Coronavirus Pandemic TRANSCRIPT: 4/13/20, The Last Word w/ Lawrence O'Donnell

Guests: Eric Bressman, Ned Lamont, Hanneke Schuitemaker, Zeke Emanuel, Andrew Zimmern

  (BEGIN VIDEO CLIP)

ANNOUNCER:  Social distancing, flattening the curve in some places.

GOV. JOHN BEL EDWARDS (D), LOUISIANA:  It is because of the hygiene practices and social distancing that that is the case.

ANNOUNCER:  While coronavirus hot spots flair up in others.

UNIDENTIFIED MALE:  We are bending the curve of the infection rate and the deaths are still rising in the city.

ANNOUNCER:  And heroes on the front lines working to save every life possible.

UNIDENTIFIED MALE:  We have no vents. We literally decide who lives and dies, and you`re playing god at that point.

ANNOUNCER:  Tonight, Lawrence O`Donnell and Dr. Ezekiel Emanuel on how long Americans need to stay home and wear face masks in our global health war.

UNIDENTIFIED FEMALE:  If we don`t continue to follow social distancing, then everything that we`ve done to flatten the curve so far will be for nothing.

ANNOUNCER:  How testing will prove key to opening the economy.

GOV. ANDREW CUOMO (D), NEW YORK:  Testing of antibodies, testing on a scale that we have not done before.

ANNOUNCER:  And the latest on the crucial efforts to find a vaccine.

This is a special edition of THE LAST WORD, "Life in the Time of Coronavirus."

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LAWRENCE O`DONNELL, MSNBC HOST:  Life in the time of coronavirus involves challenges we have never seen before. It has now delivered the largest number of people in American history who are worried about where they`re going to get their next meal or next meals. Millions of people who have lost their incomes and worry about how they did afford food are now lining up at food pantries for the first time in their lives, and the food supply from farm to supermarket is being challenged as never before.

Imagine the weight of worrying when you look at your children and wonder how you`re going to feed them next week or next month. And added to that is the worry of being infected with the deadly coronavirus, which will be with us until we have a vaccine. We`ll be joined tonight by someone who is leading research and development for that vaccine and we will get a report from inside a New York emergency room on a day when the governor of New York, Andrew Cuomo, was able to announce the number of new admissions to New York hospitals is declining for the first time.

Hospital admissions have dropped 17 percent in New York since Saturday. The death toll in New York state seems to be declining with 671 deaths in the last 24 hours. As of tonight, the United States has 23,476 reported deaths by coronavirus. And the total number of reported cases is 579,909.

Governor Cuomo has formed an alliance of governors who border New York and are close to New York to confront the coronavirus as a country should confront the coronavirus with a unified strategy. The governors have stepped into the leadership vacuum that was well-documented by "The New York Times" this weekend in reporting on how president Trump delayed taking decisive action against the coronavirus nationally and then publicly refused to take responsibility for our national defense against the coronavirus.

(BEGIN VIDEO CLIP)

DONALD TRUMP, PRESIDENT OF THE UNITED STATES:  I don`t take responsibility at all.

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O`DONNELL:  One of the governors will join us tonight, Connecticut Governor Ned Lamont. We`ll get his reaction to the president telling the lie today and there is nothing else you can call it but a lie. The lie the president has total authority to reopen the economy. The president`s lies were so extreme about this today that it provoked one reporter to finally shout out that`s not true.

As viewers of this program have known for weeks now, the president shut down nothing. The president can reopen nothing. Every word the president says about reopening the country is pure posturing. It is pure propaganda. I`ll have a last word to say about that at the end of this hour.

But for most of this hour, we are going to be concentrating on what you need to know about what is happening in our hospitals and the fight against the coronavirus, where we are and the development of a vaccine and what you need to know about our current and future food supply during this pandemic.

With me again for the hour`s discussion of science and medicine is Dr. Zeke Emanuel. Zeke Emanuel is a physician. And he holds a PhD in political philosophy. Dr. Emanuel served in the Clinton administration and Obama administration. He`s now the vice provost for global initiatives at the University of Pennsylvania. Dr. Emanuel now is an NBC News and MSNBC medical contributor.

