(BEGIN VIDEOTAPE)
ANNOUNCER: The coronavirus crisis, a high-stakes waiting game across the United States and around the world. Hospitals are bracing for the pandemic`s peaks.
UNIDENTIFIED MALE: Field tents are being set up all around New York.
ANNOUNCER: States begging for ventilators and protective gear.
GOV. JOHN BEL EDWARDS (D), LOUISIANA: We are trying to source ventilators literally all over the world. And the price has at least doubled.
ANNOUNCER: Doctors and nurses fighting a war to save lives.
UNIDENTIFIED FEMALE: It`s a microscopic enemy and we do not have the arms and we do not have the armor to protect ourselves or to protect the public.
ANNOUNCER: And the millions of newly unemployed seeking relief.
UNIDENTIFIED FEMALE: There are so many people. I`m not the only one. So, I`m just waiting, just like everyone else, waiting.
ANNOUNCER: Tonight, Lawrence O`Donnell and Dr. Ezekiel Emanuel on the challenges ahead. Which states will be hit the hardest? Are doctors any closer to a cure? And when it`s all over, what will be our new normal?
This is a special edition of THE LAST WORD, "Life in the Time of Coronavirus."
(END VIDEOTAPE)
LAWRENCE O`DONNELL, MSNBC HOST: We begin tonight with the numbers. The United States now has 364,567 reported cases of coronavirus, and as of tonight, the United States has suffered 10,841 reported deaths from coronavirus.
To put that death toll in perspective, that is more Americans than were killed in the attack on Pearl Harbor and the attack on 9/11 combined. Both of those attacks sent this country off to war in foreign lands. This time, our war is here. And it is being fought by nurses and doctors and health care workers who are on the front lines of that battle.
You`ll hear from one of those doctors tonight who has kept a video diary of the last week in New Orleans, which now has the highest percentage of infected people in the country.
The governor of Maryland will join our discussion. He closed Maryland schools before there was a single death in Maryland. He took emergency action in Maryland in February after he and other governors had a private discussion with Dr. Anthony Fauci in Washington.
Chicago Mayor Lori Lightfoot will join us in our discussion of the disproportionate impact COVID-19 is having on African-American victims.
And throughout the hour, we will be joined by Chicago native, Dr. Zeke Emanuel, as our guide through the medicine and the science. Zeke Emanuel is a physician and he holds a PhD in political philosophy. Dr. Emanuel served in the Clinton administration and the Obama administration. He is now the vice provost for global initiatives at the university of Pennsylvania. Dr. Emanuel is now an NBC News and MSNBC medical contributor.
And, Zeke, this week is the week where people are ramping up everything in an expectation that this could be our worst week yet.
DR. ZEKE EMANUEL, NBC NEWS MEDICAL CONTRIBUTOR: Yes, I think everyone is predicting it`s a bad week. You`re going to have high hospitalizations, a high death rate, but you also see today that everyone is looking for some, you know, bright light, some positive news so they are anticipating New York is peaking. Europe, maybe Italy is peaking, and I think it`s -- it is important to see the numbers and to be very in tuned with the numbers.
But I think it`s also important to be sober about this. We are not going to get to the peak and then we can ease up the physical distance that we have and all the other public health measures that we`ve put into place in terms of closing schools and closing a lot of businesses where people gather, and to remind people that you`re likely to have a resurgence after we reach the peak and come down to the bottom and ease off some of this.
And I`ll just remind people of Singapore. In the last month, they had a ten-fold increase in a number of cases. Almost 1,400 cases now, and that forced the government to close down schools and close down all non- essential businesses. This is going to be a long haul. We`re not going to get out of it when we finish the 30 days of the president`s plan.
We are in here until we can actually get a vaccine. Yes, we`ll be able to open some businesses, but only when we have put in place very good testing and very good contact tracing so we can try to close down any new case we get. And we don`t have those things in place yet.
O`DONNELL: Zeke, the big news from London today among other news from London, Prime Minister Boris Johnson was already in the hospital, now moved into intensive care today in that British hospital. What should people -- what should -- you be looking for next in Boris Johnson`s case now that he`s moved into intensive care.
EMANUEL: Well, you don`t go into intensive care if you`re doing better. You go intensive care if you`re doing worse. We don`t know whether he`s intubated or not. But his condition deteriorated.
He`s 55-year-old and I would remind your viewers who said this only affects older people. He`s 55 years old and as far as we know, he had no preexisting condition. Didn`t have heart disease, didn`t have diabetes.
He was overweight. That is true. And that is a risk factor.
But we have to remember -- people keep focusing on this is a disease of older people. It`s true about 65 percent of people who get this disease are over 70, but that means that there are a lot of people who are younger, about 20 percent are in their 60s and about 15 percent are between 30 and 59.
