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COVID-19 crisis TRANSCRIPT: 6/26/20, The Rachel Maddow Show

Guests: Will Humble, Cedric Dark

CHRIS HAYES, MSNBC HOST: That is "ALL IN" for this evening.

THE RACHEL MADDOW SHOW starts right now.

Good evening, Rachel.

RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Thank you, my friend. Happy Friday. I appreciate it.

Thanks to you at home for joining us this hour as well. Happy Friday to you at home.

Once upon a time, the last time we had a Republican president before this one, there was a huge lobbying scandal that ripped its way through Republicans in Congress, through the George W. Bush White House, through the Republican revolving door part of the D.C. lobbying industry at that time. It even ripped through the supposed Christian conservative movement. If you lived through it, it was unforgettable. It became quickly known as the Jack Abramoff scandal.

This is Jack Abramoff. He had this racket going in lobbying where the money started from him ripping off American Indian tribes to the tune of tens of millions of dollars. And in communications with his fellow lobbyists who were working on this scheme with him, lots of the people he was working with on this were former Republican congressional staffers. It would emerge in court documents over the course of this scandal that they would frequently deride and insult the Native Americans they were ripping off in their scheme by calling them morons and troglodytes, and they would sort of laugh and screech among themselves about how much they loved ripping off these tribes and taking all their money.

One of the signature moves in this Abramoff scheme was that he was secretly paying so-called Christian conservative leaders, guy likes Ralph Reed from the Christian coalition and Lou Sheldon from the Traditional Values Coalition, Abramoff and these guys would pay these Christian groups to gin up anti-gambling activism, all these supposedly Christian pious outrage about gambling.

And then Abramoff, having paid for that, he would swoop in and magnanimously offer his services to Indian tribes that had casino interests because he said he could protect their interests, their casino interests against these anti-gambling forces, these anti-gambling forces that Abramoff himself had ginned up and paid for. Super classy. Super classy.

It was also something that infected a huge swath of Republican Washington, D.C. in the second term of the George W. Bush administration because what Abramoff and his guys did with all that money they ripped off from the Indian tribes is they used it to bribe members of Congress and members of the George W. Bush administration. Twenty different officials and political figures ended up pleading guilty or being convicted in the Abramoff scandal, including staffers to Tom DeLay, who was the top Republican in the House of Representatives at that time. Tom DeLay himself appears to have only narrowly avoided prison himself in this scandal, or at least I should say indictment.

If you`re thinking about Tom DeLay`s mug shot right now, that`s actually from a whole other corruption scandal from which he even more narrowly avoided prison. The Abramoff scandal also put one Republican member of Congress in jail, a congressman named Bob Ney.

The Abramoff scandal produced prison sentences for a senior official from the office of management and budget in the George W. Bush White House. And for the number two official in the Interior Department under George W. Bush. It was just a mess.

But now, now in 2020, because you`ve been so good, because the news has been so dark and so terrible for so long, so relentless, the news gods have decided to give you a little Friday night amuse bouche tonight with the unexpected return of one of the most wretched Republican political scandals of the past generation. Because at the end of the George W. Bush administration when George W. Bush`s approval ratings were so bad, they were at like Trump levels, after all of those convictions in the Abramoff scandal and all of the guilty pleas in the Abramoff scandal, including from senior officials in George W. Bush`s administration, after Abramoff himself started serving his four years in prison, after all this had unfolded in all of its wretched glory, the Democrats in Congress passed and President George W. Bush reluctantly signed a reform law, a new ethics law for lobbying.

It was the Abramoff Scandal Reform Act. It required all sorts of new disclosures and transparency around the profession of federal lobbying. So that was passed in 2007.

But now, now, right now in the middle of everything else that`s going on in our country, federal prosecutors for the first time have finally brought charges against someone for allegedly violating that specific law that was passed because of the jack Abramoff scandal. They have finally for the first time charged someone with breaking the Abramoff law.

Do you know who they charged? They charged Jack Abramoff himself all these years later. Same guy. He did his prison time for the original Jake Abramoff scandal.

He`s been out of prison for a few years now, and apparently according to federal prosecutors, what he`s been doing to keep himself busy since getting out of prison for the original Jack Abramoff scandal, is that he`s been doing a little surreptitious lobbying for a weird like cryptocurrency thing but also for a marijuana company in California.