Zeke, we saw Dr. Anthony Fauci yesterday say that more lives could have been saved if the United States had started mitigation sooner. He said that on the day on that "The Ne York Times" published that investigative piece showing how Donald Trump personally delayed the federal government`s active support of mitigation, and then today, with Donald Trump looking on. Dr. Fauci said this.

(BEGIN VIDEO CLIP)

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES:  I was asked a hypothetical question and hypothetical questions sometimes can get you into some difficulty because it`s what would have or could have. The nature of the hypothetical question was if, in fact, we had mitigated earlier, could lives have been saved and the answer to my question was as I always do, and I`m doing right now, perfectly honestly say yes. I mean, obviously, if mitigation helps, I`ve been up here many times telling you that mitigation works.

(END VIDEO CLIP)

O`DONNELL:  Zeke, your reaction to what Dr. Fauci said yesterday and the way he repeated it today?

ZEKE EMANUEL, MSNBC MEDICAL CONTRIBUTOR:  He`s just right. We obviously knew early on in January, there were indications from the intelligence services and many others that coronavirus was around in China and was a serious threat to the country that it was going to come to the United States and that it could wreck havoc, the havoc it has had in the country before.

This was obvious to people. We know about the Peter Navarro memo to the president. So the question is could we have done something differently, and the clear answer to that, as Dr. Fauci said is yes. We could have done things differently. We could have tried to contain it when it first aroused. We could have tried to create a very robust testing mechanism that we could have had in place before the, say, March and we could have tried mitigation efforts where it took hold in Seattle.

Those things were not led by the president and administration despite a clear warnings by government officials, people inside the White House, and when Dr. Fauci just says yes, if we had done mitigation earlier, we could have kept the curves even flatter than they are today, he simply is speaking a fact. I mean, that is -- I don`t think there`s a political twist to this. It`s just a fact about the way biology works, viruses work, viruses spread. That if you start earlier, you`re going to reduce the number of people who are infected and therefore reduce the spread.

So I don`t think this is a controversial comment. And the fact that there`s an even a question about attacking Dr. Fauci for saying it seems to me just a -- fly in the face of basic biology that we know about viruses.

O`DONNELL:  Zeke, just a quick follow-up based on your experience working in the White House, we have an exhaustive report in "The New York Times" yesterday describing how long it took for the experts like Dr. Fauci to get actually in front of Donald Trump to actually tell him and brief him because the president was going through moods and he didn`t want to hear about things. And so, today, Dr. Fauci said that when we did recommend that the president make a statement encouraging social distancing, the president did what we recommended, but it was very clear track in the "New York Times" about how long it took to get Dr. Fauci in the room with the president.

You know how the White House works. You know how long that can take. What was your reading of that kind of delay of getting the medical experts in front of the president as we saw in the "New York Times" report?

EMANUEL:  Well, I worked for President Obama and he read a briefing book every night and he read it very thoroughly and if a memo like this, what we need to have done was in that briefing book, President Obama would have read it and would have called a meeting together to ask. That`s what he did when H1N1 broke out. He got a memo about it. He read it and called the meeting together and began asking people to get all the options in front of him and to understand what the situation was.

This is part of the chaos of the Trump White House for not that doesn`t allow clear reading of memos and clear instructions and getting the expert together in the Roosevelt Room, frankly.

O`DONNELL:  Joining our discussion now is one of the heroes of the frontline, Dr. Eric Bressman. He`s the chief resident in medicine at Mount Sinai and Elmhurst Hospitals in New York City.

Dr. Bressman, thank you for joining us tonight.

Is there reason to be hopeful for what we`re seeing in New York hospitals tonight?

DR. ERIC BRESSMAN, CHIEF RESIDENT IN MEDICINE, MT. SINAI HOSPITAL:  Absolutely. We`ve seen real signs I think the social distancing measure are having an impact and admissions are declining, the flow of patients is declining.

It definitely cause for optimism and I have to say, the work of the front lines, the residents, all the front line workers have been unbelievable. This is spectacular. They show up to work every single day not just out of a sense of duty but purpose and it`s been an honor and privilege to work alongside them.

EMANUEL:  What`s the most challenging thing about dealing with these patients from a medical standpoint?