So it can affect everyone and Boris Johnson is just showing, you can get very, very sick enough for the intensive care unit without being older.
O`DONNELL: Well, yesterday, the surgeon general issued this warning about the death toll that he expects to see this week.
(BEGIN VIDEO CLIP)
VICE ADMIRAL JEROME ADAMS, U.S. SURGEON GENERAL: This is going to be the hardest and the saddest week of most Americans` lives quiet frankly. This is going to be our Pearl Harbor moment, our 9/11 moment, only it`s not going to be localized. It`s going to be happening all over the country.
(END VIDEO CLIP)
O`DONNELL: Today as usual, the president tried to sound more optimistic than that and actually told reporters that he could see and he used this phrase, light at the end of the tunnel. Now that phrase fell out of use in the White House after generals and presidents used it falsely for more than ten years of the Vietnam War where there never was a light at the end of the tunnel, and in the end, we lost that war.
At the White House today, Dr. Anthony Fauci said that he`s fully confident that science will eventually win this war and that the final victory will ultimately come only when we have an effective vaccine. New Orleans is now suffering the largest number of deaths per capita in the country one week ago at this hour.
You met Dr. Najy Masri of Louisiana State University`s hospital. For the last week, Dr. Masri has been keeping a video diary for us of life and death in the emergency room in New Orleans.
(BEGN VIDEO CLIP)
DR. NAJY MASRI, LSU DIRECTOR OF HOSPITALIST SERVICES, OCHSNER MEDICAL CENTER: Hey, this is Dr. Masri. This is a video log number one. March 31st, 2020.
It`s been a little bit of a somber day today. The numbers were released today from the state. We had a 34 percent jump in cases over the last 24 hours. That`s bigger than last three days combined.
Here in Louisiana we`re over 5,000 cases. It looks like about one in every four people that gets COVID-19 is getting in the hospital down here and about 1 in every three of them that`s in the hospital end up on the ventilator.
One case that stuck out to me was a gentleman who lost pulse in his leg and fix that in the cath lab. And unfortunately, he`s requiring so much oxygen, we`re probably not going to be able to do that. So, he`s going to need an amputation.
And the worst part is his wife is in a couple rooms down I was taking care of because the whole household was affected by this virus. So, it`s a tough day today, hopefully, tomorrow will be better.
Pretty somber round so far today. The patient I mentioned yesterday with the issue with his leg, that has progressed and looks like we`re going to have to withdraw him and the difficult thing about that having to have that conversation with his wife in the other room to let her know that he`s not doing well and likely would pass.
It`s late Friday night here in New Orleans. I`m physically tired. Just finished off some notes, emotionally drained. Seen a lot that I`ve not seen in my career in the last three days, but I am oddly invigorated. I`m ready to get right back into it. I do feel like we`re making a difference.
The big thing here like I told the teams at the hospital is just, we got to keep trying to save as many as possible and those that get to the point we can`t, we got to provide the most compassionate care possible and be their family at the end since their family can`t always be there, and I hope that we do that.
(END VIDEO CLIP)
O`DONNELL: Joining our discussion now live from New Orleans is Dr. Najy Masri.
Dr. Masri, how do you summon that strength to get right back into this fight every day?
MASRI: You know, when we work in the hospital system, it`s like our extended family. And we celebrate the joys of victories together with patients and we cry together when the patients don`t do well, and the idea really there is really to come together at this time and I think it`s going to be something when this is all over, we`re going to look back on with pride.
EMANUEL: Dr. Masri -- Dr. Masri, one of the things that I`ve been seeing and hearing about is that patients look relatively stable and then, suddenly, they actually get very, very sick like the immune system is having this cytokine storm.
How are you experiencing caring for these patients?
MASRI: You know, one thing we`ve gotten very good at in the hospital is identifying those that are going to probably do well and those that aren`t going to do well. As this virus invades the lower respiratory tract, we start seeing an oxygen requirement and those patients either plateau and get better, or a lot of times continue to get worse and that`s when we start talking about ICU care, that`s when we start talking about ventilators.
Right now in Louisiana, we have about 1,800 people in the hospital, about one-third of them are on ventilators. So, it really comes to the plateau phase when they hit that inflammatory cascade and see how they do after that.
EMANUEL: And I`ve heard that it`s -- I`ve heard it`s very difficult to manage with the family that hard -- because they can`t come visit, you have to communicate over the phone, these very complex situations. How is that for a doctor?
MASRI: It can be very frustrating. You know, obviously because of infection control reasons, we can`t have anybody going in and out of the rooms. We do loosen those requirements in end of life care and mother baby, but overall, we have ton the conduit, and I give credit to the nurses. The nurses are tremendous. They go in and out of the rooms multiple times a day. They are the platform for those patients and conduit for those patients to the outside world.