But Jake Abramoff according to prosecutors did this lobbying in secret. He didn`t want to register as a lobbyist as the law now requires because of him. He didn`t want to register as a lobbyist, so he arranged for somebody else to do this lobbying on his behalf so as to keep his own role in it secret.

Lucky for us, the person -- at least lucky for us in knowing this story now, the person Jack Abramoff picked to do the secret lobbying for him turned out to be an undercover FBI agent. And so, now, he`s been charged.

That Jake Abramoff, that same guy has again been hit with federal felony corruption charges except this time he`s been charged specifically with violating the law they wrote about him during the last Republican presidency before this one. Prosecutors told the court this week in conjunction with his charges, quote: Abramoff was aware of the obligation to register as a lobbyist in part because Congress amended the lobbying disclosure act in 2007 as a reaction to Abramoff`s own past conduct as a lobbyist.

This is -- this is -- this is because you`ve been so good, because you have been such a good citizen and news consumer recently in these dark times. The news gods have prepared this for you on this Friday night after this long, grueling, terrible week of news, right? Whatever else is going on in the world, whatever else makes no sense in our country right now, at least there is some order in this little corner of American history that we`re all banging around in right now together. Today at least we can say, the anti-corruption law passed because of corrupt Republican super lobbyist Jake Abramoff has just been used for the first time against Jack Abramoff in a whole new scandal that he got himself into after getting out of prison for his other scandal. Ta-da!

I mean, news doesn`t happen like -- this is like they`re going to name the IRS building after Al Capone. This is like if another Republican presidential campaign after Watergate, after Nixon, got caught trafficking in materials stolen from the DNC during a presidential campaign.

Oh, wait. Well, actually on that front, interesting news tonight from the federal district court in Washington, D.C. where Trump campaign adviser Roger Stone, who was convicted on seven federal felony counts related on his efforts to serve as a conduit between the Trump campaign and the entity that was publishing material stolen from the DNC during the last election - - Roger Stone had been due to report to prison early next week. He`s due in prison on Tuesday.

Now, as you know, Attorney General William Barr has inserted himself into the Stone case already to insist that the sentencing recommendation for Stone be lowered. The federal prosecutor quit the case in protest and then became a whistle-blower about that this week when he testified to Congress about Barr interfering in the case to protect the president`s friend. But facing the prospect of reporting to prison on Tuesday of next week, Roger Stone`s defense team this week asked for a delay. So instead of reporting to prison next week, he could put it off and not report to prison until September.

What is interesting in this case given what`s happened thus far, is that the Justice Department said they were totally fine with that. They said they would not contest that request for an extension from Roger Stone. They said it was fine with us if he didn`t turn up to prison until September. And that might have been the end of it, both the prosecution and the defense both saying they`re okay with Stone not turning up to prison until September.

But interestingly, the judge who oversaw Roger Stone`s case in which this jury convicted him on all seven counts, right? The judge who has been overseeing Stone`s case, the judge who sentenced him demanded that the Justice Department explain why it was doing that, why they were saying they were okay with Stone delaying his report to prison. And the Justice Department had until midnight last night to submit their explanation of that. They waited until midnight last night before they submitted their filings.

But now the judge has responded. Tonight just before we got on the air, Judge Amy Berman Jackson rejected the delay. He gets a little bit of a delay but not what he asked for. Roger Stone, per the judge in his case, will get 14 days extra, not three months like Bill Barr`s Justice Department was prepared to give him. And that means we now know Roger Stone will have to report to prison on July 14th.

Which means either Roger Stone is going to report to prison on July 14th, or President Trump is going to cap off what has just been a stellar summer for him so far by issuing a pardon to Roger Stone, a pardon to his campaign adviser who was just convicted on all counts on seven felony charges by a unanimous jury, right? Convicted on seven felony charges related to his efforts to facilitate the hack and dump operation that the Russian government carried out in 2016 to help get Donald Trump elected. Going to pardon him? Tick tock.

Two weeks till Roger Stone has to be in prison. And this news from Judge Berman Jackson in D.C. arrives tonight on the same night, actually within an hour of "The New York Times" posting this bombshell on their front page. Did you see this tonight? Russia secretly offered Afghan militants bounties to kill U.S. troops. This is -- this is sort of stunning.

