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ER Doctor TRANSCRIPT: 3/20/20, The Last Word w/ Lawrence O'Donnell

Guests: Ron Klain, Vin Gupta, Lori Lightfoot, Adam Smith, Rob Davidson, Richard Painter

(COMMERCIAL BREAK)

RACHEL MADDOW, MSNBC HOST: Before we go tonight, I want to tell you about a  member of the MSNBC family who died yesterday of coronavirus. The thing you  should know about Larry -- about Larry Edgeworth is that he was a hoot. He  was a ton of fun, and he was really good at his job. He spent 25 years at  NBC News.

It was always a really good sign if you got sent into the field or to a  remote location somewhere and Larry was on the team. He was just super  charismatic, very talented, very respected by his co-workers. He is  survived by his wife and his two sons, mourned by all of us who are lucky  enough to work with him. That will do it for us tonight. See you again on  Monday.

ALI VELSHI, MSNBC HOST: We`re all thinking about Larry. Thank you, Rachel.  Restrictions are dramatically ramping up amid the growing coronavirus  pandemic. Illinois is the latest state to join California by --

(CROSSTALK)

VELSHI: Illinois Governor J.B. Pritzker has ordered the state`s 13 million  residents to stay at home for non-essential activity. I`m going to be  speaking very shortly with Chicago Mayor Lori Lightfoot about the new  measures that that state is taking.

New York Governor Andrew Cuomo has issued an executive order virtually  shutting down his state, requiring 100 percent of New York`s non-essential  workers to stay home. He called it the most drastic action they could take.

This afternoon, New York City Mayor Bill de Blasio announced that the  number of coronavirus cases in the city had climbed to 5,151. That`s nearly  a third of all the cases in the U.S. so far. Tonight, President Trump has  approved a major disaster declaration for the state of New York. In  Florida, Governor Ron DeSantis has ordered all restaurants and bars to  close.

Public health officials are warning that this virtual shutdown of our  regular lives is going to last a while, likely at least several weeks.  Tonight, we learned that a member of the office of the vice president has  tested positive for coronavirus. Neither President Trump nor Vice President  Pence had any close contact with the individual, according to the White  House.

That news comes as the number of confirmed coronavirus cases continues to  rise as more people are tested. At this hour, there are now 18,332 reported  cases of coronavirus, 237 reported deaths. School superintendents,  governors and business owner have taken it upon themselves to shut down  much of American life without getting clear guidance from the president.

At today`s coronavirus press briefing, President Trump was pressed by NBC`s  Peter Alexander on inaccurate statements that Trump made that a drug used  to treat malaria was going to be available almost immediately to combat  coronavirus. The president suggested that it already had been FDA-approved  to do so. Today, Dr. Anthony Fauci, the nation`s top infectious disease  expert, said the president is wrong.

(BEGIN VIDEO CLIP)

JOHN ROBERTS, FOX NEWS JOURNALIST: Dr. Fauci, if I could -- Dr. Fauci, it  was explained yesterday that there has been some promise with  hydroxychloroquine, this potential therapy for people who are infected with  coronavirus. Is there any evidence to suggest that, as with malaria, it  might be used as a prophylaxis against COVID-19?

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS  DISEASES: The answer is no. The evidence that you`re talking about, John,  is anecdotal evidence.

(END VIDEO CLIP)

VELSHI: The answer is no and the evidence is anecdotal. But the president  said it would work. Dr. Fauci also seemed to be on a different page than  Trump when it came to the problems around testing. And of course, as is so  often the case with this president, the press conference devolved into a  series of personal attacks as the president made the briefing more about  him than about the crisis.

(BEGIN VIDEO CLIP)

PETER ALEXANDER, NBC NEWS WHITE HOUSE CORRESPONDENT: What do you say to the  Americans who were scared, though? I guess nearly 200 dead, 14,000 who are  sick, millions, as you witnessed, who are scared right now. What do you to  Americans who are watching you right now who are scared?

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I say that you`re a terrible  reporter. That`s what I say. I think that`s a very nasty question, and I  think it`s a very bad signal that you`re putting out to the American  people.

(END VIDEO CLIP)

VELSHI: All right. In another exchange with PBS`s Yamiche Alcindor, who you  see often on the show, the president said that he hadn`t heard about  Americans with symptoms of coronavirus not being able to get tested despite  the widespread reporting on that very issue.

(BEGIN VIDEO CLIP)

YAMICHE ALCINDOR, WHITE HOUSE CORRESPONDENT, PBS NEWSHOUR: When will every  American who needs a test get a test and be able to get a test? And why not  have medical equipment being shipped right now to hospitals who need it --

TRUMP: We`re hearing very positive things about testing. And just so you  understand, we don`t want every American to go out and get a test --

ALCINDOR: People need test.

TRUMP: Three hundred and fifty million people. We don`t want that. We want  people that have a problem.

ALCINDOR: There are Americans though who say that they have symptoms and  they can`t get tested. What do you say to the Americans --

TRUMP: I`m not hearing it.

