protective gear TRANSCRIPT: 4/21/20, The Rachel Maddow Show

Guests: Alexandria Ocasio-Cortez, Ben Kesling

ALBERT SAMAHA, BUZZFEED INVESTIGATIVE REPORTER:  -- factor that both the governor and the company have cited is the fact that a lot of their workers are immigrants who live close together.

CHRIS HAYES, MSNBC HOST, "ALL IN":  Yes. Albert Samaha, who along with Katie Becker (ph), did some phenomenal reporting about this plant. It`s one of several that have really bad outbreaks. I want to keep on this story.

Thank you very much.

SAMAHA:  Thank you.

HAYES:  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. I`m happy to have you with us tonight.

I would like to start tonight by introducing you to someone. This is Hannah Blakley. She is a nurse in Avon, Indiana.

(BEGIN VIDEO CLIP)

HANNAH BLAKLEY, NURSE, IU HEALTH WEST HOSPITAL, AVON, INDIANA:  Hi, my name is Hannah Blakley, and I`m a nurse in IU Health West Hospital in Avon. I work on a med surge floor that is currently all COVID.

I think one of the biggest things for me in the mornings is the car ride over to the hospital. Every inch I get closer, the anxiety has gotten bigger. And the anxiety is mostly just from, is this the day that I bring COVID home to my husband? Is this the day that I walk in and my patient is on hospice and their family won`t be there with them during their transmission?

Is this the day, you know, that is the end of my -- my stick? You know, am I going to lose it? Is my coworker going to lose it?

Just remember to stay home. We are fighting for you on the front lines. And the biggest thing you can do is stay home, wash your hands, make sure that you don`t end up in my hospital.

(END VIDEO CLIP)

MADDOW:  Make sure that you don`t end up many any hospital. I feel like we`re in this moment in terms of media coverage of this crisis where you`d think that everyone off the coasts is not only fine, they`re all chomping at the bit to wind down efforts from the coronavirus and to keep people from getting sick. I feel like if you just look at American media right now, you might have that impression.

The polling of the American public doesn`t suggest that`s what people believe at all, even if that`s how the media is portraying. Americans by huge proportions recognize that what we`re doing right now to slow down the spread of the virus is necessary and prefer that we don`t dump those policies too soon and thereby endanger ourselves and put ourselves in even worse shape than we are now.

But, you know, don`t take it from the polling. Don`t take it from me. Front line health workers across the country are telling this story very, very well themselves about this not being something that is just on the coasts and this being something that we need to take seriously. I mean, whether it`s the nurses and health workers and their masks standing silently in front of the fringe traveling Trump rally we don`t believe in coronavirus protesters that we`ve seen in a few states, or whether it`s them taking time in the middle of this crisis, in the middle of their work days to just tell us what it is that they are dealing with.

(BEGIN VIDEO CLIP)

MEGHAN DANCY, NURSE, ST. LUKE`S HOSPITAL, CHESTERFIELD, MO:  Hi. My name is Meghan Dancy, an RN here at St. Luke`s Hospital in Chesterfield, Missouri. I just finished a 12-hour day shift on division 9,700. It`s one of the med surge divisions here at St. Luke`s.

For about three weeks we`ve been designated COVID unit, along with the entire 9th floor here at St. Luke`s. I`ve been a nurse for 11 years and I have to say this is something that I`ve never seen before. These patients are very sick. They deteriorate quickly.

The first shift I had after we were completely designated COVID floor, I transferred three of my four patients to the ICU to be intubated. These patients were young, about my parents` age. So, that weighed on me personally.

They were alone, you know, family or friends -- we have no visitors here right now. These patients are alone and they`re trusting us to take care of them. Their families are trusting us, and it`s scary.

I have a 4-year-old, a 6-year-old, and a husband at home. And that`s one of my biggest fears. I drove home that night, that first night, and I just cried because I couldn`t -- I really couldn`t fathom the thought of bringing COVID home and exposing my family to that. That would be something if had an ill outcome, I don`t know that I could bear that.

That`s -- but that`s just the reality of where we`re at right now. We are here in the middle of the country so we`ve been able to kind of take some ideas and kind of have a little bit of an idea of what we`re going to experience because we`ve seen on the coast before it came here.