Here`s the lead. American intelligence officials have concluded that a Russian military intelligence unit secretly offered bounties to Taliban- linked militants for killing coalition forces in Afghanistan, including targeting American troops amid the peace talks to end the long-running war there according to officials briefed on the matter.

The U.S. concluded months ago that the Russian unit had covertly offered rewards for successful attacks last year. Islamist militants or armed criminal elements closely associated with them are believed to have collected some bounty money, the officials said. Twenty Americans were killed in combat in Afghanistan in 2019 last year, but it was not clear which killings were under suspicion.

Intelligence finding was briefed to President Trump and the White House`s national security counsel discussed the problem at an interagency meeting in late March. Officials developed a menu of potential options starting with making a diplomatic complaint to Moscow and a demand that it stop along with an escalating series of sanctions and other possible responses. But despite having created that menu of potential options for the president, quote, the White House has yet to authorize any step.

The officials did not explain the White House delay in deciding how to respond to the intelligence about Russia. Yeah, raise your hand if you think you might be able to explain that delay from the White House.

I mean, this is -- this is jaw-dropping. This is like kind of sickening news, right? Even for those of us whose jaws are already sprained from having dropped so far and so frequently this summer. I mean, if this "Times" report is correct, this means that U.S. intelligence has concluded that Vladimir Putin is offering bounties for the scalps of American soldiers in Afghanistan. Not only offering, offering money to people who kill Americans, but some of the bounties that Putin has offered have been collected, meaning the Russians at least believe that their offering cash to kill Americans has actually worked to get some Americans killed.

The Russians at least believe if these bounties have been paid out that the people to whom they have offered this money have successfully gone out and killed American soldiers because of it and the Russians have therefore paid for that service.

And President Trump was told about this in March, and he has done nothing, nothing about it. He was given -- what did they describe it as a menu. A menu of possible responses. And so far, he has chosen off the menu that he`ll have none of it, thank you. He`ll do nothing.

I mean, there are -- there are 20 American families grieving today, grieving right now because their American soldier, their dad or mom or son or daughter or brother or sister was killed in combat in Afghanistan in the past year. Imagine you`re a member of one of those families, and you have just found out that Russia may have paid for the death of your loved one, cash money paid as a reward for killing an American soldier. Imagine that American soldier was a member of your family.

And now you know from this reporting in "The New York Times," which has since been confirmed by "The Wall Street Journal," that not only does the president know that Russia was paying for American soldiers` deaths, paying rewards for Americans dead, the president knows it. He`s been told. And what he`s done with that information since he was briefed on it in March is -- well, what has he done to Russia since then? Well, there was that unexpected and apparently friendly conversation he had with Vladimir Putin on June 1st. We learned about that from the Kremlin.

According to the Kremlin, what they discussed on that call was how much Russia would please like to be allowed back into the G7. President Trump then got off that call with Vladimir Putin and immediately started publicly calling for Russia to be allowed back into the g7. Remember why they were kicked out in the first place? They were kicked out for invading a neighboring country and taking part of it for themselves.

The rest of the countries in the G8 decided a country like that, Russia, could not be part of this elite club of countries that worked together on big economic issues, not if Russia was going to behave like that. That`s why they`re kicked out of the G8. That`s why it became the G7.

And, of course, Russia wants back into the G8. Of course they do. There`s a reason why they were kicked out, though, right? Think about this timeline. President Trump gets briefed in March that Russia is paying bounty money for dead American soldiers right now, and his response to that is nothing except a friendly call and please, hey, everybody, let`s now do this nice thing for Putin and let him back into this elite club of major countries.

Oh, what else did he do right after that? He announced unilaterally that he wants to pull thousands of U.S. troops out of Germany, which has freaked out even congressional Republicans because of how much it is widely viewed to be a unilateral strategic gift to Russia, one that would undermine NATO, which is Russia`s main geostrategic imperative, and would directly benefit Putin in exchange for nothing. That`s how President Trump is standing up for Americans being killed for rubles paid by Putin`s government.