(END VIDEO CLIP)

VELSHI: Leading off our discussion tonight, Ron Klain, former senior aide  to Vice President Joe Biden and President Obama. He served as the Ebola  czar during the Obama presidency. Also joining us is Dr. Vin Gupta,  pulmonologist and global health policy expert. He is an affiliate assistant  professor at University of Washington Medical Center. And Dr. Irwin  Redlener is the director of National Center for Disaster Preparedness at  Columbia University. He is an MSNBC public health analyst.

Gentlemen, thank you for being with us. Irwin, let me just start with you.  There is nobody in America who doesn`t know that there are people who  either want to -- need to be tested or whose doctors want them to be tested  who are not able to get tested. That is just -- I don`t know what kind of  language we can use to describe that, but it`s untrue. For the president to  say he didn`t know that is worrisome at this point in the crisis.

IRWIN REDLENER, MSNBC PUBLIC HEALTH ANALYST: Listen, just another jaw- dropping press conference that we have to experience far too often. I think  it is beyond preposterous. It`s hard to know how to describe this.

But I can tell you, I speak to emergency medicine doctors every single day,  and they are absolutely panicked about the lack of testing. They can`t get  the test results back fast enough when they do get tests. And now, they are  in the process of worrying about the fact that they`re going to be running  out of all the protective equipment they need to keep themselves safe.

The level of crisis in this country is accelerating by the day without any  doubt and it`s so unhelpful for the president to be at the podium, the  national podium, saying things that are blatantly untrue. I just don`t even  understand it. And especially, Dr. Fauci come up, you know, seconds after  the president finishes speaking and contradicting him.

Something is terribly disconnected. I am just very worried about it. This  communication problem is overwhelming our ability to have confidence in  public officials. I have never seen anything like this.

VELSHI: Ron -- it`s remarkable, Ron, because Fauci two times had to come  out and say, which must be a very uncomfortable position in front of the  president, that something the president said as fact is simply not fact.  There are a whole bunch of things that Fauci wasn`t there to correct what  the president said.

I have to remind people, when we were covering Ebola, there was a sense of  organization and sort of a nation behind this whole thing. I remember that  one particular shot of a nurse in Texas getting on a plane to get treatment  and there were -- all the networks were on it. We were watching this  person. We were sort of all in it together.

You just heard Rachel Maddow say that at this point, it might be a  disservice to cover Donald Trump`s press conferences about this because  there`s so much mistruth coming out of them.

RON KLAIN, EBOLA CZAR, OBAMA PRESIDENCY: Yes. I`ll leave the decision on  coverage to the journalist and the First Amendment. What I will say is that  Americans shouldn`t listen to what he`s saying. And at this point in time,  it doesn`t matter what he`s saying. The only thing that we should look at  is what is happening.

His words will not save anyone. But the question is: Is he taking necessary  actions? And they`re still behind on testing, even though they have known  for three months we need to fix the testing problem. It`s still not fixed.  We`re still way behind other countries on that. There is no excuse for  that.

We`re behind on getting hospital beds at place. Governor Cuomo last two  weeks ago ordered the corps of engineers to start to build hospitals in New  York. Nothing is happening on that.

We`re behind on getting the kind of gear for our medical workers that Dr.  Redlener talked about a second ago. Again, the president has the authority  under the Defense Production Act to order industrial facilities to produce  these goods. He hasn`t issued that order.

At this point in time, I don`t think anyone should care one whit what  Donald Trump says to the podium. The question is what is getting done, and  the things that need to get done are not getting done.

VELSHI: Vin Gupta, give us your assessment. You work in the field. We have  two different issues going on. We got medical professionals and public  health officials who are telling us that there is a problem with the  testing, with the equipment, with the treatment.

And then we`ve got sort of now secondary problems that are starting to  develop because of our medical system. We talked about flattening the  curve. Until we flatten that curve, we are going to start bumping up  against capacity for medical treatment, the type that you offer on a  regular basis.

VIN GUPTA, PULMONOLOGIST, GLOBAL PUBLIC HEALTH EXPERT: You know, Ali, I  think we need to move towards a national lockdown and approach where one  state does this but there is no consistency across state lines is causing  confusion for all of us in public health. How can you actually have an  effective response akin to what they did in Wuhan if we don`t do it as a  country?

We can`t overcompensate on the West Coast or in the Midwest, states that  don`t do what they should be doing, social distancing and compelling people  to stay home. That`s where we are now. We know what works. We should be  doing it.

If we don`t do it, we`re going to continue to see the problems that we`re  already seeing in ICUs, like the one I`m staffing tonight. We`re seeing  that we don`t have the personal protective wear that nurses and doctors  need to stay safe.

We all want to care for our patients. All my colleagues, we all want to do  what`s best for our patients. We also want to come home and not expose our  families. And so the more and more we have this approach where some states  do one thing, another state does another thing, we`re just creating this  constant crisis that`s not going to go away.

We need unanimity, a national lockdown, so that we can focus on things that  really matter now. ICU surge capacity, building out more beds, as Ron just  said, getting the Army Corps of Engineers to build more ICU beds. That is  what they`re good at. I`m a former military reservist. I know what the  military can do when it comes to putting up a triage hospital in no matter  of time. That is what they are capable of doing. We need to activate that  now.

