`re most worried about in terms of the impact of the epidemic in your state, in the coming weeks?

WHITMER: Sure, so, you know, we have taken an aggressive stay-at-home order stance, similar to a lot of other states right around us, both Republican- led and Democratic-led. This is not a partisan issue. COVID-19 does not respect party lines or state lines, and that`s why we all got to be in this together.

The -- what we`ve seen is the curve looks as though it`s flattening. We`re pushing the curve down. That means we`re saving lives. That means we`ve saved our health care system from being completely overrun and inundated.

That means fewer people are getting sick. It comes with a sacrifice. There is no question. People are -- all people are making a sacrifice right now.

But I think the thing that I`m concerned most about, and that I think my fellow governors are as well, is a resurgence. When you see a -- you know, a political rally, that`s what it was yesterday, a political rally like that where people aren`t wearing masks and they`re in close quarters and they are touching one another, you know that that`s precisely what makes this kind of a disease drag out and expose more people.

People can converge together in Lansing and then they went back out to their homes across the state of Michigan, you know, the odds are very high that that`s, they`re spreading COVID-19 along with it. And so, it`s that kind of irresponsible action that puts us in this situation where we might have to actually think about extending stay-at-home orders, which is supposedly what they were protesting.

MADDOW: I know that you have joined a regional plan along with other Midwestern governors. It`s -- you, Michigan, plus Wisconsin, and Minnesota, Ohio, Indiana, Kentucky, Illinois, to try to work together, as governors, in that big region of the country, to work, essentially, with policies that are copacetic, that makes sense on a regional level, that you`re not undoing one another`s good work in terms of the way that you proceed.

You guys are a pretty diverse lot. How hard was it to come together of a group of that size to agree that this is a common cause?

WHITMER: Well, you know, one of the things that I have come to appreciate in this awfully tough situation is that there are a lot of other governors who reach out, we share our best practices, our thoughts. We`re listening to one another, listening to our experts, and sharing that intelligence.

You know, Mike DeWine who is my neighbor to the south in the state of Ohio, Republican governor, my friend J.B. Pritzker over in Illinois, a Democratic governor -- you know, this group of seven governors, Republican and Democratic alike, know that our economies are similar, know that we have shared borders, and it`s important for all of us that we get this right.

If one of us just takes away all of the precautions, and we`re out of this miraculously, we`re back to normal life, that means COVID-19 is going to spread, and so a regional approach really made a lot of sense to us. It doesn`t mean we`re all going to do exactly the same thing at the same cadence, but we are going to be sharing our practices, how we`re going to do it, we`re going to be talking regularly to make sure that as we are determining case load, and testing, and, you know, all of the mitigation tactics that we`ve -- that we`ve been able to pursue, and see what the numbers mean, that we`re making the best educated decision based on the best science and always centered around the health of our people.

MADDOW: One of the places in which you are sort of out ahead of your fellow governors, even regionally, is this executive order that you`ve just issued about nursing homes, and we`ve been trying to keep the spotlight on nursing homes, in large part because I -- even when I try to talk about other things, I find myself being unable to think about much else, because I`m so concerned about what I expect is going to be the ultimate death toll and what we`re already seeing in terms of the death toll really piling up in American nursing homes.

This executive order you issued has a number of different components. You`re mandating that nursing homes report their cases. You`re mandating that they find a way to separate coronavirus patients from non-coronavirus patients, and that they indeed may have to send patients to regional hubs if they`re small enough facilities, that they can`t manage that kind of separation on their own.

What kind of principals did you consult, what kind of expertise did you consult to come up with this list of imperatives for nursing homes because you`re really cutting some new terri -- cutting a new path here in a way that other states haven`t done?

WHITMER: Well, we know that our older populations are, you know, uniquely at risk here, in this moment. And so, it`s important that we are taking extra efforts to protect people.

One part of the executive order also is that employees of these nursing homes can`t get fired if they don`t come to work because they`re ill. That is an important piece because we know low wage workers who don`t have paid sick leave and don`t have health care are compelled to go into work for fear of losing their jobs. And that`s one of the contributing factors to the spread of COVID-19, and in a nursing home, it`s particularly dangerous.

And so, we`ve been working with our experts. We`ve been working with, you know, people that work in our nursing homes to see how -- what actions do we need to protect this uniquely vulnerable population in our state.

MADDOW: Governor, I have to ask you, and I`m sure you know it is coming. I know it is probably all the national discussion about you, it`s probably been a distraction while you`re dealing with this crisis in your state, but as Joe Biden enters into his -- the phase of his candidacy in which he needs to be thinking about a running mate, a lot of people have talked about you.

If Vice President Biden asked you to be his running mate, would you say yes?