BRESSMAN:  Well, I think we`re fighting two battles here. The first is this public health battle, the effort to flatten the curve, which as I said seems to be going well. But the second one is a clinical and scientific battle to better understand the course of the disease and understand what is happening to these patients. We still can`t really predict with reasonable certainty who will do well and who`s going to do poorly, and as a medical community, we`re still very much in the dark.

And that weighs heavily on us as clinicians. There is a tremendous amount of research going on. Mount Sinai lead the way with convalescent plasma therapy and other therapies and working on vaccines, as well. But that uncertainty really weighs a lot on clinicians to have to look patients in the eye --

(CROSSSTALK)

EMANUEL:  Dr. Bressman, as I understand it, we get a lot of cases where patients are on the vent, they seem to be doing well and then, suddenly, they have clots in different places, they have heart attacks, they have unexpected medical complications.

Is that what you`re experiencing?

BRESSMAN:  We`re definitely seeing that and there are a lot of theories circulating around, clots is a big part of this disease. The jury is still out. There is theories this is an overwhelming immune response.

I think, again, when the dust settles and we look back, we`ll probably see different types of patients who take different courses, but it certainly is a fascinating time to be in the medical field and see this happen and play out in real time but in the moment, it`s unsettling and it`s difficult.

EMANUEL:  So why do you think as a front line doctor. The most difficult social or patient interactions you have going forward are?

BRESSMAN:  You know, I mean, to start with, it is uncertainty. As a young generation of physicians, we have been raised on a lot of certainty. We didn`t live through the AIDS epidemic.

We know -- we were taught everything. We knew how every virus acted down to the smallest to not know right now for us is incredibly, incredibly humbling.

It`s also very difficult to watch these patients suffer alone. They don`t have visitors. Their family members aren`t with them and we`re really their only family in the time of need and while that`s a tremendous opportunity for us, it really difficult to watch.

O`DONNELL:  Dr. Eric Bressman, thank you once again for joining our discussion. We really appreciate it.

BRESSMAN:  No problem.

O`DONNELL:  Thank you, Doc.

Well, Connecticut is one of the seven northeastern states that today announced an alliance of governors who are fighting the coronavirus and who will eventually consider the extremely complex questions that have to be answered before those governors can relax or remove their orders for all non-essential workers to stay home.

And joining us now is the governor of Connecticut, Ned Lamont.

Governor, thank you very much for joining us. We really appreciate it.

GOV. NED LAMONT (D), CONNECTICUT:  Good evening, Lawrence.

O`DONNELL:  I`m sure by now you have heard that Donald Trump has declared you have absolutely no power to, quote, reopen Connecticut. It`s totally up to him. The president said his authority is total.

Luckily, at least, one White House reporter got it right and shouted out that`s not true. But what was your reaction to the president telling this?

And I won`t drag you into the debate over it, I`m just going to let the audience know it`s a complete lie, the president has no authority. He didn`t shut anything down in Connecticut.

But what is your reaction to the way the president spoke about it today?

LAMONT:  These comments come and go. He loves us to run down these rabbit holes.

We had a good meeting with the COVID task force, including Vice President Pence. He knows that all of the regional governors here in the Northeast are going to work together in a collaborative way for a phased reopening based upon testing. We`re going to open up our state. We`re going to do it in the safest way possible.

O`DONNELL:  Governor, you said you`re teamed up with all your neighboring states -- Rhode Island, Massachusetts, New York. And New York added to that team New Jersey, Pennsylvania on the New York border, Delaware also agreeing to approach this, pardon the expression but as a country would approach it, as we kind of expected the president to lead this kind of approach to it, because obviously, what happens in New York, what happens in Rhode Island, Massachusetts has a huge effect on Connecticut.

So you can`t make these decisions independently.

LAMONT:  No, you can`t. I mean, if I look how the COVID pandemic hit Connecticut, came up along Metro North and I-95 from New York, going all the way through Fairfield County up to New Haven, that`s the COVID corridor for Connecticut right now.

I cannot solve that unless Andrew Cuomo helps solve it in his side of the border, as well. That`s why we`re thinking together in terms of where we want to do the molecular testing, where we do the antibody testing, how we share that data and then we do. We`ll share that with the federal government so they can make the right decisions, as well.