VELSHI: Irwin, let us talk about that.

REDLENER: Yes.

VELSHI: You and I have been having this conversation for a few weeks now,  the idea that there are certain institutions in this country. Put aside  President Trump on whether you should or shouldn`t be listening to them  because unfortunately a lot of people do and they conduct activities based  on what he says.

REDLENER: Yes.

VELSHI: But put that aside for a second. There is the Army Corps of  Engineers, there`s the National Guard, there`s the Department of Veteran  Affairs which actually has pretty good capacity. What has to happen now?  What`s the next step so that we do not bump up -- I can`t overestimate what  you first told me and the country has heard a lot about, is that if we bump  up against that capacity of our health care system, that`s not just about  people who get coronavirus, that`s everybody else in the country who  consumes health care on a daily basis.

REDLENER: Right. A friend of mine called me about two hours ago. He is a  physician. He has a patient on Long Island with appendicitis, and he can`t  find a surgeon to take care of his patient. And I`m telling you, this is  what we`ve been talking about exactly on that the -- we`re so far behind.  We were behind in the testing and OK, we`re trying to deal with that.

But now we`re behind in all the things that Dr. Gupta and all of us have  been talking about. We don`t have enough supplies. Here is the issue now,  too. The hospital beds that need to be built also need to be staffed and  they need to be supplied. And where are we going to get these doctors from?  I heard some governors calling for volunteers, retired physicians coming to  help out.

Those are the specific doctors who are going to be at risk. They are older.  They have pre-existing medical conditions. Can we morally put doctors or  nurses who are at high risk and put them into situations to work for COVID- 19? Patients, I don`t think so. The other thing to note is that, yes, we`re  talking about doctors and nurses, but hospitals need everybody. The team is  registrars, the dieticians, the respiratory therapists --

VELSHI: Right.

REDLENER: -- as well as the medical staff. We don`t have those people right  now. We haven`t given them the medical supplies that they need. We`ve put  ourselves in a really big jam. I want to -- if I can just talk for one  minute about what we need to do given those restrictions. We now need to  find people.

For example, we have a whole -- we have 10,000 or so international medical  graduates. These are people who went through medical school in some other  country. They got their training. They went to practice. They legally can`t  practice in the U.S. until they`ve done another residency right here. I  think we should eliminate those restrictions, for example.

Second of all, there are some lower level medical practitioners that may  be, say, nurse practitioners and physicians assistants, we should upgrade  them so they can step in and really help directly. There are things that  can be done and we`re not doing any of it. It`s -- I`m basically speechless  except I can`t be speechless on your show.

So this is what we`re dealing with, a problem that we`ve known about for  many, many weeks and the level of inactivity that is jaw-dropping, as I  said at the beginning of this.

VELSHI: And Ron, we have known about this and administration has known  about it. In fact, The New York Times is -- I`m sorry, The Washington Post  was reporting on U.S. intelligence agencies, issuing ominous classified  warnings in January and then February again about the global danger posed  by coronavirus, while President Trump and lawmakers played down the threat  and failed to take action that might have slowed the spread of the  pathogen, according to U.S. officials familiar with spy agency reporting.

But, Ron, we don`t even need to look at that kind of information. How long  was it? It was two weeks ago -- maybe a week ago when the president was  saying, I don`t want those people getting off the cruise ship because it`s  going to increase our numbers, it`s going to double our numbers. Is it the  messaging or is there a real decision-making problem in this  administration? 

KLAIN: Well, it`s both. The decision-making has been badly flawed. I think  there are a number of warnings in January, warnings privately and warnings  publicly. I mean, I myself wrote a big piece in The Washington Post in  January saying that this was coming and laid out the steps that need to be  taken.

There were no shortages of warnings. But there was a decision by the  president, a delivered decision to downplay it, to sideline public  officials who said, hey, this is dangerous. Dr. Nancy Messonnier, one of  the senior officials at the Centers for Disease Control, said publicly it  is coming here, it is inevitable. After that, she basically disappeared  from public appearances of the coronavirus task force.

So this was a deliberate decision to try to reassure the American people by  offering them false statements about the dangers that we face in the hope  that somehow we wouldn`t notice or if we didn`t get ready, it wouldn`t  come. That obviously was a deliberate decision by the Trump administration  that we`re all paying the price for right now.

VELSHI: Dr. Gupta, you`re on the frontline here. You are the people who are  crying out for the things that you mentioned that we need the supplies, the  staffing, the Army Corps of Engineers, more hospital spaces. If someone is  listening to you, a decision-maker in public health policy right now or in  the administration or on the coronavirus task force, what`s your message to  them?

GUPTA: I think we need to activate the U.S. military. We need -- every  state needs to activate their national guard. We need to increase ICU surge  capacity immediately. This is the issue now. There is such an over emphasis  on testing. Testing is important but we are so consumed by it that we`re  not focussing enough on the lack of ventilators. Now, we are focused a  little bit more on it.

But right now, any day now, any day now, we could be facing Italy across  the country. We faced it to a certain extent here in Seattle already. As  Dr. Redlener said, we don`t have enough health care work force capacity at  baseline, much less ICU nurses and doctors.