EMANUEL: Thank you, Dr. Masri. Thank you for joining us and giving us the report from the front lines in New Orleans.
MASRI: Thank you.
O`DONNELL: Well, 57 days ago on February 9th, Maryland Governor Larry Hogan who serves as the current chair of the National Governors Association, convened a meeting in Washington with a group of governors and Dr. Anthony Fauci on the threat of coronavirus. After that meeting, Governor Hogan told residents of Maryland he was, quote, hoping for the best but preparing for the worst.
Tonight, Maryland, a state of 6 million people, currently has about 4,000 confirmed cases of coronavirus and 91 reported deaths, while Louisiana with a smaller population than Maryland has five times more reported COVID-19 cases and five times more reported deaths than Maryland.
We are joined now by Maryland Governor Larry Hogan. He is the chair of the National Governors Association.
Governor, thank you very much for joining us.
You had a meeting with the National Governors Association and Dr. Fauci on February 9th. What did you hear at that meeting that made you take immediate action and that apparently some other governors didn`t hear?
GOV. LARRY HOGAN (R), MARYLAND: Well, so, this was the National Governors Association winter meeting in Washington and maybe about 40 governors were there. It was really a group of specialists from the federal government, including Dr. Fauci, who they just talked about the -- at that point was kind of the beginning of the crisis around the time when things were breaking out in the state of Washington. And, you know, they gave us kind of an overview of what they thought might be happening, what we might be on the cusp of.
And, you know, I just took it maybe a little more urgently than some folks but -- I mean, we certainly -- nobody gave us the indication that we`d be where we are today, but they at least raise enough alarm bells where I knew it was time to get to work.
O`DONNELL: But you were -- you and Ohio Governor DeWine, both Republican governors, were the first governors to close down your schools, and you did that before there was a single death in Maryland from coronavirus.
How did you know then? How did you know before other governors this was going to be a necessary step?
HOGAN: So I started looking at this really at the beginning of January. I was watching things that were happening in Asia, starting in China. And then I heard this meeting at the beginning -- at the beginning of February where I heard from some of the leaders in Washington. I put together an emergency coronavirus task force made up of some of the smartest epidemiologists and doctors in our state from places like Johns Hopkins and University of Maryland and started listening to their advice.
But when we got our first three cases 31 days ago, I declared a state of emergency. Not too long after that, I -- Governor DeWine and I were the first ones, as you said, that shut down the schools and then I`ve taken unprecedented actions nearly every single day for the past 31 days, just to try to stay ahead of this.
O`DONNELL: And, Governor, your wife is a Korean immigrant. Did she help your view of this in the way you saw developments in Asia?
HOGAN: I think maybe just because of that, I was paying a little more attention to what was going on in Asia. My wife, most of her entire family is in Korea. And so, we were checking on their welfare to make sure that they were doing OK. They were, you know, obviously, had the outbreak there long before we did.
We also, by the way, the night before we had this briefing in Washington, I hosted all the governors at the Korean ambassador`s house in Washington the night before we went to the White House. So, you know, we have a pretty good relationship with the folks and -- with the president and the first lady and the ambassador from South Korea, and maybe -- maybe those relationships helped me be paying more attention earlier on.
O`DONNELL: And I`ve read that that also helped you get supplies from South Korea.
HOGAN: Well, you know, just being able to speak the language and having those relationships and I -- I got my wife on the phone with the ambassador and with some of the leaders just to say, hey, let`s just speak to them in Korean directly and ask for their help.
I`m not the only one to do that. I think governors across America have been reaching out desperately trying to get the PPE, you know, the masks and all the protective equipment and ventilators and things everywhere we can both from the federal government and from domestic sources, but also from everywhere we can find them anywhere in the world. And Korea has been really helpful.
O`DONNELL: Governor, what would you have to see in Maryland and surrounding states -- since it a small state, and so, you`re obviously influenced by events in Delaware, Pennsylvania, West Virginia. What would you have to see to reopen schools in Maryland?
HOGAN: Well, so we`re just -- we`re behind -- again, California and New York and New Orleans, but we`re now just at the start of the ramping up. So, we`ve quadrupled in just the past few days. We now in Maryland, D.C. and Virginia, we have surpassed 8,000 cases. We`ve had some of our worst days with respect to the number of deaths and the number of new cases. We expect it to get much worse over the coming weeks.
But it`s going to be very difficult for any governor to make those decisions about when -- when really it`s going to be safe, and I`m just going to rely on the best advice from the doctors and the scientists on that just like we did on the way up. On the way back down, it`s going to be probably just as hard to make those decisions, but we`re going to -- we`re going to do it based on the facts and the science on the ground.
O`DONNELL: And, Governor, before you go, I`d like to get a last word about your own situation. You are what they categorize as a high-risk for this illness. You`re a cancer survivor. You`re in your early 60s.