O`DONNELL:  I just want to clarify for viewers, although you as a governor and Governor Cuomo and others had the authority to simply close down businesses and say no non-essential businesses are allowed to operate, when you relax that order, that doesn`t actually mean that any private business has to reopen.

So although you have the power to close them, you don`t really have the power to open businesses.

LAMONT:  No, but what we do do is allow them to open, allow them to have more than two or five people in there, and I think they`re clamoring for that opportunity. But nobody obligates them to open. You`re absolutely right, if they feel unsafe and want to stay closed longer, they can.

What I care about is the public health. I just cannot have, you know, 100 people clambering into a store next Thursday because that`s the second wave of a pandemic.

O`DONNELL:  (AUDIO GAP) to have, in order to evaluate the risk for people going back to work or going back to school?

LAMONT:  Well, first thing I want to do is test the first responders, make sure they`re safe going into the hospital, going into the nursing home.

Secondly, I want to test the folks that work at Electric Boat and Pratt & Whitney, they`re going into the factory floor. By law, I got to keep them open. They`ve got a number of infections there at E.B. right now. They need the gowns. They need the fever meters. They got to be tested.

And then more broadly, I`ll test the person at the nail salon and barbershop to make sure they`re not infecting 12 people a day, even the patients come in on appointment basis only.

O`DONNELL:  And just for the audience, Electric Boat is a major defense contractor in Connecticut, and obviously an essential operation. That`s why that`s open. But it`s right in that New London, Connecticut area, where people working there on a daily basis.

The question becomes what happens in their commute, what happens when they go home, what kind of exposure do people have from workers who are out there already and coming home every day? We don`t really know the answers to those questions, do we?

LAMONT:  No, but we`ve certainly set some guidance there. Once you tested on the way in, fever test, tested on the way out, you got to stay at home and not see anybody.

These are the conditions of working in a critical defense industry, because all you need is five or six people infected and pretty soon, the whole factory floor could be infected.

O`DONNELL:  Governor, what would -- what would you say to the president about how he should deal with this question about who has the authority in Connecticut to close down businesses and who has the authority to release that order of closing down businesses?

LAMONT:  I`d say, Mr. President, I remember a couple of weeks, you`re on your way to the helicopter and you said, hey, maybe we should have a mandatory quarantine of the New York metropolitan area. And I got together with Cuomo. I got together with Governor Murphy and we had no idea what that meant.

Did you want to shut down highways leading in and out? Shut down rail?

And we did have a good conversation, a firm conversation, said this is unenforceable law and we pulled back some of the extremes, and we reached an agreement that was workable for all of us. I`d like to think that`s where we`re going to end up opening our states, as well.

O`DONNELL:  So, just so Connecticut -- people working in Connecticut can understand, should they be listening to you or should they be listening to Donald Trump about when they might be able to go back to work?

LAMONT:  Look, I think everybody knows it`s the governors that enforce the rules. It`s the governors that, you know, have -- where the rubber meets the road. So, I would certainly lead with the governors, because that`s the way the White House has done as well. They`re saying, governors, you have to take the lead on stopping this pandemic, now, we want you to take the lead on opening the business on an appropriate way.

O`DONNELL:  Governor Ned Lamont, thank you very much for joining us tonight. We really appreciate it.

LAMONT:  Thanks, Lawrence. Nice to see you.

O`DONNELL:  And Dr. Zeke Emanuel is back with us.

Zeke, the governor said that the plan is eventually for a phased reopening based on testing. Those were his words. When will these governors have the kind of testing they need to suggest businesses are able to reopen?

EMANUEL:  The honest answer is we don`t know. I think doctor or Governor Lamont had some really good points. First, the importance of travel between states as a conduit for re-infecting areas. And so, even when we open up, that is a serious worry, and being able to test people who might come into a community is very, very important, just to be sure whether we`re getting new infections in a community.

Second, you heard him. He needs to test first responders. He needs to tell healthcare workers. He needs to test workers and essential industries. That`s tens of thousands of tests in the state of Connecticut probably every day, every other day, and that`s -- we haven`t even spoken about patients or the asymptomatic spreaders that will also need to be tested or family relatives of someone who turns out to be positive.