Now, we`re talking about not enough beds. We need to focus on ICU  capabilities now. If you`re a public health leader or a decision-maker, let  us focus -- also in addition to testing, let`s focus on what we can do to  build up more ICU capability.

VELSHI: I know you`re going back to work, so we appreciate -- sorry. Irwin,  go ahead.

GUPTA: Yes. I just want to say this. One of the amazing things here is that  there are some incredibly dedicated and talented people at Health and Human  Services. There are two assistant secretaries at HHS and a guy named Robert  Kadlec who works as assistant secretary for Preparedness Response.

They are extremely talented people that should have been let loose a long  time ago. They knew what had to be done. I don`t know where they got  constraints from. I`m only assuming it must have been the White House that  didn`t want to sound the alarm just like Ron was saying. It is an  inexplicable failure of leadership that has put America in its gravest  danger since 1918 and really concerning.

VELSHI: I wish we were talking about this in the past tense, Irwin, but  that failure continues today. Dr. Irwin Redlener, Dr. Vin Gupta who is  going back to work right now, and Ron Klain, thank you for starting us off  tonight.

Coming up next, one in five Americans are under orders to stay home.  Illinois is the latest state trying to flatten the curve. Chicago Mayor  Lori Lightfoot joins us right now -- right after this. And later, if you`re  out of work because of the pandemic, what is the federal government doing  to help you?

(COMMERCIAL BREAK)

VELSHI: We have breaking news. President Trump has approved the disaster  declaration for New York that will allow the federal government to provide  more resources and relief to fight the coronavirus pandemic. The aid for  New York comes as over 70 million Americans find themselves under  instructions to stay at home.

California`s governor, Gavin Newsom, issued the stay-at-home order last  night, effectively shutting down the most populous state in the country. In  making his decision, Governor Newsom showed a model that suggested that 56  percent of Californians -- that`s more than 25 million people -- could be  infected over eight weeks without extreme social distancing.

Today, New York Governor Andrew Cuomo announced a statewide stay-at-home  executive order, demanding all non-essential businesses to close by 8:00  p.m. on Sunday. New York City has over 5,100 cases of coronavirus. That is  over one-third of the national total.

Illinois Governor J.B. Pritzker is joining California and New York to issue  a stay-at-home order for the 13 million citizens of Illinois. That order is  expected to begin at 5:00 p.m. tomorrow, 5:00 p.m. Saturday and continue  through April the 7th.

Joining me now is Mayor Lori Lightfoot of Chicago. Mayor, thank you for  joining me. This is a difficult matter at the best of times. But in a city  like Chicago or a city like New York where people exist by being around  each other and interacting with each other on a constant basis many more  times a day that any of us realized until this started to happen, how do  you manage that?

How do you manage that with emergency services? How do you manage it with  police? How do you determine what essential services are and what there  not? Who has to stay home and what happens if they don`t?

MAYOR LORI LIGHTFOOT (D-IL): Well, we`ve been working and going in this  direction now for about a week to 10 days. For us, we have been looking and  guided by the science and the data that our public health officials had  been generating, the data analysis.

And we knew that if we didn`t do something fairly dramatic like countries  like Japan or Singapore or South Korea, then we are going to see an upward  ark of this virus with no end. And all of us have been talking about  flattening the curve, bending the curve.

VELSHI: Yes.

LIGHTFOOT: The bottom line is you got to contain the spread.

VELSHI: Mayor, you mentioned Japan and South Korea and Singapore. The  distinction there is that you did not have local authorities and state  authorities sort of having ongoing disagreements with federal authorities.  This does continue to be an issue because we`re not getting consistent  messages across the country and at different levels of government. How do  you manage that with people in Chicago? 

LIGHTFOOT: Well, look, I think we learned early on in the ark of this virus  coming to the United States that candidly we wouldn`t get a lot of help  from the federal government. And if we waited for them for direction, I  don`t even know where we would be.

So we knew in Chicago that we have to take matters into our own hands.  Luckily, we have a governor who understands that we have to be guided by  the data and science. So we`ve been working hand and glove not only with  the state but also our county officials. Public health seamlessly working  together to craft a set of strategies and closures that we knew are going  to be important to protect the public.

So we started by shutting down large scale events, then we closed bars and  restaurants, then we went to groups of 50, and we were just looking at the  data science and really looking at the ark of this virus and knew that we  had to take another big dramatic step.

The truth is in Chicago, over the course of this last week, because of the  measures we had already taken, this order that was entered today is not  such a huge step forward, but we knew it was important not only for Chicago  but the metropolitan area and the entire state, that we were all on the  same page.

I agree with one of your prior participants who said this patchwork across  the United States isn`t really tenable. But when the federal government is  not leading and we`re not getting the kind of support that we need --

VELSHI: Yup.

LIGHTFOOT: -- we got to do it at the state and local level.

VELSHI: We`re grateful for leaders like you at the state and local level  who are doing the things that necessary to keep us safe. Chicago Mayor Lori  Lightfoot, thank you for taking time out of your schedule. We know it`s  particularly busy to talk with us.

LIGHTFOOT: Thank you.