But I`m telling you, like, I couldn`t fully understand or even -- I couldn`t -- I wasn`t prepared for what we saw, what we`re seeing. It`s definitely something new, something we have never seen before.

(END VIDEO CLIP)

MADDOW:  Just one thing to see it hit first on the coasts like she`s saying there.

But, A, what that`s supposed to do is buy you time to prepare. And B, seeing it hit somewhere else doesn`t necessarily prepare you even as a health care worker for the magnitude of what is coming when it comes. So, that`s an RN in Missouri.

I also want to show you this which I think you should see this. This is from a trauma nurse who was working with coronavirus patients at Stony Brook University Hospital, which is on Long Island, outside of New York City.

(BEGIN VIDEO CLIP)

AMY PACHOLK, SURGICAL TRAUMA NURSE, STONY BROOK UNIVERSITY HOSPITAL, NEW YORK:  I listen to politicians speak on TV, reporters speak on TV. We always have the TV on listening to some sort of news. And all I keep hearing is that the curve is flattening. The curve is flattening, the curve is flattening. It`s working. Stay at home, stay at home.

So, that may be true, but all the ICUs are still full. They`re full. The sickest people are still there. Some people are getting extubated, but the truth is that there are still people on the floors that need to be intubated and come to us.

So, I mean we may have a bed or two available but it`s not like we`re emptying out. If, you know, if we choose to open too soon, we`re going to be at capacity. We`ve already used our reserves. There`s, like, nothing left.

We are maxed out. We have these wonderful nurses from Syracuse helping us out where we are. If it wasn`t for them, we would all be dead. I had a crazy day today. We were super busy.

I just -- I just can`t imagine what people are thinking. The ICUs are full. We really can`t open. We can`t open this country. We can`t open the tri- state area. That`s for sure.

None of us in the downstate area of New York can even handle anything more. There`s no way. We`re full. If you want to live, stay home.

My God, don`t open up this country. It needs to be closed until at least June, please.

(END VIDEO CLIP)

MADDOW:  Please. When she talks about the tri-state area, she means New York, New Jersey, and Connecticut which as of today, those three states alone have had more than 20,000 deaths from coronavirus just between them. Three states account for more than 20,000 deaths out of the 44,000 plus deaths that we`ve had in the country at large.

And that is a tragedy for the tri-state area. It tells you something about how beleaguered health workers and health resources are in the tri-state area. It tells you something about why. It`s also an opportunity for the rest of the country to watch that and learn from it, to use that time of those places going first before it starts to scale up in the rest of the country like that.

Because the tri-state -- because New York first and then the tri-state area went first, it has been doctors and nurses working in the tri-state area making so many of these first-person recordings about what they`re going through and what they`re seeing. You`re seeing doctors and nurses in the middle of the country saying don`t underestimate this. You see doctors and nurses in the tri-state area where they`ve been absolutely overtopped saying you need to prepare for how you are going to cope here, right?

They`ve been trying to let the rest of the country know to not underestimate this thing. It`s interesting, we`ve been watching these front line reports day after day after day as they come in. Particularly this week, what we`re starting to see from people who work in hospitals in the hardest hit areas is that they`re trying to let people know, first of all, patients are incredibly sick and they`re incredibly hard to bring back from the brink.

But also we`re seeing a lot more young people than you might president exam. So, do not feel immune if you are not 60 or 70 or 80 years old.

(BEGIN VIDEO CLIP)

DR. ABDEL BASSILY-MARCUS:  We had a very busy day, a lot of emergencies on both sides of the unit, go from one patient to another. Interestingly, a lot of our patients are young with no past medical history unlike the common knowledge that it only affects older patients with a lot of comorbidities. That`s not really what we`re observing here.

We have a lot of young patients. This patient here who is unfortunately at the verge of being intubate. We`re trying to save her. Don`t be surprised if she`s going to be on the ventilator by the end of the day.

DR. HAMID SHAABAN, INFECTIOUS DISEASE SPECIALIST, ST. MICHAEL`S MEDICAL CENTER, NJ:  Today was a difficult day because we lost two young patients who are under the age of 50. No matter how many times we lose lives in the hospital, especially during this COVID-19 crisis, we will never get used to the loss of the young lives.