And we don`t seem to have the testing infrastructure. Nothing about testing has gone right in this country. Abbott with that 15-minute test, a lot of those are not being used because we don`t have the reagents, we don`t have trained personnel.

So, I`m a little skeptical we`re going to have testing infrastructure to release, have non-essential businesses really begin to start sort of in May or in June. There doesn`t seem to be any work that was really done to put that in place now. We`ll have to work furiously for the month of May.

O`DONNELL:  Yes. I mean, as we sit here tonight, there is no testing infrastructure out there on the horizon. We`d have to at least be able to see it on the horizon to say that it`s ready to be used at some point in the future.

Zeke Emanuel, stand by and stay with us.

And when we come back, the race to find a vaccine. First the vaccine has to be created, then tested, then validated and then manufactured and then distributed worldwide. Not just in the United States.

We will be joined next by a scientist who will be involved in every step of that process. That`s next.

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O`DONNELL:  Whenever you hear a serious scientists or serious governor talk about returning to normal in the time of coronavirus, somewhere very close to the word normal, you will hear the word vaccine.

In the past, developing vaccines has sometimes taken decades but scientists around the world are now working at ultrahigh speed in the hope of getting a vaccine into distribution next year.

Dr. Zeke Emanuel is back with us.

Zeke, is there actual hope of a virus as early as next year?

EMANUEL:  Lawrence, there is a hope of a vaccine being ready in 2021. That`s conceivable because scientists began working on a vaccine practically the day that the viral genome was made public.

And we`ve decided to break it down for you, break down how we make a vaccine with some animated help from our friends at Bio Digital.

The virus is a tiny package of genetic information covered by a fat layer in which there are protein spikes. The virus then hitches a ride into the body, goes down into the lung and lung sacs where it attaches to special receptors on the lung cells. It invades the cells of the air airways and then replicates exponentially.

The immune system either succeeds in flushing the virus out but sometimes it can cause substantial and even fatal harm to the body. Vaccines generally target the middle of this process after the virus gets into the body, and they try to interrupt the virus from binding to the cells and hijacking the cells and replicating.

Generally speaking, vaccines train your immune system to respond and prepare you to fight off the virus before it becomes and infects the cells of your body.

Here is what scientists hope to achieve with a successful vaccine. If you`ve ever been vaccinated, you possess billions of antibodies and immune cells ready to fight off the virus if you become exposed to it. These are represented in green.

Antibodies serve many purposes in the immune system but for simplicity sake, they play two key roles. The first is blocking the binding of the virus to your lung cells, occupying the spike proteins on the outside of the virus. The second function is as a signal, antibodies tell the rest of your immune system to send in reinforcing cells to target and kill the viral intruder.

The thing to remember is vaccines train your immune system to produce those antibodies and those antibodies prevent the virus from doing harm to you. So, let`s say we developed a candidate vaccine.

What are the barriers from keeping me from getting that vaccine?

Well, vaccines work because scientists take the time necessary to ensure that they`re safe and that they are effective to prevent you from becoming infected. To get to that point, there are usually three phases of clinical trials.

Phase one is a safety trial. Can I give this healthy person a vaccine and not make them sick and, god forbid, kill them?

Phase two is efficacy. Does the vaccine actually produce an increased in antibodies directed at the virus.

And importantly, phase three is an effectiveness trial. Does the vaccine actually prevent you from getting coronavirus?

Once you clear those three hurdles, then the FDA gives the green light to mass produce and distribute the doses to the hundreds of millions of people who need it. Every one of these step involves patients, volunteers and scientists, and there is no one long step but rather many small steps that cause the process to take many months into a year and a half before you can get a shot. And if you get it in a year and a half, that would be record time.

Right know, countless scientists are racing to get a vaccine for the novel coronavirus. One of the efforts you might have heard about comes from the pharmaceutical giant Johnson & Johnson. They`re part of a billion-dollar effort along with the Department of Health and Human Services. That was really good news for the Johnson & Johnson stock price especially the headline that they might be able to start testing a vaccine on human beings as early as September.

Now, we get to ask how the work is going.