VELSHI: Coming up next, the leadership crisis coming from the White House.  Why the president continues to drag his feet on invoking power that he  could use to help hospitals in crisis. Congressman Adam Smith, the chairman  of the House Armed Services Committee, joins me next.

(COMMERCIAL BREAK)

VELSHI: If you`re not feeling it already, you are someone you know may soon  feel the massive economic and health impact of the coronavirus pandemic.  So, today, the Senate sped up negotiations over a third stimulus package of  at least a trillion dollars. 

The centerpiece of the Republican proposal is a direct payment of up to  $1,200 per person for those who make up to $75,000 a year. Those making  more than $99,000 would not receive any money. For those who make less than  $2,500 a year, the payment can be as low as $600. 

The proposal also includes relief for small businesses and the airline  industry. House Speaker Nancy Pelosi says the Republican proposal is "not  at all pro-worker and puts corporations ahead of working people. As  written, it is a non-starter." 

Senate Minority Leader Chuck Schumer said tonight there are many issues to  negotiate, but he hopes to reach a deal as early as tomorrow. Meanwhile,  hospitals across the country, as we have discussed this evening, are facing  severe shortages of essential medical equipment. 

For at least a week, Democrats and some Republicans had been urging  President Trump to invoke the Defense Production Act. This Act gives  President Trump the power to direct U.S. manufacturers to make equipment  such as ventilators, masks, gowns, gloves, swabs. You`ve heard about this.  You all know about it from the movies and we`re reading about it. It`s what  we do in wartimes. 

President Trump has resisted saying, invoking the Act will be a "worst-case  scenario." How bad does he want this to get? Today, President Trump  announced that he was, after all, using the special powers granted by the  Act. He said that after Senator Majority Leader Chuck Schumer urged Donald  Trump over the phone to use that Act. 

The spokesperson for Schumer says, "The President yelled to someone in his  office to do it now." But later, Donald Trump gave conflicting answers  about whether the Act was actually in effect and he could not name  companies that he was asking to make ventilators or masks. 

Joining me now, Congressman Adam Smith. He`s a Democrat from Washington and  the Chairman of the House Armed Services Committee. 

Congressman, first of all, your constituency is one that has been uniquely  hard hit by coronavirus. Can you tell us what`s going on where you are? 

REP. ADAM SMITH (D-WA): Certainly. We were hit first and had the largest  number of, certainly, fatalities and cases. And our health care system is  really being pushed to the brink. We have heard today that more help is on  the way in terms of personal protective gear. People are trying to make  more ventilators. Basically ramp up the production of the things that we  need. There are creative solutions about where to house people, not trying  to get access to some hotels, working with the hotel companies, working  with the Department of Defense to get their hospital ship up here. So we`re  scrambling. 

We got hit first, and we`re preparing as best as we can. But this is what`s  coming to much of the rest of the country, and we need a national effort  now. It is exactly like World War II in terms of the need to--

VELSHI: Yes. 

SMITH: --massively ramp up production of key gear, so we can deal with  this. 

VELSHI: But it would be remarkable. This will - this illness and infection  will do what it does. It would be remarkable for us to lose lives because  we don`t have enough ventilators, because we don`t have enough masks,  because we don`t have enough protective equipment. And yet, we are hearing  - you heard it earlier in this show. We hear it from everyone in the  profession and public health officials. That`s actually a fact. 

And for the president to suggest - in fact, he suggested this yesterday  when he was asked about why governors are being pressed to do this rather  than the federal government. Listen to what he said. 

(BEGIN VIDEO CLIP)

DONALD TRUMP, PRESIDENT, UNITED STATES OF AMERICA: Governors are supposed  to be doing a lot of this work and they are doing a lot of this work. The  federal government is not supposed to be out there buying vast amounts of  items and then shipping. You know, we`re not a shipping clerk. 

(END VIDEO CLIP)

SMITH: Yes. He`s wrong about that. 

VELSHI: "The federal government is not supposed to be out here buying vast  amounts of items and then shipping. You know we`re not a shipping clerk." I  mean, it`s flippant and does not seem to be sort of cognizant of what`s  going on. 

SMITH: Well, as the Chairman of the House Armed Services Committee, I can  tell you that the Department of Defense ships things better than anybody in  the world, with all due respect to FedEx and UPS. So we do know how to  handle those logistics. 

Look, a big part of the problem here, and I talk on a fairly regular basis  with several members of the task force working on the coronavirus response  from the federal government, and they are much more proactive on this than  the President sounds. I mean, I don`t know why he would say that. I could  speculate, but I`d rather not. 

But I know we just got off a conference call with Dr. Kadlec at HHS. They  are invoking - or - I don`t know if they are invoking this Act, but they`re  putting pressure on private companies to massively ramp up production. What  needs to happen from the federal government, though, production is one  thing, distribution is the key--

VELSHI: Yes. 

SMITH: --because what we`re falling into right now is, even as production  increases, it becomes a fight, state-to-state. I mean, desperate  constituencies trying to protect their people. You`ve got New York and  Washington, Washington and Illinois, California and Nevada fighting over  who gets how many masks. 