What are your own concerns and how do you handle yourself day to day knowing that you are more at risk than others?
HOGAN: Well, I just try to follow the same advice I give to everybody else in our state and that`s just to be more careful. You know, wash your hands repeatedly. Try to maintain that six-foot distance and to not be around crowds, just to try to, you know, stay away from folks and social distance -- it`s is really hard in my position. But I`m still working as hard as I possibly can.
I haven`t tried to give too much thought to my personal situation because I`m worried about the more than 6 million people in my state that I`m trying to take care of. But I -- definitely people that are older and have the kinds of preexisting, underlying health conditions are more vulnerable, but we`re -- we`re advising folks like that and everybody else just to be as careful as they possibly can.
O`DONNELL: Governor, I`ve spoken to some people in Maryland today, including people in the opposing party to you in Maryland, and unanimously, very strong support for the actions you`ve taken and very strong pride in Maryland`s approach to this so far.
So, thank you very much for joining us tonight, Governor. We really appreciate it.
HOGAN: Well, thank you so much, Lawrence.
O`DONNELL: Coming up, what would Dr. Anthony Fauci have said if Donald Trump allowed him to answer a very important question yesterday?
And later, why are 70 percent of coronavirus victims in Chicago and some other cities, African-American? Chicago Mayor Lori Lightfoot will join our discussion.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
REPORTER: Would you weight in on this issue of hydroxychloroquine? What do you think about this? And what is the -- what is the medical evidence?
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: You know how many times he`s answered that question? Fifteen times.
REPORTER: It`s for the doctor.
TRUMP: You don`t have to answer that question.
REPORTER: He`s your medical expert, correct?
TRUMP: He answered the question 15 times.
REPORTER: Dr. Fauci, why are you not wearing a facemask?
(END VIDEO CLIP)
O`DONNELL: And so, we never got an answer to that question yesterday when White House reporters changed the subject.
Dr. Zeke Emanuel is back with us.
Zeke, we`ve heard experts say that side effects from the anti-malaria medicine that Donald Trump is pushing include possibilities like death for people with heart conditions. So what would someone with Dr. Fauci`s experience say about the use of anti-malaria drugs to fight off coronavirus?
EMANUEL: Well, I think the first thing you would say is let`s wait for the data to show us whether it works or not.
But if he were rounding with doctors and nurses, he would say, let`s look at how the virus works and look at what happens when chloroquine comes in. So let`s look at that. A virus is essentially a tiny package of genetic material surrounded by a layer of fat. Take a look at this animation courtesy of YouTube channel Kurzgesagt in a nutshell.
We know this virus gets in through the nose, eyes and throat. From there, it can do real damage if it reaches down into your lungs. The novel coronavirus invades the cells lining your lung air sacs by binding to special receptors like opening a locked door. Once inside, the virus has one mission, to hijack the cell`s machinery to replicate itself.
In the process, it destroys those lung cells. The new copied virus molecules are now free to infect more cells in your body or get spewed into the world often through a cough or sneeze or just talking.
While this invasion is playing out inside your body, your body starts to react. Your immune kicks into gear for a good and bad.
The good is obvious. The initial cells send out a mayday signal to the rest of the immune system. Think of it like calling in reinforcement, and the immune system responds trying to kill the enemy virus.
You may have heard the term that cytokines, they are proteins that immune cells use to ramp up a response or dampen it down. But sometimes with this virus and we still don`t know why, the mayday requests ends up requesting a massive strike. And where a small strike is needed, hyper immune response is delivered, called a cytokine storm.
So, as your body fights the virus, healthy tissue, in this example, the lungs, can often suffer extraordinary collateral damage.
Eventually, the damage and debris from this battle can cause substantial, even fatal harm to your lungs, heart and many other organs.
Most of us if we get infected with coronavirus may not suffer much more than a fever initiated by the immune cells. But when it goes wrong, the hyper immune response can lead to organ failure and prove fatal.
So, Lawrence, the virus hitches a ride into the body. It invades the cells of the lungs, it replicates exponentially, and the rest is up to the immune system and whether it can react without causing irreparable and sometimes fatal harm.
O`DONNELL: Well, joining our discussion now is Shannon Bennett. She`s a virologist and chief of science at the California Academy of Sciences.
And, Shannon, on that little video that we saw of the virus going down the throat, how -- do we know how much, how frequently it makes it all the way into the lungs and how many patients, how many people does it -- does it stop and not make it all the way down there?
SHANNON BENNETT, VIROLOGIST: Well, there`s new data coming out all the time. This is an active study. That`s a big question. What we do know, dose is everything.
So, we talk a little bit about viral load. That`s really talking about the number of virus particles that are either in the body or in a dose. So when you take on a droplet, whether you breathe it in or it`s on your hands and you touch your mucus membranes, you`re delivering a dose into your body and certainly dose is going to be dependent on how far that virus spreads in the body and how much it grows, how the viral load builds up and eventually how much disease it creates.