You know, there`s been this long string of resignations from the Trump administration over the past few weeks, which haven`t received much notice, right? The head of the criminal division of the Justice Department resigned. The head of the civil division of the Justice Department resigned. The solicitor general resigned.

The top financial person at the Pentagon resigned. The top Pentagon person on international security issues resigned. The top two technology people at the Pentagon also resigned.

This whole string of resignations has kind of gone unremarked upon. But we also just learned that the person who runs the Russia desk at the National Security Council, senior director for Russia at the National Security Council also just resigned as well. I mean that`s been a pretty hot seat in this particular administration. Trump has burned through four different people in that job already in less than four years. But the fourth one just left suddenly and with no explanation.

But now we know that that resignation was not long after the National Security Council and Trump were told about Putin paying cash bounties for dead U.S. soldiers, and Trump did nothing about it in response for months and counting.

But, you know, he has been busy, continually and creatively botching the response to a completely out of control viral pandemic that`s closing in on 125,000 American deaths in 16 weeks here at home. That is now, you know, every day breaking records for the number of new infections reported each day. That`s got to keep you busy.

Today, there were 43,122 reported new infections in the United States. We used to freak about the fact that we had 20,000 new infections in a day. Then it went 25,000, 30,000, 35,000, now we`re up over 40,000, up over 45,000.

Our new infections per day not only dwarves every other place on earth, it shatters our own previous records for how quickly this thing can get worse. Remember, that`s not cumulative cases. That`s new cases each day. That`s how much bigger it`s getting each day.

When New York was at the apex of destruction, there were 10,000 new cases in New York a day. That was the very peak. There were nearly 9,000 new cases today in Florida. That was the new record for them today.

Nearly 6,000 new cases today in Texas. That was a record for them today too. Arizona also hit a new record for infections reported today, as did South Carolina, as did Tennessee, as did Idaho, as did Georgia, as did Utah.

I mean, just for perspective on what`s going on right now in the country, Maricopa County alone where Phoenix is in Arizona, they`re now seeing as many as 2,000 new cases a day, which "The Washington Post" notes today, quote, eclipses the boroughs of New York city even on their worst days from what was previously the worst from the pandemic and remains the worst any American can possibly imagine about how bad it can get. Maricopa County more new cases per day than the worst of New York in the worst of it.

Arizona now has more per capita cases than those recorded by any country in Europe, even more than the confirmed cases in Brazil. That`s Arizona.

Florida`s situation, think about this for a second -- Florida is at 123,000 cases statewide, 123,000. More than 33,000 of those cases have come in the last week. Nearly 9,000 came in the last 24 hours.

I mean this thing is taking off. This thing is hurtling through space now, out of control.

And here`s Baghdad Bob Pence at the White House Coronavirus Task Force briefing today, insisting that actually, if you look on the bright side, everything seems fine to him.


MIKE PENCE, VICE PRESIDENT OF THE UNITED STATES: We`ve all seen the encouraging news as we open up America again. All 50 states and territories across this country are opening up safely and responsibly.


MADDOW: Ah. You know, here on earth one, Texas and Florida actually both reinstated previous restrictions today. They`re not reopening safely or otherwise. They are locking back down because they need to, because the epidemic there is not only worse than ever, it`s worse than ever and completely out of control.

Texas and Florida, very, very large American U.S. states. I mean, states including Arizona, Arkansas, Utah, Michigan, Kansas, Idaho, North Carolina, Delaware, New Mexico, I probably missed some, all of those states have now stopped any reopening efforts in their tracks. But the White House says everything`s fine. We are on track to reopen. Everybody`s just very jealous of how great our reopening has gone.

That`s the White House while this thing is doing what it`s doing right now. There`s one last thing I`m going to show you here before we move on tonight. Just one little -- maybe this is a glimmer that at least the pressure may be starting to hit the right place, that maybe they will finally start to pay some kind of political price for some of what`s been done wrong. I think that little glimmer, at least for me, is this.


AD NARRATOR: The most deceptive, lying president in history finally told the truth. Somehow, it was more shocking than all his deceptions.

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: When you do testing to that extent, you`re going to find more people. You`re going to find more cases. So I said to my people, slow the testing down, please.

AD NARRATOR: Slow the testing down? Slow down our chance to save tens of thousands of lives. Slow down our understanding of where COVID is and how it`s spreading. Slow down the steps to reopen the economy. Every single expert told him to test more and test faster. And now we know his response.