The federal government needs to do a conditions-based assessment and have  better control of where that crucial equipment goes. No one can organize  this like the federal government. And the President is still holding back  from that commitment. I think he needs to step forward and be assertive  about the federal government role. 

I mean, to begin with, I`m very pleased to hear that New York got their  disaster declaration, our governor here in the State of Washington has made  that request. We need that request approved as soon as possible. 

VELSHI: Yes. Yes. He called your governor a snake. 

SMITH: Yes. 

VELSHI: Economic projections - let`s just talk about that. "Washington  Post" reported that JPMorgan Chase has estimated that the United States  economy could shrink by 14 percent between April and June. That would be  the biggest contraction in the post World War II era. Goldman Sachs has  estimated that 2.25 million people filed for unemployment this week. That`s  a ten-fold increase from a week ago and the largest number ever recorded. 

Congressman, we have a whole lot of inequality and disparity in our nation.  And sometimes when asked to fix those things, people say it`s too hard, it  takes too much money. Now we`re about to embark on things that are really  hard and are going to cost a lot of money. It doesn`t seem - I think we`ve  got to put sort of the least among us in the forefront. 

SMITH: Absolutely. But two things about that. First of all, the only thing  that`s going to begin to slow that and begin to get us going in the right  direction is to deal with the health care crisis in front of us and that  means testing. That`s the only way we can do this. 

Wide, massive increases in testing all across this country, so you can  figure out who is at risk of spreading this disease and you can figure out  who isn`t. And then you can isolate the people who are at risk and let  everybody else go back to work, go back to school, get back to work. But  absent massive testing, you will never know that. That`s the other big  production that we need to ramp up. And we need to ramp up with tests that  take less than two or three days. 

China has developed a test. They get back in four to five hours. So they  check just about - well, not quite everybody, but they isolate people. They  check them. That`s what we`ve got to do in this country. So that`s number  one. Now, no matter what we do, we are headed for a massive - we`re already  in the middle of a massive economic slowdown and we have got to help the  people who are most on the edge. 

VELSHI: Yes. 

SMITH: If you`ve got money, you know, you can afford to not have anything  coming in for a month or two. But so much of our population can`t. They  can`t go a week or two--

VELSHI: That`s right. 

SMITH: --without a paycheck. We`ve got to fill that void. 

VELSHI: Congressman, thank you for your time tonight. And we wish you  continued recovery in King County and in Washington State. Congressman Adam  Smith. 

SMITH: Thank you. 

VELSHI: Up next, the heroes on the front lines, the doctors, the nurses of  America. After this break, we`re going to talk to an ER doctor who`s taking  his night off to tell the country what needs to happen now to save the  greatest number of lives.

(COMMERCIAL BREAK)

VELSHI: Hospitals in the United States are preparing for a possibly  overwhelming number of coronavirus patients in the coming weeks as the  cases continue to rise. But doctors, nurses and health care workers are  confronting a dire shortage of basic things like masks, surgical gowns, and  eye gear to protect them from the virus. 

Yesterday President Trump said there was no immediate plan to address  medical equipment shortages by activating the Defense Production Act.  Today, the President said this. 

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: --nature of ventilators, Mr. President? 

(CROSSTALK) 

UNIDENTIFIED FEMALE: You just said that you haven`t had to require  companies to up their production of medical supplies. But you said last  night you invoked the--

TRUMP: But I didn`t say--

(CROSSTALK) 

UNIDENTIFIED FEMALE: --DPA.

TRUMP: Yes. 

UNIDENTIFIED FEMALE: I`m confused--

(CROSSTALK) 

TRUMP: When we need something--

(CROSSTALK) 

UNIDENTIFIED FEMALE: --require them for--

TRUMP: When we need something - because of the Act, when we need something,  we order something. 

(END VIDEO CLIP)

VELSHI: Joining us now is Dr. Rob Davidson. He`s an emergency medicine  physician in Michigan. He`s the Executive Director of the Committee to  Protect Medicare. 

Dr. Davidson, thank you for being with us. What is it? Which one is it? Is  the government invoking its ability to get the manufacturer of these things  or are they not? Because it does - the messages are entirely clear from  everyone in the medical and public health community, with whom I`ve spoken  to in the last few days, there are about to be critical shortages. 

ROB DAVIDSON, ER PHYSICIAN: Yes. And we`re in full preparation mode for  what is to come over the next several weeks. And in our hospital and  hospitals across our system in West Michigan, we`re conserving masks. We`re  using the same mask for an entire shift and storing it in a paper bag and  sterilizing our hands as we put the mask on and take the mask off, as we go  into every room. 

We understand that with the influx of patients that we are anticipating,  these supplies will run out at some point. So I don`t know what they`re  doing behind the scenes, but certainly the mixed messages from the  President - or if he`s declaring that no one has told him that it`s a  problem or doctors aren`t saying that to him - if he`s watching right now,  there is a doctor here, and I am representing many doctors across this  country. We need their help. We need leadership in this respect. 

VELSHI: Dr. Davidson, let`s just play this out for a second. Let`s say I`m  not believing any of this hype. Right? Somehow I`m consuming the  information the President is putting out there that anybody who needs a  test can get tested. There`s no shortages. We don`t need to invoke these  kinds of things. 