ASHLEY WAY, TRUSTAFF TRAVEL NURSE, MOUNT SINAI HOSPITAL, NY:  We ended up getting a patient in a room that -- I mean, she was basically dying. She was very unstable. We were too worried to move her upstairs because -- sorry. We were afraid that she would die in the hallway.

So, Mount Sinai has Zoom set up where they can bring the iPads in the room, and they get the family on the phones to make a phone call. To say their good-byes over Zoom because we`re not allowed to have any visitors right now.

So, I`ve never had to see anything like that ever. So, it was pretty tough in that sense. I`ve never had to see anything like that ever, not having someone at their side while they`re sitting there dying and just watching their blood pressure drop slowly and their oxygen levels drop slowly. And, you know, It was tough, for sure.

DR. MATTHEW BAI, E.R. PHYSICIAN:  The volume is down but they`re coming in sicker. So, when they come in, they can be to the extreme where they have no pulse already or they`re coming in breathing really fast and hypoxic with very low oxygen level and cold and blue, some of them. And this is -- this seems to be the course of COVID-19.

When they do come in and they need a lot of work, it`s a lot of work and stressful on us. And it`s even more stressful when the young patients come in and they don`t end up making it. It takes an emotional toll on everyone. It makes us realize that everyone can be affected and actually kind of scares me a little bit because when I get it, there`s no telling if I`m going to be a mild case or a serious case.

The sobering thing is these patients aren`t the ones you expect to come in severely affected by COVID-19. Those cases are especially emotionally taxing, because they were previously healthy and had a family and, all of a sudden, this happens and everything changes in the blink of an eye.

(END VIDEO CLIP)

MADDOW:  That`s Dr. Matthew Bai who`s an ER physician at Mount Sinai Hospital in Queens.

Again and again from these front line providers, particularly in the areas that have been hardest hit so far, they are saying take this super seriously. People are super sick by the time they get to us. And do not feel immune if you are not an older person. We are seeing lots of people including younger people without comorbidities.

You see health workers saying, please take this more seriously than you are. The workers that are in the areas hardest hit are broadcasting that not only to us, the public, across the country but to their fellow health workers in other places in the country that haven`t been hit that hard yet telling them what`s coming.

But that last doctor, as I said, works at Mount Sinai in Queens. Queens and the Bronx, both neighborhoods in New York City, they`re both part of the 14th congressional in New York. And the 14th congressional district in New York is represented by the high profile freshman Congresswoman Alexandria Ocasio-Cortez. It is a fair estimate that her congressional district may be the hardest hit district in the whole country, at least for now.

Congressman Ocasio-Cortez is going to join us live in just a moment tonight.

One of the things that she has been advocating for from the federal government is more direct support for nursing homes, including hard-hit nursing homes in her district. When New York state started releasing data a few days ago about the worst hit nursing homes in the state, that list included the Kings Harbor Multicare Center in the Bronx, which is in Alexandria Cortez`s district. The state says that 45 Americans have died from coronavirus at that long term care facility already, 45 deaths.

The congresswoman`s district is home to these two nursing homes where 12 Americans have died at the home on the left in the Bronx and where 15 Americans have died at the one on the right in Queens.

So, we`re going to talk with Congresswoman Ocasio-Cortez about what it means right now to be representing such a hard, hard, hard hit district and what the federal government, what Congress is trying to do in terms of its newest relief bill.

I should also mention though the congresswoman also has Rikers Island in her district, the huge New York City jail where nearly 10 percent of the roughly 4,000 prisoners held there have tested positive. That alone is a stand alone crisis in the crisis that is New York City.

But we are seeing some of the largest outbreaks all across the country turn up in jails and in prisons including the largest outbreak known anywhere in the country which is right now at the Marion Correctional Institution in Ohio. At that one state prison in Ohio, they`ve got 1,950 confirmed cases among prisoners. That`s 78 percent of the prisoners in that facility have coronavirus.

Last night, we also mentioned a huge new outbreak in Arkansas. Notably in Arkansas, there is no stay-at-home order, thanks to Republican Governor Asa Hutchinson. Governor Hutchinson today announced more cases. At the Cummins Prison in rural Lincoln County, Arkansas, the new cases he announced bring the total to 850 known positive cases in that one prison, with more test results still to come in there.