TRUMP: Slow the testing down, please.

AD NARRATOR: That`s why this November, more than ever the choice is clear. It`s America or Trump.


MADDOW: A little heavy-handed, I know. But that`s a new ad this week from the Lincoln Project about the president`s response to this virus.

And, you know, it`s important to keep perspective on these things. You know, I have spent the last 12 years on TV and lots of years on radio before that talking about political scandals, including fatal political scandals and big, bad corruption problems and really bad governance in our country. We`ve never had anything like this, never, anything like this.

If our next big political decision as a country ends up being made on the grounds of that ad, ends up being made about what`s been done wrong in this epidemic, we could do worse than that. If it ends up being a referendum with ads like that about what`s gone wrong in this epidemic and how this has been botched and how many Americans have died because of it, we could do worse than that as the basis for an election. That gives me hope we might make better decisions this time around, maybe.

Lots more ahead tonight. Stay with us.


MADDOW: I mentioned earlier this "Washington Post" report today, this front-page story about how really, really bad things are in the great state of Arizona. We`ve had eyes on Arizona for a couple weeks here on this show, see this national coverage of how bad things are there. It`s more than warranted.

"The Post" says, quote: Maricopa County which includes Phoenix is recording as many as 2,000 cases a day, quote, eclipsing the New York City boroughs even on their worst days. And that eclipsing part of the quote is actually "The Post" quoting from the very well-regarded disease trackers at the children`s hospital of Philadelphia. And their work on Arizona includes this terrifying projection of the rise in cases in Maricopa County.

You see that dotted line shooting straight up. That`s the projection for the next couple weeks in Maricopa County. That`s a two-week projection. The disease trackers write, quote, it is fair to say that the state of Arizona has lost control of the epidemic.

This is from "The Post" reporting. Quote: Physicians, public health experts, advocates and local officials say the crisis was predictable in Arizona where local ordinances requiring masks were forbidden until Republican Governor Doug Ducey reversed course last week.

Quote: State leaders did not take the necessary precautions or model safe behavior. These observers maintain even in the face of compelling evidence and repeated pleas from authoritative voices.

Quote: When forbearance was most required as the state began to open, despite continued community transmission, an abrupt and uniform approach without transparent benchmarks or latitude for stricken areas to hold back led large parts of the public to believe the pandemic was over. Well, yeah, of course large parts of the public believed that in Arizona because that`s the way the state was governed through all of this.

Remember how Arizona specifically opened up? Do you remember the specific circumstances of it? Arizona had been relying on state-specific projections about what was going on. The governor had been talking about potentially doing some sort of reopening, potentially sort of weeks away.

But then he turned on a dime in early May. Arizona`s governor changed his plans, told everybody everything was going so well, actually despite what he had open up the state early. Why did he make that quick change and open up everything early? Well, because that announcement -- I`m not kidding, was time to coincide with a visit to Arizona from President Trump, who on that visit literally toured a mask manufacturing plant without wearing a mask while the song "Live and Let Die" played over the loudspeakers.

That visit from the president seems to have been the occasion for Arizona hurrying up its reopening. And now, lo and behold, less than two months later, quote, Arizona is facing more per capita cases than recorded by any country in Europe or even more than the confirmed cases in hard-hit Brazil. Among states with at least 20 people hospitalized for COVID, no state has seen its rate of hospitalizations increase more rapidly since Memorial Day.

This week, Arizona reported not just a record single-day increase in new cases but also record use of inpatient beds and ventilators for suspected and confirmed cases. Public health experts warn Arizona hospitals could be stretched so thin, they may begin triaging patients by mid-July. Soon, the only option might be crisis standards of care, said Will Humble, former director of the Arizona Department of Health Services.

If you`re in a bed, normally, they`ll keep you for a few days. But they`re going to send you home with oxygen.

Joining us now is Will Humble, former director of the Arizona Department of Health Services, now executive director of the Arizona Public Health Association.

Mr. Humble, you were here early on to talk to us about things seeming to go off the rails in Arizona. What you said at the time early on was right, but I have to ask you, if you knew that it was going to get this bad this fast or if you are among those who is surprised at just how out of control things got in Arizona?