EMANUEL: Can I ask you a question about thinking about where we would target the therapeutics and begin with what are the different places we target new medications to fight the coronavirus? What are the three or four places?
BENNETT: So this coronavirus is infecting respiratory cells, and you mentioned in your video that it`s binding to the ACE2 receptor. So, there are many potential therapies in our suite -- in our tool box that could maybe address this problem. One of those could be something that might block the ability of the virus to bind to the host cell receptor.
So, you mentioned the proteins on the outside of the virus. They`re called the spike proteins. They are the key that gets into the lock of the host cell receptor and once --
EMANUEL: And does chloroquine -- does chloroquine block them or not?
BENNETT: Well, chloroquine is definitely one of the things we`ve been talking about a lot. We actually don`t know a lot about how chloroquine works but it`s probably having an indirect effect. It`s not actually acting directly on the virus. It might be changing the ph of the vessel that is created around the virus when that lock and key happens and the virus is taken into the cell and begins to start its replication cycle.
It`s probably affecting the way the immune system is responding to the virus. That`s how chloroquine works when it`s used to treat lupus, for example.
So, the danger here is that we don`t really know how chloroquine is working.
EMANUEL: And where else might we look for therapies to fight the coronavirus? I`ve talked -- I mean, you talked about antivirals. What exactly are antivirals?
BENNETT: So there`s a suite of small molecules that have antiviral properties and we`ve investigated antiviral properties in many situations like for influenza, to treat Ebola and even to treat a relative MERS, the Middle East Respiratory Syndrome virus. And they attack different parts of the life cycle directly. So they work very well when they can target a key element in the virus life cycle.
The other kinds of therapies out there are antibody therapies and some of those could be broad, so they can generally protect against a range of kinds of viruses, or they can be targeted antibodies, monoclonal antibodies that are specific to a disease.
EMANUEL: Now I`ve heard a lot of researchers talk to me about -- you know, I`m an oncologist, that one drug is not likely to be enough. Like for HIV and for cancer where we have to have multi-drug regimens, we target maybe the binding site, an anti-viral to prevent--
SHANNON BENNETT, VIROLOGIST: Right.
EMANUEL: --the virus from replicating, something for the immune system. Are we likely to have one drug--
BENNETT: So the thing about viruses is that they`re fast evolving. And if you just treat them with one weapon in your armature, they can evolve very rapidly to escape that impact. So, in the case of HIV, it`s actually a cocktail of drugs that need to be applied to control that virus. In the case of influenza, Tamiflu works pretty well. With this virus, what we would want to do is have a full spectrum of multiple tools in our tool kit.
O`DONNELL: That is the best discussion I`ve heard yet about how these medicines work, and I`ve taken anti-malaria pills many, many times in my travels in Africa. Never had any idea how they were working.
Shannon Bennett, thank you very much for your expertise in joining this discussion tonight. We really appreciate it.
BENNETT: You`re welcome. Thanks for having me.
O`DONNELL: Thank you. And when we come back, we have stunning numbers from some places around the country, including Chicago, that are showing 70 percent of the victims of coronavirus are African-Americans. Chicago Mayor Lori Lightfoot joins our discussion after this break.
(COMMERCIAL BREAK)
O`DONNELL: The CDC and most state health departments have been releasing very little demographic information about people who test positive for COVID-19 and the people who are dying after being infected. But some states, counties and cities are releasing more demographic data that show in some places a hugely disproportion effect on African-Americans.
Joining our discussion now, NBC News Correspondent Morgan Radford.
Morgan, what do we know?
MORGAN RADFORD, NBC NEWS CORRESPONDENT: Well, Lawrence, we know that this is a crisis within a crisis. If you actually look at the data, it shows that COVID-19 affects people of color disproportionately high rates and essentially a ticking time bomb. And what`s interesting is that the CDC doesn`t actually share the racial breakdown of its data. But certain cities and certain states do, and those numbers are alarming.
If you look at the entire State of Louisiana, for example, 70 percent of the people who die from COVID-19 are black people. If you look at the State of Michigan, 40 percent of those deaths are African-American, and that`s in a state that only has a 14 percent population of black people.
Then, if you look at blacks and Latinos in places like Milwaukee, they account for 78 percent of the deaths. And if you look right here in New York City, 56 percent of the deaths are concentrated in Bronx and concentrated in Queens. And as you know, those are both majority and minority communities.
But what`s interesting about all of this, Lawrence, is when we talk to experts and we talk to people who were personally affected by this virus, they point to three contributing factors; health, jobs and, most surprisingly, misinformation. Take a listen.