Still though, somehow this kind of news which we`re seeing escalating day after day now all across the country, nowhere is safe, somehow this kind of news translates in national politics into President Trump closing down immigration for 60 days, since that will surely protect America from coronavirus.

You know, I don`t mean to oversimplify here, but it`s not like we`re getting it from other places at this point, right? I mean, America is the largest coronavirus disaster in the world by a million miles.

These are the top five largest outbreaks on Earth. Number five is Germany, with just under 150,000 cases as of today. Number four is France, just under 160,000 cases. Number three is Italy. Number two is Spain with just over 200,000 cases.

And then there`s us, USA, USA, biggest outbreak in the world, with over 800,000 cases now. We have more coronavirus cases than all of the other top five countries combined.

According to the COVID tracking project, our single day death toll hit a new record high today in the United States. In the past 24 hours, 2,674 Americans are reported to have died from coronavirus, which means we are losing one American every 32 seconds to this virus as of today.

But sure, stop immigration into the United States. That will surely cure what ails us. Yes, surely it`s foreigners and not us who have this problem.

I mean, if you want to see the dynamic that`s actually at work in the biggest coronavirus disaster on earth right now which is our country, this actually shows -- this is from group Topos which we`ve talked about in terms of data visualization over the past couple of weeks. This shows how coronavirus spread across the country, cases per capita by county day after day.

This is what`s happening with the American coronavirus outbreak. But sure, stop immigration from other countries. That at least sounds great to the president.

The front page of the "Omaha World Herald" today in Nebraska, where Republican Governor Pete Ricketts says there`s no need for a stay-at-home order, everything`s fine. The front page of the biggest paper in Omaha today is a main story about how all the meat packing plants in Nebraska are becoming coronavirus clusters, one after the other.

The Western Reserve meat processing plant in Hastings, Nebraska. The Costco chicken plant in Fremont, Nebraska. The JBS beef plant in Grand Island, Nebraska, where the local mayor has pleaded for a stay-at-home order and the local hospital is maxing out.

Smithfield pork plant in Crete, Nebraska, a Tyson plant in Dakota City, Nebraska. Another Tyson plant in Lexington, Nebraska.

Locals there telling the "World Herald" that even workers who are testing positive at the plants aren`t able to get their own family members tested for the virus even when they themselves have tested positive. And they`ve been living with their families when they come home from work every day.

But yes, no stay-at-home order in Nebraska because everything will be fine. Surely that little problem they`ve got in all the meat packing plants will stay right there inside the meat packing plants, right? Nothing a little deep cleaning can`t fix. Sure, it will be fine.

Last night, we reported on a big shopping mall outside Omaha, Nebraska. It happens to be run by a major donor to Nebraska Governor Pete Ricketts. That mall as we reported last night had announced that it was going to reopen its stores next week.

We`re reopening America, reopening the economy. Drive on out, ride on Interstate 80. Come shopping at a mall in Nebraska, come hell or high water, why not?

Today, that mall announced that maybe they`re not going to do that. They are walking back their plan to open up this week.

In South Dakota, where more than 760 employees from one pork processing plant in Sioux Falls are now confirmed to have coronavirus, the governor of South Dakota says she`s not even planning to try to get testing for the other people who work at that same plant, 760-plus cases among people who work at that plant, not to mention all of the dozens of cases that have been found among their family members already. But they`re not planning on testing the other people who work at the plant?

And there`s still no stay-at-home order in South Dakota because everything`s fine. State is planning on holding a big car racing event with a big live audience just outside Sioux City on Saturday night. Woo-hoo. They`re thinking they`ll have 700 people in the stands for that. The governor keeps insisting everything is fine, there doesn`t need to be a statewide order in South Dakota so, see you at the races, see you there?

Governor of South Dakota, Governor Noem, said today that people shouldn`t go to that car racing event on Saturday night outside Sioux Fall. As far as she`s concerned, she thinks that isn`t a great idea, but she`s not actually doing anything to stop it because she doesn`t want to. They are, as I said, expecting a huge crowd.

In Georgia, the Georgia governor`s plans to rip the lid off and reopen everything including tattoo parlors and massage parlors and nail salons and dine in restaurants, as of next, that plan from Georgia Republican Governor Brian Kemp turns out is a plan the governor announced without consulting the rest of his supposed state coronavirus task force. He also apparently didn`t even run it by the largest cities in his state, the mayors of which were totally blindsided by this order from Governor Kemp.