And all of a sudden, I`m a man of a certain age, I get a heart attack, or  something else happens, or my appendix needs treatment, and I call 911, and  I go to a hospital, and I find out that there are beds that are problematic  or you`ve been using the same mask all day, or the red cross says they  might be two weeks away from running out of blood. This is not just about  coronavirus. This is about our entire medical system. 

DAVIDSON: Absolutely. I mean, our committee of doctors, the Committee to  Protect Medicare is advocating for affordable health care. Before this  started - after we eventually see our way through this - but this is what I  tell people who try to say, well, I won`t be affected or I have such a low  likelihood of being affected myself.

A, we see young healthy people on ventilators already with this crisis, but  if our hospitals are overwhelmed with patients with coronavirus, what  happens - that`s what I`m concerned about. I`ve been serving in my  community for over 20 - for nearly 20 years. And I`ve kind of taken a  pledge to serve those folks. And we have to make tough decisions from time  to time. 

I don`t want those decisions to be tough because my government has let me  down and not gotten us the equipment we needed. If he thinks that anyone  who wants a test can get a test, I can tell you, I`ve worked the last three  nights, and just a few nights ago, on one particular shift, I saw a handful  of patients, each one of them should have had a test if they were  available, but we are rationing tests because they just aren`t there. We`re  saving them for the sickest patients. 

VELSHI: So, Dr. Davidson--

DAVIDSON: So we`re sending people home and telling them - yes. 

VELSHI: I don`t mean to interrupt you, but--

DAVIDSON: Yes. 

VELSHI: --let`s just be clear about this. In fact, let me - I`m going to  ask my control room to just play a shortened version of an answer, a  conversation between our PBS colleague, Yamiche Alcindor, and the President  about the availability to testing. Let`s listen to this. 

(BEGIN VIDEO CLIP)

YAMICHE ALCINDOR, WHITE HOUSE CORRESPONDENT, PBS NEWSHOUR: There are  Americans that say--

TRUMP: It just is embarrassing. 

ALCINDOR: --that they have symptoms and they can`t get tested. 

TRUMP: Yes. Well, I think--

ALCINDOR: What do you say to the Americans who are saying they have the--

TRUMP: I`m not - I`m not hearing it. 

(END VIDEO CLIP)

VELSHI: I`m not hearing it. Dr. Davidson, is that a possibility? I mean,  I`m not in the business of accusing the President of lying if I don`t know  otherwise. I don`t imagine how any American has heard that there aren`t  shortages of tests for people who may need them. 

DAVIDSON: Right. If he`s not hearing it, he`s not listening, because we`ve  been crying out as a chorus of doctors and nurses and folks in health care  across this country. And I will tell you, there is a shortage. We are  rationing. In the United States of America, we are rationing these tests. 

Our first case in this country was the same day as the first case in South  Korea. And they were testing 10,000 a day from a week after that. And we`re  still struggling in my state and I know in states across this country. 

But in my hospital, again, a handful of people, five people I saw in the  night shift, and not one of them could get a test because, frankly, we just  (inaudible) we don`t have the ability to do that. This is coming down from  the state. They have limited supplies. I understand why the state is doing  this. But for the President to suggest that, again, I guess I wouldn`t be  in the business of calling him a liar, but he`s obviously not listening to  the people on the front lines. 

VELSHI: Dr. Davidson, let`s talk about remedies for this. We have heard all  sorts of things. There are people who are asking for the National Guard,  for the Army Corps of Engineers, for emergency hospitals to be built, for  the Defense Act to be invoked so that manufacturing companies can be caused  to make some of these things. Others are calling for a shutdown, a near  total shutdown. 

Now, there are very many people who are already worried about the economic  situation, saying what would happen if you shut the country down for a  month. Tell me what you think should be done. 

DAVIDSON: Yes. Our organization today came out very strongly, and we are  supporting a national - essentially a national shutdown. And I think this  has to be for a defined period of time, but this has to be in conjunction  with massive testing. We all hear about the surge, and what we know, we can  handle the number of patients we may get eventually over a period of maybe  four months, six months. We can`t handle that same number of patients in  the span of a month or two months. 

And so if we can dedicate ourselves to truly having essentially a shutdown,  where people are having extreme measures of social distancing, combined  with a massive number of tests being done on the well and the unwell so we  can truly identify where these hot spots are, we can then start resuming  business in certain parts of the country and certain communities and do it  safely while we`re monitoring. 

This lack of testing has put us behind, but the lack of decisive leadership  in this respect is putting us behind the eight ball even further. This is  all we want right now is a national approach to this national problem. The  virus just doesn`t care if it goes across the Illinois border from Indiana  into Illinois. If Illinois is shutting down but Indiana is not, those  people in Illinois aren`t protected. 

VELSHI: Yes. 

DAVIDSON: My governor in Michigan is protecting us, but we need this across  all 50 states.

VELSHI: Dr. Rob Davidson, thank you for joining me, sir, and thank you for  all you`re doing on the front lines of this pandemic. 