WILL HUMBLE, ARIZONA PUBLIC HEALTH ASSOCIATION EXECUTIVE DIRECTOR: Let me think about that. I knew things were going to get bad. You asked me how soon. I thought it would probably be sometime in July, but I`m now confident that we`ll be in crisis standards of care within the next few days if not by the end of the weekend. I mean, it`s gotten so bad so fast, and the reason is because the public policy that we developed and that was used at the end of the stay-at-home order really set an honor system.

And an honor system isn`t adequate to direct the kind of human behavior that we need to slow down the spread of this virus. So that`s really what happened is this is directly related to policy decisions that have been made. This is not bad luck. This isn`t like that. These are directly related to policy decisions that happened in this state.

MADDOW: Can you explain in layman`s terms what you mean by crisis standards of care? I know that`s a term of art in terms of public health and the way that hospitals think about this. But for those of us who aren`t fluent in that language, can you explain what that means?

HUMBLE: Well, a lot of it has to do with how you triage patients and how you decide what patients get what kind of care. And so, there`s a protocol we have in place in Arizona that provides guidance for doctors about how to make those decisions when there`s inadequate resources to treat everybody that`s in the hospital.

So there`s a -- it`s actually a scoring system, and all states have this. Part of it is how acute is the illness that the person has? How risky is it that that person is going to end up in multi-organ failure? And the other part of the equation is how old is this patient, and if they recover from COVID, how many years or months would they likely have left anyway?

And so crisis standards of care, you combine those two parts of the equation to come up with an algorithm to decide who gets care and who doesn`t.

MADDOW: And in terms of not getting care, you mean people who are in the hospital now getting discharged to make room for more people, or people turning up sick and being told, sorry, there`s no room at the inn?

HUMBLE: Well, it`s all of those things. So like, for example, if you would have gone into an emergency department under normal circumstances, they might say, let`s send you upstairs to an inpatient bed and watch you for a couple days so you can get better care. When you`re in crisis standards of care, you might just be sent home from the E.D. when you normally would have gotten a bed.

Likewise when you`re in a hospital bed under normal circumstances, if you start to deteriorate, you might get an intensive care bed because you need that kind of care. When you`re in crisis standards of care, you triage who gets that ICU bed. So you might end up staying on a regular hospital floor when normally you would have gotten that more intensive care.

So the standard of care changes when you get into surge status, and I think it`s important for everybody to know in all the states, as your governors and elected officials make decisions that when they start talking about using hospital capacity as a control measure, as an end point for how they`re going to manage this epidemic, start worrying because what you really should be doing is putting together policies in place to change people`s behavior, to slow the spread of the virus so that you don`t end up like us in crisis standards of care.

MADDOW: Arizona has closing in on 70,000 cases now. 2,000 cases a day in Maricopa County alone. We`ve heard so much what you`ve just described and what we`ve heard from frontline providers about how strained the hospitals are already in the state.

You used to run the department of health services for the state of Arizona. If you were back in that job right now and you had a governor who said, I need your guidance, you need you to tell me what this state needs to do, I need you to set policy here, what policies would you put in place right now for the state to try to turn this around?

HUMBLE: Well, there`s two -- there`s two tracks. Number one is to do some implementation of immediate policies to change what we`re expecting of businesses, et cetera, a statewide mask-wearing requirement. That`s on the prevention side, to try to slow things down in the future. Those things are going to take at least two to three weeks to start working.

On the urgent side, it`s pulling together all your hospital stakeholders and finding out what is it exactly that they need that the state can provide to help them provide the best level of care that they possibly can, given the circumstances that will be coming in the next weeks. We`re in a - - this is a very dire situation, and at this point, there`s the prevention side, which it`s late to do those things, but you still need to do them. But the acute thing is that, you know, let`s try to keep as many people alive as we can.

MADDOW: Will Humble, executive director of the Arizona`s Public Health Association, the former director of Arizona`s Department of Health Services -- Will, thanks for helping us understand what`s going on in your state, keeping us honest about this stuff, it`s been scary, but it`s just vital. Thank you so much. Good luck over these next few days. Come back soon.

HUMBLE: All right. Take care.