Now, the mayor of Atlanta is left asking Atlanta residents to please ignore what the governor`s doing, please ignore the governor saying all these businesses should be open, please just pretend he`s not doing that.

The leadership shown in this country by elected officials in Washington and in the states that are pretending this isn`t really happening or it`s not a big deal, that`s what`s given us so far the run away largest coronavirus epidemic on Earth, and more than 44,000 Americans dead, more than 2,600 Americans dying just in the past day.

And for the U.S. death numbers being so unimaginably high right now, you cannot put the blame on New York. New York`s death numbers are finally coming down. The spike in American deaths today is what it looks like when we see the rest of the country`s death numbers coming up now. And Americans are dying fastest in the nursing homes, and they`re getting infected the fastest, it appears, in the prisons and jails and in large workplaces and states with lax responses and lax protections.

New York went into the deep water first. New York and then the tri-state area, their doctors and nurses, their politicians even have been trying to warn the rest of the country about what was coming.

Well, now here it is. Congresswoman Alexandria Ocasio-Cortez representing the worst hit congressional district joins us live, next.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

REP. ALEXANDRIA OCASIO-CORTEZ (D-NY):  In my district and in New York City and in our community, we have had more deaths than 9/11. Multiple times of 9/11 have happened in the time since Congress has recessed.

So, I`m not here with the luxury of time. I need legislation that`s going to save peoples` lives. And the fact that Republicans do not want to have recurring payments, the fact that Republicans don`t want to fund states and cities, the fact that Republicans don`t want to guarantee peoples` health care is unacceptable to me.

(END VIDEO CLIP)

MADDOW:  Joining us now live is Congresswoman Alexandria Ocasio-Cortez of the great state of New York. Her district includes portions of the Bronx and Queens. Of all congressional districts in the country, hers appears to be the hardest hit, so far, in terms of the impact of this virus.

Congresswoman, I know you have a lot on your plate. Thank you so much for making time to be here with us tonight.

OCASIO-CORTEZ:  Of course. Thank you for having me.

MADDOW:  I can tell from looking at the hospitals in your district and right on the border of your district, the hard-hit nursing homes in your district, I can tell from looking at the overall borough by borough numbers in New York City, how badly your constituents are suffering right now and how many of them have been killed by this virus.

But can you just tell us more about what your constituents are telling you, what they`re asking from you?

OCASIO-CORTEZ:  I mean, their requests are absolutely reflecting how dire the situation is getting, and they`re also reflecting the lack of adequate federal response. You know, two, three weeks ago, people were concerned about unemployment. They were concerned about stimulus checks.

But now that rent payments have gone out, now that we have another rent payment around the corner on May 1st, people are not asking about food assistance. People are now scared to leave their homes. There are people that are scared to answer the door when food does come because we`re getting reports of continued ICE activity throughout this pandemic.

And so, what we`re really starting to see is people going from "I don`t know how to pay my rent" to "I don`t know how I`m going to eat next month" because 43 percent of Americans right now have either had their incomes dramatically reduced or completely ended overall. And this crisis, that aspect of a crisis is a choice, and it is a choice that Republicans are affirmatively making right now by denying people the recurring payments and the amount of aid that people need.

And when it comes to the health impacts that we have right now, we still need PPE. You know, hospitals, thankfully, we`re starting to get to the levels that are necessary, but we still have home health aides. We still have nursing home workers. We have plenty of people who provide assistance that aren`t necessarily in a hospital or clinic but are going into the homes of vulnerable people and the elderly that do not feel like they have the support or the assistance that they need right now.

MADDOW:  I hear you in terms of the home health aides and people who are working like health assistance paraprofessional roles. That`s absolutely key in terms of those folks not being protected. We are also seeing in nursing homes and long term care facilities, these incredible numbers. I know you`ve had dire circumstances in terms of the death rates with some nursing homes in your district.

And that`s one of the things that you have advocated for there to be more of a federal response on.

What do you want to see the federal government do when it comes to those congregate care facilities, long-term care nursing homes? What do you think they should be doing?