(BEGIN VIDEO CLIP)
KAYODE OWENS, SOUTH BRONX RESIDENT: There was a little bit of like, oh, black people can`t get it. Right? Well, guess what? Here I am. I got it. Look, I think it`s going to get really bad for black and brown people. Right? That`s just a fact.
REP. DAVID BOWEN, MILWAUKEE ASSEMBLY, DISTRICT 10: I`m your typical average healthy millennial, and this virus had me barely able to stay awake because my body was burning up. I had a winter hat on in my home. There was so much misinformation being pushed to our community, and people are sharing it out of fear. They are sharing it because they do not trust a number of systems and political leaders that should be there to protect us. If it hurts the white community, it can kill the black community.
(END VIDEO CLIP)
RADFORD: So breaking down those three factors, when you talk about health, the CDC says those preexisting conditions that make COVID-19 deadly, like a heart disease, diabetes, asthma, those are already over-represented in black and brown communities. So it`s not like black people are more susceptible to getting the virus itself. It`s that they`re disproportionately affected when it comes to severe and deadly complications.
And then secondly, when it comes to jobs, they`re over-representing those direct-contact service jobs. And finally, the CDC had to actually create a web portal trying to dispel those myths, things like black people couldn`t get it. So that`s why we`re seeing those numbers as high as they are, and it`s a cause for concern.
Lawrence.
O`DONNELL: Morgan Radford, thank you for your reporting.
Today, Chicago Mayor Lori Lightfoot said the Chicago Department of Public Health statistics show, "72 percent of Chicago`s deaths have been among black Chicagoans, though black Chicagoans make up just 30 percent of the city`s population."
(BEGIN VIDEO CLIP)
MAYOR LORI LIGHTFOOT, (D) CHICAGO: Those numbers take your breath away. When we talk about equity and inclusion, they`re not just nice notions. They are an imperative that we must embrace as a city. And we see this even more urgently when we look at these numbers and this disparity. It`s unacceptable. No one should think that this is OK.
(END VIDEO CLIP)
O`DONNELL: Joining us now is Chicago Mayor Lori Lightfoot. Mayor Lightfoot, you must have had a feeling that this was what the numbers were going to show even before the data was assembled with this overwhelming impact on African-Americans in Chicago. Do you have any working theory about why it is?
LIGHTFOOT: Well, I think the reporting that you just showed, which is when you have all these health disparities pre-COVID, where you got a disproportionate number of people in the African-American community with diabetes, with health ailments, with respiratory problems, this disease attacks and feasts on those underlying conditions. And that`s what we`re seeing manifest in the numbers. I mean, it`s breathtaking.
When I first saw these numbers, I had a hard time thinking about anything else because I knew that this was going to land like a bomb and that we had to come up with some concrete rapid responses to help people in these communities.
O`DONNELL: And there hasn`t been any emphasis on this or even a word about it as far as I know at the White House briefings, which are the most prominent kind of public transfers of information about this, and yet, we heard in the report just now that there was also - there has been a lot of misinformation--
LIGHTFOOT: Yes.
O`DONNELL: --out there for - do you have any sense of what kind of misinformation there has been in the black community?
LIGHTFOOT: I think there`s been a misinformation that black people can`t actually get the virus. And the truth is, in Chicago, the first reported death was an African-American woman, who then gave it to her sister who then also died. So there is - the numbers speak for themselves. The fact that black people are dying at seven times the rate of any other demographic is stunning. It is a red alarm, an alert we`ve got to respond to and we are in our city.
O`DONNELL: And Mayor, how do you respond to it in terms of public information? What is the message you want to get to African-Americans? And how do you deliver that message, both in Chicago and beyond Chicago?
LIGHTFOOT: Well, what we`ve done is we formed a strike force. And it`s going to be hyper-local targeted outreach to people of color, and particularly black folks, in their neighborhoods. We`re going to be calling upon the faith community, elected officials, street outreach workers, people in black clubs to get the word out and then connect people up with services.
We`ve been saying, 60 or over, we`re going to lower that to 50 or over in the black community and really focus on getting people tested, getting them supports, talking about what they can do to protect themselves, but we`ve got to reach more people and quickly.
O`DONNELL: Mayor, how is the hospital system in Chicago bearing the burden so far?
LIGHTFOOT: Well, so far, we`re OK. We`ve been tracking ICU numbers overall, the number of people in ICU beds that are tested positive, the number of people under investigation for coronavirus that are in ICU beds. We`ve been hovering around 75, 76 percent over the last couple days. It`s dipped down to about 71 percent. But we know that we are far from out of the woods.
We`re concerned, of course, like everybody is, about ventilators, PPE, and testing. We are not testing nearly the number of people that we should be, and this is one of the tools that we`re going to have to employ in thinking about how we reach black people. We`ve got to bring more testing to those neighborhoods so we understand what the underlying data really is.