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



JUDGE LINA HIDALGO, HARRIS COUNTY, TEXAS: Let me begin by stating a simple but harsh truth. Today, we find ourselves careening toward a catastrophic and unsustainable situation. Our current hospitalization rate is on pace to overwhelm the hospital in the near future.

There are some who will say there`s no real cause for concern, that we can adjust to this, that there is space in our hospital surge capacity. When did we lose our respect for human life and the economy to the degree that we`re saying let`s fill our ICU beds and surge capacity before we take any meaningful action? Since when did we decide as a society that instead of saving a life and preventing the spread of the virus, we would treat human lives, the lives of our neighbors, as collateral damage to be dealt with?

I`ve directed that as of noon today, we elevate our public threat level from significant orange level two to severe, red level one. This is the highest possible COVID threat level in Harris County. It means there is severe and uncontrolled level of COVID-19. The outbreaks are worsening. Our public health capacity is strained or exceeded. Health care surge is not only likely but is already in progress. This is a serious situation.


MADDOW: That is the top elected official in Harris County, Texas, today. Her name is Judge Lina Hidalgo. Harris County includes Houston, one of America`s largest cities. Harris County is the third most populous county in the nation, and it has one of the fastest growing outbreaks of coronavirus not just in our country but in the whole world right now. So that`s again the top executive from Harris County, Judge Hidalgo, moving her county to the highest threat level that they have today, red, level one.

All residents of Harris County are encouraged to stay home, to limit nonessential travel, to cancel large gatherings and visits to nursing homes because of what health officials say is a severe and uncontrolled spread now of coronavirus in that community. What you see on the screen here is a push alert that Harris County residents all got on their cell phones today. Public safety alert: Stay home.

The uncontrolled spread of the virus in and around Houston is now translating into an uncontrolled surge of sick people in Houston area hospitals. Houston hospitals have now overtopped their normal ICU capacity. Plans for an overwhelmed health care system have already been activated. They`re in what they call surge capacity already, which means they`re beyond their normal means.

We`re going to take a trip to those front lines next.

Stay with us.


HIDALGO: Our hospitals, the largest medical center in the world, are using 100 percent of their base operational capacity right now. Every day since June 13th, our hospital and ICU populations have been higher than our previous highs in April. Our situation is far worse today than when we issued the first stay-at-home order in Harris County and when the state issued their first stay-at-home order. This is unacceptable.



MADDOW: Back in April, as Texas was bracing for a spike in COVID patients, officials in Harris County, the county that`s home to Houston, unveiled a new field hospital. They turned a football stadium into a field hospital that could handle up to 2,000 patients.

They opened it up but within weeks, they shut it back down without ever seeing any patients there, which is great news, right? Quote, area hospitals were not overwhelmed as feared.

That was April.

Now that field hospital in Houston may be making a comeback. In fact, cities across Texas are starting to scramble to find and build out additional capacity now as the hospitals and ICU units have filled up now thanks to what has turned out to be an out of control rush of COVID infections in Texas here in late June. Houston says when it does activate that field hospital again, they think it can be up and running within 72 hours. Staff for that site are on standby, which again is good news.

Ever since Texas went into phase two of reopening, hospitalizations in Houston have gone straight up. These are the numbers.

This is specifically a snapshot of the ICU beds in Houston. It shows you a breakdown between COVID and non-COVID patients in Houston`s 1,300 ICU beds. But see that little number 5 there next to the zero percent? That`s the literal number of how many open ICU beds Houston had as of two nights ago. Five beds for a city with a population of 2.3 million.

Statistically speaking, you can go ahead and round that to 0 percent of ICU beds still being available while new infections continue to climb through the roof, right? And this two to three-week delay between new infection and when some proportion of those newly infected people are going to start turning up at the hospital door, many of them needing critical care attention.

What`s it feel like to be in the middle of that?

Joining us now is Dr. Cedric Dark. He`s an emergency medicine physician in Houston.

Dr. Dark, I know how valuable your time is right now. I really appreciate you taking a few minutes to be here with us tonight. Thank you.

DR. CEDRIC DARK, EMERGENCY ROOM PHYSICIAN, HOUSTON, TX: Thank you very much for having me on.