Up next, major ethical questions swirling around several senators who had  large stock sales before the coronavirus panic hit the markets. There are  calls for investigations and resignations. More ahead. 

(COMMERCIAL BREAK)

VELSHI: Tonight, four senators are trying to explain their decisions to  sell millions of dollars in stocks before concern over coronavirus caused  the markets to tank. 

"ProPublica" reports that Senate Intelligence Committee Chairman Richard  Burr sold up to $1.7 million of his holdings, including in hotel chains, on  February the 13th. That was a week before the market plunge. Senate aides  tell NBC News that Burr`s committee had received a number of briefings and  intelligence report in January and February that included non-public  information about the virus. 

Burr responded today, saying he "relied solely on public news reports, not  insider information," but called on the Senate Ethics Committee to  investigate his sales. Calls are now growing for Burr`s resignation, but  also the resignation of Georgia Republican Senator Kelly Loeffler, who by  the way would know about this because her husband is the Chairman of the  New York Stock Exchange. 

Federal disclosure forms obtained by "The Daily Beast" revealed that  Loeffler sold up to $3.1 million in stock - sitting down for this? - while  purchasing stock in a teleconferencing company. The trades began on January  the 24th, quote, "the very day that her committee, the Senate Health  Committee, hosted a private all-senators briefing from administration  officials." End quote. 

Loeffler tweeted, quote, "Investment decisions are made by multiple third- party advisors without my or my husband`s knowledge or involvement." She  also starts off by saying "This is a ridiculous and baseless attack." 

Republican Senator Jim Inhofe said he had no involvement in the trades that  dumped $400,000 in stock in late January. And Democratic Senator Dianne  Feinstein said that her assets are in a blind trust and that the sale of  millions` worth in stock in a biotech company were made by her husband. 

There`s a lot to unpack here. Joining me now is the guy to help us unpack  it, Richard Painter. He`s the Chief White House Ethics Lawyer, was under  President George W. Bush. 

There are a whole load of problems here, Richard, the first of which is  that there is a law in place that actually says that when members of  Congress sell a stock, all they have to do is report it, I think, within 30  days. It`s called the STOCK Act. So the rules that apply to guys like you  and me don`t even apply to members of the Senate, but there`s an ethical  problem if they had inside information and traded on it.

RICHARD PAINTER, FORMER CHIEF ETHICS LAWYER, WHITE HOUSE: Criminal insider  trading. The insider trading laws do apply to the members of the House and  Senate. So if they have possession of non-public information that a  reasonable investor would consider important in making an investment  decision and they got that information from the government, for example, in  a classified briefing, and they trade on that information, that is  criminal. They go to jail for that just like everybody else. 

They aren`t subject to the conflict of interest statutes that a lot of  executive branch officials are, which is why they have the stock to begin  with. They really shouldn`t have these stocks in individual companies, as  they`re regulating those companies. 

But put that issue aside. It is a crime if these members of the House and  Senate get classified briefings, confidential information, and they go  trade on that information, and they could go to jail for that. Now, you`d  have to prove, of course, that they knew that information that (inaudible)  made the decision. Yes. 

(CROSSTALK) 

VELSHI: Yes. Some of these look more interesting than others. I will say  the Dianne Feinstein thing struck me as interesting because she calls it a  blind trust. Now, we`ve all been confused by the concept of a blind trust  because Donald Trump immediately after he got - won the Presidency, he told  us all he was putting his (inaudible) a blind trust. And it absolutely  wasn`t a blind trust. So there`s a distinction if you really have a blind  trust, meaning you have zero to do with it, zero input, zero contact versus  your husband did it or someone else did it. 

PAINTER: Well, yes. It`s not really a blind trust if the husband is making  the trades. Now, that one I believe is one biotech company, and there might  have been a reason to sell that company that had obviously nothing to do  with this information. We`ll find out. 

I have to say that somebody who sells hotel stocks or someone who buys a  video conferencing company, that sounds a little bit more suspicious, I`ve  got to say. And we`re going to have to find out what these senators knew  that was non-public information and whether that information was used for  the trades. But this looks horrible. 

Let`s think about what`s really going on. We have a crisis in this country.  We were caught unprepared. Now we`re going to have a lot of people die. Our  economy is going to go in the tank. A lot of people are going to be  suffering, losing their jobs. We could have a 20 percent unemployment rate. 

And what`s going on? We have a whole bunch of senators who are bailing out  of the stock market at the high before it crashes. It looks horrible  whether or not something illegal actually happened. We`re all in this  together. We shouldn`t be trying to profit at each other`s expense. 

VELSHI: Richard, it`s almost quaint, you and me talking about what looks  unethical or doesn`t look right at this point after the last three-and-a- half years. But you know what? Someone`s got to keep saying it. And we  appreciate that you continue to do so. Richard Painter, thank you for  joining us tonight. 

And that is tonight`s "Last Word." I`m Ali Velshi. I`m going to see you  tomorrow morning, as usual, from 8:00 to 10:00 a.m. right here on MSNBC.  But in these extraordinary times, as Richard says, I will also see you at  8:00 to 10:00 p.m. tomorrow night. 

"The 11th Hour with Brian Williams" begins now.

END