And the last thing I`ll say is, we`ve got to make sure that our health care providers are providing us with the demographic information. As stark as these numbers are, we know that we`re missing 20 percent, 25 percent of the demographic information on testing that`s positive. So we`ve got to - we`ve got to really ignite the consciousness of our health care providers to make sure they give us that demographic information.
O`DONNELL: Chicago Mayor Lori Lightfoot, thank you very much for emphasizing this crisis publicly and helping us emphasize this point that really has not been part of the national discussion as it should be so far. We really appreciate it, Madam Mayor. Thank you.
LIGHTFOOT: Thank you.
O`DONNELL: And joining our discussion is Dr. Vanessa Northington Gamble. She`s a physician and a historian of race and American medicine. She`s a professor of medical humanities at George Washington University. And Zeke Emanuel is back with us. I`m just going to get out of the way so the two medical professionals can talk to each other about this.
EMANUEL: Dr. Gamble, you have seen these data and you`ve dedicated your life to erasing the disparities and health care between African-Americans and whites. What do you think would be the most effective way both to educate the community to get them to practice physical distancing and really to wipe away this hard disparity?
DR. VANESSA NORTHINGTON GAMBLE, HISTORIAN OF RACE AND AMERICAN MEDICINE & PROFESSOR OF MEDICAL HUMANITIES, GEORGE WASHINGTON UNIVERSITY: I mean, Zeke, I think the first thing we need to do, and the Mayor brought this up, is release the data. I mean, Chicago is one of the few places. Illinois, North Carolina and Michigan are one of the - are the few places that release data, racial data with regard to coronavirus.
So I think we have to have this information to work with particular communities so that they see their faces. They see their neighbors dying, but at the same time, they don`t see our leaders talking about this.
EMANUEL: And how should we educate them about the correct practices to protect their lives, really?
GAMBLE: I mean, I think - first of all, I think that in - we have to be really - we have to be real here because we tell people, stay home and social distancing. A lot of people can`t stay home. Some of us can - you know, right now, I can stay home and work from home. But if I am working in food service, if I am working in janitorial service, I cannot stay home. In Philadelphia, I have to take the El. I have to take the subway in New York.
So in terms of our messaging, we have to be - when we tell people, stay home, and also, when we tell -when we tell people to social distancing, you know, so - I think that we have to be very clear with ourselves about what we are saying to people.
And at the same time, we have to educate not just people of color, we have to educate our leaders, we also have to educate medical professionals that this is not just a medical issue. This is a social justice issue. And one of the things that we are now seeing is that we are seeing the fault line of - the fault lines of hundreds of years of social inequalities.
EMANUEL: Do you think there`s something the medical system can do this moment to sort of treat African-Americans better? Is it that they need to go into the community to do more testing and make people aware that way?
GAMBLE: Well, first of all, I have to hand it to my colleagues who are in places like the Bronx and Queens, who are on the lines taking care of poor people and black people. I have to hand it to them. But at the same time, I think we also need to work with communities to find out what they need, what`s the best way? I mean, one of the things that`s happening in Milwaukee and also Chicago is trying to find those leaders within the communities that can help spread the message.
O`DONNELL: Dr. Vanessa Northington Gamble, thank you very much for helping us emphasize this very important issue tonight. We really appreciate it.
GAMBLE: Thank you very much.
O`DONNELL: And when we come back, we`ll get a last word from Dr. Zeke Emanuel on when we might return to normal and what normal might look like. But first, there has been a national outpouring of well-deserved support, admiration and gratitude for our brave medical professionals who risk their lives every day to save lives in this pandemic. We give them a special thanks tonight with thank you notes sent to them from all over the country and read by the health care professionals who received those thank you notes.
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YUSIMI SOBRINO-BONILLA, PATIENT CARE, RIDGEWOOD, NEW JERSEY: Thank you will never be enough. Your tremendous bravery, knowledge and life-saving skills are not going unnoticed.
DR. LEON PIRAK, ANESTHESIOLOGIST, ELIZABETH, NEW JERSEY: These shields were made with love and appreciation by myself and my two children ages 10 and eight. We cannot express our care and concern enough for you in keeping you in our hearts and prayers.
STARLA RODDAN, ER NURSE, OLYMPIA, WASHINGTON: Thanks for the sacrifices you have made with the long hours, the time away from home and family. Thank you for your leadership and team work.
DEIRDRE O`FLAHERTY, DIRECTOR, PATIENT CARE, NEW YORK, NEW YORK: Every day non-stop you are saving people`s lives while risking your own. Having no time to rest or calm down, too busy saving lives to go home and see your family.
TERRY BERTOLOTTI, ER NURSE MANAGER, ENGLEWOOD, NEW JERSEY: I`m so grateful for the few hours out of a week that we`re able to do puzzles together, eat dinner as a family, all while you console my fears and assure me that we`re going to get through this. Thank you for being the amazing mother and the nurse that you are. I love you. Your daughter, Fina (ph).