OCASIO-CORTEZ:  We need to really get in the weeds and start digging into reimbursement and Medicare reimbursement, Medicaid reimbursement, to make sure that people are able to access all of the care that is necessary and so that those facilities can provide as much of the care as necessary for everybody in need right now, COVID patients and non-COVID patients that are in these facilities.

You know, early on, I was even hearing and seeing on the way that these reimbursement rules are drafted, even folks who are -- who are able to offer telemedicine early on in this still had to physically show up in a clinic in order to provide telemedicine because the reimbursement for those services was only eligible if the person showed up to the clinic, even though they would be able to do the same work from home.

So, a lot of this has to do with how the federal government reimburses some of this work. A lot of it also just has to do with some of the other factors that we have to contend with right now. We have a broken health care system that is very disjointed that nickel and dimes people.

And we`re in the midst of a pandemic where someone could come in with a pneumonia but because they didn`t have the ability to access a COVID test, they have to jump through certain hoops, whether it`s through paid sick leave or whether it`s through, you know, what kind of health care you can get, it`s very difficult for people to make sure that they get the whole person care that they need because our current rules are putting up a lot of red tape.

So, what we need to do is dramatically expand Medicare so that it covers peoples` health care costs and so that it covers the cost of the uninsured. Pramila Jayapal has a fantastic bill that covers that.

But we also need to make sure that we`re caring for peoples` economic -- economic situation. And these aren`t unrelated because when people are able to safely feel like they will be able to pay next month`s rent, then they will stay inside. But if people are scared that they are going to be evicted, foreclosed on, or have any other sort of life-altering economic event, they are starting to go outside and trying to expose -- and trying to find work and exposing themselves to unnecessary risk because they are frightened about the instability of their economic situation.

MADDOW:  Now, there is going to be a bill that`s expected to be voted on the day after tomorrow. And I know that you`ve been critical and very outspoken about the fact that it ought to -- that we ought to be talking about things like recurring payments to people, not just individual sort of stimulus-style checks. You`ve talked about some of the kinds of reforms that you want to see as well.

And I`m -- I am quite sure that that bill does not meet what you think it ought to meet in terms of the immediate needs of the American public right now and your constituents. But do you plan on voting for it? Do you have -- do you know if it`s -- if it`s going to be better than nothing at this point in terms of whether it`s going to earn your vote?

OCASIO-CORTEZ:  Yes, you know, we`re just -- the final text was not ready for the majority of this week. We`re hearing that it just rolled out from the Senate and we`re starting to pore over it.

But, you know, I think what we really need to realize is that this small bill, while something may be better than nothing, it is happening in the context of Congress having gone on recess for a month. We are going to pass a small potatoes bill, and then we are talking about recessing again until May 4th.

And if we are going to bring every member or call back almost every member who can back to D.C. to pass a small incremental bill with the knowledge that we are not coming back until next month again, that`s two rent checks. And the last time we left, again, we lost over one 9/11`s worth of people due to this lack of action.

And so, we really need to acknowledge that this small bill -- whilst again something is better than nothing -- and, frankly, Democrats fought very, very hard to get basic things like testing. Republicans didn`t want to fund hospitals. They didn`t want to fund mass testing which is what is actually going to allow us to reopen the economy.

So, I appreciate the strife they made in that. But, ultimately, in voting on the text of this bill, knowing that Congress is -- we are abdicating our responsibility. We haven`t legislated for a month, and thousands of people are dying. Thousands of people are dying every day.

And we aren`t going -- and we`re talking about coming back. And every time we pass one of these bills, we`re hearing that the real solution is coming in the next bill and then the next bill and the next bill.

And at some point, we have to raise our hands and say, when is the solution coming? Because two months of rent are going to pass by before we`re actually even entertaining a real bill.

And people -- we`re talking about a mass -- we`re talk about the scope of mass displacement in the United States of America. We are also talking about major cities -- New York City, Los Angeles, Chicago -- laying off almost every city worker or large -- thousands of city workers and essentially only keeping certain personnel.

We`re talking about laying off first responders and police officers because we aren`t getting state and municipal funding.

So, I appreciate when in Congress, we say we`re going to get to it, but we need to get to it in time. And that is ultimately the issue that we have.