WHITMER: You know, Rachel, I`m not going to -- I`m not going to even go there with you. I`ve got my hands full with COVID-19, and trying to save lives in the state of Michigan. This is the job that I worked for two years to get.

I am grateful, even on these hardest days where there`s rallies outside my window, where I`m worried about the health of the people rallying and I`m on the -- on the Zoom with, you know, health care providers who are telling me about cold storage, and efforts that they have to do to -- the herculean efforts that they`re making to save lives.

And so, I`m not thinking about politics right now, I am focused 100 percent trying to do the best I can as the governor of Michigan, and I appreciate your effort, but I`m not going there with you.

MADDOW: I hear you. And I absolutely respect you for it, and more broadly.

Governor -- Governor Gretchen Whitmer of Michigan, you really do have your hands full, Governor, in terms of the serious situation in your state. Come back any time, anything that you want us to help get the word out nationwide about what`s happening in Michigan, and what you need, just come back and let us know.

WHITMER: Thank you.

MADDOW: All right. Much more ahead here tonight, including checking in with nurses and doctors in one of our hardest-hit states, who have a take on this that you might not expect. That`s coming up next. Stay with us.



UNIDENTIFIED MALE: I don`t think anybody expects to go to the hospital, to end up in the ICU, and not to come home. We`ve seen certain families where everyone has been affected, you know, every member of the family has either gotten the virus or multiple members have died.

DIRECTOR OF NURSING, NEW ORLEANS EAST HOSPITAL MEDICAL SURGICAL UNIT: New Orleans east is normally a very small community hospital. With COVID-19, our world has been turned upside down. Patients that we`re seeing are very, very sick.

Unfortunately, we`re seeing a lot of patients, they are not getting better. We`re seeing them get worse and they die. And that`s the reality of it. We`re having to hold their hand, and be that family member with them as they go.

This is bringing out the best in the nurses. Because their compassion is just, it`s a beautiful thing to see. Nurses calling to say, hey, do you need me to come and work? Do you need me tonight? I may not be able to do a full shift but I can do four hours just to help out.

They don`t care, I work in this department or I normally do this, just where do you need me? And then just ready to go to work. They want to make sure these patients are well taken care of, because we all live in the community. These are our neighbors, our friends, that are in these beds, and we don`t want to see anyone else succumb to it.

EMERGENCY DEPARTMENT CHARGE NURSE, UNIVERSITY OF MEDICAL CENTER, NEW ORLEANS: Taking care of patients that are in the hospital, are intubated, and, you know, on a ventilator, not doing so well, that`s when it becomes really heart breaking because now you don`t have family members that are at the bedside with these people, it gets personal, very sad times. You don`t know if this is the day that you`re going to contract this virus, or if this is the day that you`ll be personally affected by it with one of your family members.

DR. SCOTT MACKEY, LCMC HEALTH, NEW ORLEANS, LA: It`s pretty terrible, to be totally honest. Like the entire world is flipped upside down. So before, we would see, you know, one isolation patient, maybe every couple of days in the E.R., now we`re seeing every single isolation patient every day in the E.R. We`re using a month`s worth of PPE in one day right now.

So before, we would use 2,500 masks in a month, and now we`re using 2,500 masks in a day, as a hospital system. You can see the nurses text all of the patient care people, even housekeeping, the same, the same boat which is kind of nice everybody is, all of a sudden, on the same, very strange team, that they have done a lot of things to work together, to get PPE groups that they`re sharing stuff with each other, they`re buying their own supplies that they need.

That`s what America needs to do in their health care system is, get all of those supply lines working, get all of this testing that keeps being talked about to actually function.


MADDOW: That`s what America needs to do to support their health care system is get all of those supply lines working, get all of this testing that keeps being talked about and actually functioning. A snapshot from New Orleans from nurses and doctors in the hard hit state of Louisiana where yesterday and the day before were the two highest daily death tolls yet.

We`ve been trying to stay in touch with lots of front line health providers all over the country to bring their first person perspectives about what`s going right and what`s going wrong.

The last thing you heard there from Dr. Scott Mackey in New Orleans, when he said we need to get all of this testing that keeps being talked about actually functioning, that`s what America needs to do to support our health care system, it turns out there is another physician like Dr. Mackey in New Orleans, who happens to be in a really influential position, who happens to have a really good idea about how to make a specific part of that happen.

That good idea and that doctor are here next.


MADDOW: As the White House continues to push out fantasy happy talk about how ready the country is to open back up, while a state like South Dakota still doesn`t even have a stay-at-home order despite the fact that they`ve got a huge cluster of more than 700 cases, emanating from a single meat packing plant, while the idea of testing of everyone in America remains a fantasy, let alone then tracing the contacts of every positive case, while the reality of raging American epidemic continues unabated and the White House continues to pretend it`s all under control and we`re about to get over it.