DR. YVES DUROSEAU, EMERGENCY MEDICINE, NEW YORK, NEW YORK: I`m sure you`re scared too, but you put your fears aside and help those people to hopefully recover.
BERT GASKA, ER NURSE, FOUNTAIN VALLEY, CALIFORNIA: You`re real super heroes, super heroes that save lives from all around the world every day, and those super heroes are you.
CHRISTEN CUDINA, ER ASSISTANT NURSE MANAGER, NEW YORK, NEW YORK: I hope from reading this, it could help you find hope knowing how hard it must be running around the hospital and working overtime to make sure everyone is safe.
DAVID EDMUND ANSTEY, CARDIOLOGIST, NEW YORK, NEW YORK: I came home yesterday to find this. Dear Dr. David, thank you for all your hard work. This came from a young boy in our building. Really appreciated it.
SHAWN ULREICH, CHIEF NURSE, GRAND RAPIDS, MICHIGAN: Nurses, thank you for your work. I love you. You guys are awesome. It touched my heart and it brought a huge smile to my face. So thank you for taking the time to write to us.
(END VIDEO CLIP)
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O`DONNELL: Sometimes these days, it can feel as if we are a nation of little kids sitting in the back seat on a long drive, asking our parents how much longer it`s going to be. But the question we`re all asking on this long drive is not produced by boredom. It is a mix of fear and hope and confusion.
And the question that we all keep asking each other is when will we get back to normal? And as soon as we hear ourselves use that word "normal," we all realize that we might not recognize normal when we get there.
Dr. Zeke Emanuel is back with us.
Zeke, how do you answer that big question of when do we get back to normal and what will normal look like?
EMANUEL: No one is immune to the COVID-19 virus. It threatens all of us. But while we are all experiencing the same pandemic, we are not experiencing it in the same way. The first dividing line is whether you or someone you love has gotten sick. Many Americans have not yet seen firsthand what devastation a positive test can inflict.
Another dividing line is whether you have a job that lets you stay at home, working as you juggle child care and video chats. 60 million Americans are still out there not sheltering in place and instead tirelessly working to keep everything going for the rest of us. You keep the electricity flowing and the Internet running, food and groceries moving. You are putting your own health on the line to ensure the rest of us are living as normally as possible.
And then there are the tens of millions of Americans who have lost jobs and businesses or who fear that they`re just about to. Your anxiety about the virus is coupled with worry over having a paycheck, covering the mortgage, keeping the lights on, and buying food.
Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that`s dreadful news to hear. How are people supposed to find work if this goes on in some form for a year-and-a-half? Is all that economic pain worth trying to stop COVID-19? The truth is, we have no choice.
If we prematurely end that physical distancing and the other measures keeping it at bay, deaths could skyrocket into the hundreds of thousands, if not a million. We cannot return to normal until there`s a vaccine. Conferences, concerts, sporting events, religious services, dinner in a restaurant, none of that will resume until we find a vaccine, a treatment, or a cure.
One thing I`ve learned as a cancer doctor is that it`s wrong to paint an overly rosy picture in order to maintain a patient`s hope. It`s wrong because it fails. It`s false. Biology and disease are formidable opponents that inevitably tell us the truth.
We cannot relieve the oppression of this pandemic until we are realistic. We need to prepare ourselves for this to last 18 months or so and for the toll that it will take. We need to develop a long-term solution based on those facts. It has to account for what we are losing while this fight goes on, things like schooling and income and contact with our friends and extended family.
Lawrence, the crisis is not going to go away in a few weeks or after the 30-day plan comes to an end. Although COVID-19 is affecting us in different ways, we have to be up to it and fight together.
O`DONNELL: Zeke, will we adjust gradually? Meaning, we won`t go into big audience groups anytime soon, but will there be an intermediate stage where we`re doing other things that we are not now doing?
EMANUEL: Yes. I think we`re going to slowly open the economy, probably first with schools and education because younger people are more likely to be protected, less likely to die. But that`s going to have to be on a voluntary basis. And then we`re going to see how it goes. But we can only do that opening once we have testing and the right public health infrastructure. And that`s still not there.
O`DONNELL: Dr. Zeke Emanuel gets tonight`s last word. Thank you once again, Zeke, for joining me for this hour. We really appreciate it.
EMANUEL: Thank you.
O`DONNELL: And a programming note. Tomorrow night at this hour, 10:00 p.m., we will have a live NBC News and MSNBC special program "Coronavirus Pandemic" with Lester Holt.
And you`ve seen a lot of Brian Williams today. He`s been doing a lot of extra duty, but "THE 11TH HOUR WITH BRIAN WILLIAMS" will be up next.
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THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. END