And so, I`m reading the text, but we cannot just throw our hands and say that this is someone else`s problem or that we`re going to get to it eventually, because if we pass a relief bill next year, we`re going to be paying for morgues. If we pass relief bill now, we`ll be paying for prevention. And that`s the difference.

MADDOW:  Congresswoman Alexandria Ocasio-Cortez of New York, incredibly hard hit district, I know you have a ton on your plate -- thank you for making time for be here with us tonight.

And in terms of what`s going on in your district and what you want -- what you think the country needs to know, come back any time. We`d love to have you any time that you want to be here.

OCASIO-CORTEZ:  Of course. Thank you so much.

MADDOW:  All right. Thank you.

All right. Coming up next, we`ve got a bit of a scoop. Despite very, very happy talk from an important government agency, we`ve got ahold of internal documents that shows how a very dire situation has been papered over by the Trump administration. We`ll show you the receipts, next.

(COMMERCIAL BREAK)

MADDOW:  Nurses protesting outside the Atlanta V.A. Medical Center a few days ago over having to work despite a lack of protective gear to keep themselves from getting infected. V.A. Medical Center workers around the country have been saying that they`re being ordered to ration and recycle PPE like masks which is putting them at greater risk for getting coronavirus on the job.

You can see the sign this one woman is holding. It says "Say no to one mask per week." Sounds dire, right? One mask per week?

Practically no medical system in the U.S. has what it needs in terms of protective equipment. But for weeks, we`ve been hearing about particularly dire shortages in the country`s V.A. facilities and that`s worrying because V.A. facilities are responsible for the care of more than 9 million American veterans, a majority of whom are older and therefore at increased risk when it comes to coronavirus.

For the times, we`ve been seeing these reports, the V.A.`s leadership has been insisting that all is well and people are complaining for no reason because the V.A. and all its workers have everything they need.

When "The Wall Street Journal", for example, reported on internal documents showing that facility has really had begun rationing PPE, a spokesperson said in response, quote, the premise of your question is false. All employees who need PPE have it.

That may be the line from the V.A., but I can also prove to you that that is absolutely not the situation on the ground. We recently obtained an email sent to employees at the V.A. Medical Center in Charleston, South Carolina. It has to do with the face mask policy in effect at that facility.

According to the memo, V.A. workers are separated into two groups. The first is priority group one, those at high risk of exposure.

Here`s the face mask guidance for the priority one employees. Quote: Employees caring for COVID-19 positive patients not undergoing high risk procedures will receive five face masks as a two-week supply. The patient should be encouraged to put on a face mask when someone enters their room. The employees` face masks are reusable between patients.

Those employees, those priority one employees are encouraged to store their own masks in their paper bags when they`re not using them. But again, those are the lucky employees because V.A. says they`re at high risk, so they each get a grand total of five masks to last two weeks.

As for priority group two, V.A. workers who work in outpatient care or as screeners of these facilities or folks who work at community-based outpatient clinics, well, here`s the guidance for them. They`ll be issued one mask per week in the paper bag. At the end of the week, store the mask in a paper bag. At the beginning of the second week, staff will begin a second mask. Those two weeks will be a four-week supply. One mask to be worn each week, and each mask reused for a second week.

Like their colleagues in the priority one high risk pool, the priority two employees are encouraged to keep their masks in paper bags when they`re not using them. So, the highest risk medical workers get five masks to last them two weeks. The second group of V.A. employees, including people working as screeners of these facilities, they get two masks that are supposed to last them a month.

Use one for a week. Use the second one for a week, then go back to the first one for the third week, then use the -- we asked that V.A. facility for comment to see if this policy is still in place. They forwarded us to the National Press Office for the Department of Veterans Affairs where that national spokesperson told us in part, quote, V.A. is currently adhering to CDC`s contingency capacity for PPE use. V.A.`s PPE practices are keeping veterans and employees safe during challenging times, and the numbers prove it.

The spokesperson also says, quote, there is no V.A.-wide guidance categorizing staff by priority groups. Well, I guess we know that means there`s no standard guidance across the board for V.A. workers when it comes to using face masks. It just depends on which part of the enormous V.A. you work for?

I mean, the sheer scale of the V.A. makes this an enormous problem. The failure to get the equipment needed in the hands of caregiver now, right now, I mean, we`re hearing that from V.A. workers who are picketing and protesting outside their workplaces so people know this is what`s going on.