A not so modest proposal has been put forth in the Journal of the American Medical Association. Quote: The U.S. should consider suspending the first year of medical school for one year and giving the incoming 20,000 medical students the opportunity to join a national service program for public health. The program should begin at the start of July, incoming medical students should spend the month in online training in infectious disease epidemiology, infectious disease control and high risk setting, and outbreak response.

In August, students should deploy to state and local public health departments to enhance the capacity to support a test, trace, track and quarantine strategy. The federal government should fund this project as a national service effort with a salary for the students and health coverage. Along with testing and tracing, the medical students should be deployed to nursing homes and prisons where coronavirus is, of course, tearing through those populations absolutely unabated.

It`s a novel idea, but one that seems oddly rational given the fact that we don`t really know what the people who would otherwise be first-year medical students are going to be doing this fall anyway. Doesn`t this seem like kind of the perfect thing to apply them to?

Joining us now is Dr. Joshua Sharfstein. He`s one of the authors of that article in "The Journal of American Medical Association". He`s a public health professor at Johns Hopkins.

Professor, thanks very much for being here. Appreciate your time.


MADDOW: I am just a layman observing these things and reading the news every day, and trying to understand what`s happening. But it seems to me from my admitted position of ignorance that we really do need a kind of public health corps, a public health pseudo-army to do really labor intensive work both in terms of infectious disease control and the kind of contact-tracing that really is data-driven, you know, phone work and computer work to get this thing under control.

Is that your sense in terms of our national need for manpower here and why would this be the right group of people to do it?

SHARFSTEIN: Absolutely. What we need to do is slow the spread of the virus and one way we`ve done that so far is through this extreme social distancing.

But if we`re going to ever be able to open up, you know, absent a transformative treatment or vaccine, we`re going to have to be able to slow the spread of the virus without shutting everything down and the way you do that is find the people who are sick as quick as possible through testing. We make sure that they isolate and give them support to isolate themselves. You find their contacts and before their contacts become infectious, you quarantine them and give them support to be able to stay in quarantine and that all takes people. It takes resources, and it`s a huge commitment but one that we can do.

It probably will take about 100,000 people in the United States and a down payment on that number could be medical students who volunteer to do this. We also think other kinds of students, public health students, but also people from affected communities could be doing it because really, we`re going to need a tremendous work force and a National Health Service program for public health do you remember a way to do that.

MADDOW: And what kinds of entities would do the right kind of training for folks to do this sort of thing? We`ve seen in Massachusetts a big effort to hire up 1,000 people to do contact tracing. That`s the state in partnership with the big, non-governmental organization that has the history of doing this, particularly in developing countries abroad.

If we were going to try to do this sort of thing nationwide, is it a federal agency that we will be well-positioned to do this training or would you expect medical schools would be the right place to train the cadre of people that you`d need to do this kind of work.

SHARFSTEIN: Well, I think public schools will play a big role in the training and then you`d have a national service program and people could deploy to different places. They could be helping to staff partners in health, which is a great organization in Massachusetts or local health departments or state health departments, depending on the strategy that is chosen but you`d have, like, a trained work force ready to go to do all kinds of work, not just finding individuals and figuring out their contacts but talking about -- talking to them about the importance of staying isolated and quarantined and also, meeting their needs.

We don`t want people to say they`ll stay at home but really got to get out and get food. We got to figure a way to get them food. In some cases, people may need some income support to be able to stay at home. It`s money well-worth spending because what we`re doing is stopping the virus from passing from person to person.

MADDOW: Dr. Sharfstein, I only got about 30 seconds here, but let me ask you one important question, I have lost my faith that the federal government and that national efforts are going to come together in time here. Does this kind of idea you`re talking about scale so that it could be done by individual states or small consortiums of states?

SHARFSTEIN: It could. It could be done that way. Of course, like many things, it would be better if it were federal, but if that`s not in the cards, a group of states could figure out how to do that.

And I think that would help because you would get a lot of people well- trained, ready to serve and play this important role that we really need right now.

MADDOW: Dr. Joshua Sharfstein, public health professor at Johns Hopkins -- thank you for being here and talking about this idea. It`s really constructive, thanks.

SHARFSTEIN: My pleasure.

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


MADDOW: I want to tell you tomorrow night, we`re going to be joined by Governor J.B. Pritzker of Illinois, who among other things has recently been involved in a pseudo secret effort this week to fly chartered planes full of medical supplies into Illinois basically under the radar in order to evade the federal government, so the federal government wouldn`t steal those supplies, like they have from other states.

We`re going to talk with Governor Pritzker about that and lots more tomorrow night live. We`ll see you then.


Good evening, Lawrence.

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