MADDOW: So I`ve just said a lot of words about Houston and about Texas and how things are. Let me just ask if that comports with your understanding or if you feel like from your perspective, we`re talking about any of this in the wrong way or missing any of the important points.

DARK: I think you`re right on about it. I mean I was working a few days ago, and it was pretty obvious to me that there were no hospital beds for any patients that had COVID throughout the entire Houston area, and that`s, you know, ranging as far south as Galveston and upwards into the Woodlands. Nobody had any capacity to take care of a patient with coronavirus, and it`s pretty ashamed to say that`s the state of our city. It`s very worrisome, and one of the things I wish Judge Hidalgo would do is to activate NRG so that we can have an escape valve for our overcrowded emergency departments.

MADDOW: How does that manifest for you as a doctor, you and your colleagues when you`ve got a patient with COVID who needs care that you don`t have room for, and you start looking for someplace to transfer them to? Can you tell us what that`s like and sort of what plan B is when you realize you can`t fully find a place to send them?

DARK: Plan B is they stay in the emergency department ultimately. What we tend to do if there`s a patient that needs any kind of care, whether it`s COVID care or some other kind of higher level of care and they don`t have space for that at their particular hospital, they have to seek a transfer, and it requires another hospital have the capacity to be able to accept that patient. Otherwise, you can`t transfer them.

So in our case, if we`re stuck in that situation, what we would have to do is continue to manage those patients in the emergency department on our own, and that`s not something that we as emergency physicians, you know, necessarily want to do because we`re used to finding and diagnosing the problem and then getting the person to where they need to be. But unfortunately we`re put in a situation right now where we`re having to function as either hospitalist or as an internist or an intensivist if there`s no space upstairs in the hospitals for us to care for our patients. This is what we saw in Europe.

MADDOW: Does that have an impact -- does that have an impact on patients who have other emergency room presentations? I mean, people who don`t have COVID or might be infected but that`s not what they`re coming in for, is that having an effect? Should people expect that would have an effect in terms of the normal function of the E.R., and how people get care for all kinds of things?

DARK: It certainly can because what happens is it can slow down the flow through the emergency department and back up waiting rooms and therefore if you are walking in or your loved one`s walking in with chest pain and they need to see a doctor to make sure they`re not having a heart attack, you know, every step along the way, if you slow down the output from the emergency department, then it`s going to be slow on the input side, and that might lead to delays in care, which can ultimately cause devastating harm to patients that need it whether or not they have coronavirus or if they have something like a heart attack or a stroke or trauma.

MADDOW: You mentioned New York just a moment ago. I found myself thinking actually just over the course of this hour, talking to the former director of the state health department in Arizona, talking to you right now, looking at these numbers, and I found myself thinking about Governor Andrew Cuomo in New York when New York was in the worst of it. And he`s just in the last few days stopped doing his daily press briefings.

But I remember him saying in the worst of it that New York would reciprocate, that he wanted other states to send health workers to New York because New York was in such a crunch. And he said, and when this happens to you, when this goes so badly in your state in the future and it will, we will send people to you.

Are we at a place where states, places like Houston, places like Arizona that are that hard hit, should start to think about tapping a sort of medical reserve corps from workers around the country trying to tap national resources to protect your hospitals? It`s very concerning to hear you say that already, for the last few days, you got nowhere to send COVID patients.

DARK: I mean the wonderful thing about Houston is there is like a doctor almost everywhere around and a nurse everywhere around the city because we are the home of the Texas Medical Center, which is the largest medical center in the world.

So, for right now, I don`t think that the human resource is a problem. I think right now it`s mostly the physical resources that we`re struggling with and that we need a little help with.

MADDOW: Dr. Cedric Dark, emergency medicine physician in Houston, Texas -- again, your time right now is incredibly valuable. Thank you. Keep us apprised going forward.

I`m hoping that there`s going to be change in terms of resources available to you and your colleagues over the next few days. But we`d love to have you back anytime soon to let us know how things are going.

DARK: Anytime. Just ask.

MADDOW: All right. Thanks.

We`ll be right back.


MADDOW: It has been a tough week in the news this week, it`s probably going to be a tough week in the news next week. If you get any time off this weekend, take care of yourself, take care of yourself. Your country needs you.

All right. We`ll see you again on Monday.


Good evening, Lawrence.

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