But the strategy from the V.A. which again is a federal agency, as part of our government, the strategy from them over and over again has been to happy talk this problem. And that might have worked for a while were it not for the protests of health care workers themselves and were it not for one intrepid reporter in particular who has consistently exposed the extent of this problem despite the V.A. saying there`s nothing to worry about.

And that intrepid reporter joins us next. Stay with us.

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MADDOW:  This is the first big scoop almost two weeks ago. The headline: Veterans Affairs hospital facing serious short an of protective gear, internal memos show, even while, publicly, the V.A. was saying everything was fine.

One health care professional told "The Wall Street Journal" reporter Ben Kesling, quote, the fear is palpable, when Kesling kept reporting on this, as a line of inquiry at "The Journal".

And then just a few days ago, Ben Kesling got the V.A. secretary himself to finally acknowledge the problem, quote, in a better situation, would we have more supplies available? Yes, but we are competing with the rest of the country.

Joining us now is "Wall Street Journal" reporter Ben Kesling who`s really been driving the heck out of this very important story.

Mr. Kesling, thank you for your joining us tonight. Thanks for your reporting on this issue so far.

BEN KESLING, REPORTER, THE WALL STREET JOURNAL:  Thanks for having me.

MADDOW:  The thing that I find remarkable about this story and what you have reported is not that V.A. has had a hard time putting together enough PPE to protect all of their medical staff. That does not surprise me. Sadly, I`m disappointed and worried about it, but not surprised.

What I`m surprised about is there`s this huge disconnect with that fact on the ground and all this happy talk that the V.A. has been spreading about it, trying to say it`s fine and there`s no problem. That`s at least the impression I`ve had. But I wanted to ask whether that lines up with your impression as you have pursued this line of inquiry.

KESLING:  It lines up exactly with what I`ve been reporting. Talking to doctors and nurses, providers on the ground, they understand there`s shortages. We all know the shortages.

The nation is facing a shortage in PPE, from masks to gowns to face shields to everything. Since the V.A. is part of the national medical system, they`re, of course, going to be facing shortages. Doctors and nurses just want that to be honestly conveyed to them.

And until recently, the V.A. was not saying that there were any shortages. Every time I would reach out for comment, I would be told that the premise of my question is wrong, and that -- and that I -- and that there was plenty of gear. There were no shortages.

MADDOW:  I know that a lot of your reporting has been based on internal memos that are being circulated among top level V.A. employees. So they have this public facing line that everything is fine, but at the highest level of the agency, they`re circulating memos very concerned about rationing and that extreme things they`re needing to do in order to try to spread minimal PPE around this huge workforce.

And, obviously, I`m not asking you to compromise or even characterize your sources, but is it fair for those of us reading your reporting to draw the conclusion that there are a lot of people at the V.A., including high level people at the V.A., who see value in having this information out there, despite the fact that it contradicts the official line from the agency?

KESLING:  Yes. In a word, yes. And the folks who were providing these -- providing a view into these memos, they want to make sure that this contradiction is pointed out, that it`s shown that the V.A. just needs to step forward and say, hey, we -- we don`t have all the supplies we need. We understand that. We`re going to have to use crisis level de facto rationing of equipment, and we were working to get more equipment, but we don`t have it.

And doctors and nurses, the folks who are seeing -- who are part of this system seeing these memos, just want that to be honestly conveyed. Until recently, it hasn`t been conveyed. And it`s only in the past couple of days the V.A. leadership has really stepped out and started doing more broader media appearances and talking about the fact that there is not, as the secretary puts it, optimal levels of PPE. And that the department is going through 130,000 some masks a day, and you`re going to run up hard against shortages when you do that.

And they`re now coming out and saying the messaging could have been better. We could have talked about this more. We could have -- we could have just told people that we were in the same boat as the rest of the nation.

MADDOW:  Ben Kesling, reporter for "The Wall Street Journal", I will tell you, your reporting is what has finally forced them to be more honest about it. And we all you owe a debt for that. Thank you for staying on this. Thanks for your time tonight.

KESLING:  Thank you.

MADDOW:  Good luck.

KESLING:  Thanks.

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

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MADDOW:  That is going to do it for us tonight. We will see you again tomorrow night.

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

Good evening, Lawrence.

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