Joining us is Hanneke Schuitemaker. She`s the global head of viral vaccines at Johnson & Johnson. She`s also a professor of virology at the Amsterdam University Medical Center.

Welcome, Hanneke.

HANNEKE SCHUITEMAKER, GLOBAL HEAD OF VIRAL VACCINE DISCOVERY, JOHNSON & JOHNSON:  Thank you.

EMANUEL:  So I want to ask you about the nature of the vaccine that you at Johnson & Johnson are trying. How is it special?

SCHUITEMAKER:  Yes, so we are using what we call a (INAUDIBLE) system. So it`s really the method by which we present the corona piece to the human body. And we applied this system also in our Ebola vaccine and also for our HIV vaccine candidate and our Zika vaccine candidate.

So it`s a replication in competence to common cold virus, of which we have deleted the piece of genetic material and replaced that, in this case, with a piece of genetic material of the coronavirus. That`s coding for the S protein.

EMANUEL: So you`re taking a common cold virus, putting some of the coronavirus protein in it, and that is going to present to the body to rev up the immune system to fight the coronavirus?

SCHUITEMAKER: Absolutely, yes. So it - by that, it`s really mimicking the protein of the coronavirus as it is on the virus. And so the immune system sees really the native protein and makes the correct immune response. At least that`s what we are hoping for and also see now in our first experiments.

EMANUEL: And when will the whole thing be ready? Do you think September is a realistic timeline to start the phase one safety testing?

SCHUITEMAKER: Well, yes, I think it is. Of course, we have a lot of first- time, right, assumptions in that timeline, but currently, we are meeting all the deadlines that we have set ourselves. And of course, it`s also always with permission of the authorities, right? So we will have discussions with the regulatory authorities if they agree with our package, but so far, we are in a good dialogue.

EMANUEL: In the phase one safety testing, how many humans do you expect to get your vaccine?

SCHUITEMAKER: Yes. So we want to initiate with a group of 250 people to do some dose finding and also see if we need one or two doses to get the good immune response. And then, of course, we need to go and extend the safety cohort before we would go into larger groups for efficacy testing.

EMANUEL: And in your type of system, what are the major side effects you see, say, the side effects you see with the Ebola attempt? What are you really looking for in terms of adverse events?

SCHUITEMAKER: Yes. So what we know from our different vaccines that are based on the same platform, so all on that common cold virus system, we know that people can have some fever in the beginning, but we market as a very well tolerated vaccine and also with a very favorable safety profile. So I think - well, of course, we should not do any presumptions on what it will look like, but we have good expectations.

EMANUEL: And then you`re going to move to a phase two efficacy study where you`re expecting the body to produce antibodies to the protein. Is that correct?

SCHUITEMAKER: Yes. So, first, also this phase one study assures to find out whether it`s immunogenic. So whether we can get these antibodies and also good cellular immune responses. And if we have the package ready and then again, of course, with permission of the authorities, we will hopefully start with an efficacy study early next year.

And in that study, we will test whether the immune response (inaudible) will give protective immunity. So whether it will prevent people from developing COVID-19, did this really caused by--

EMANUEL: So that`s actually more - that`s actually more an effectiveness study. That`s actually assessing whether people are protected from getting COVID-19. Is that correct?

SCHUITEMAKER: Yes. Yes, that is correct. So first, to test whether it`s immunogenic - first, whether it`s safe and immunogenic, and then in the next phase, we can test whether it`s effective.

EMANUEL: And that I take it would be record time to get a vaccine into people?

SCHUITEMAKER: Yes. So what we have seen, of course, is that other companies with even faster platforms are already in people. I think we are sort of on the intermediate timeline, but our forte is really that we know how to produce our vaccine and that we can ramp up production really with good speed so that we have that stockpile ready, and by the end of next year, we foresee that we have produced 1 billion doses. So that`s I think really the strength of our platform.

EMANUEL: Thank you, Hanneke Schuitemaker, Global Head of Viral Vaccines at Johnson & Johnson. Thank you very much for helping us understand how you produce vaccines against coronavirus.

LAWRENCE O`DONNELL, ANCHOR MSNBC: And when we come back, food insecurity across the country. Long lines at the food banks now include many people who used to serve food for a living since the restaurant industry has basically closed down. And at the same time, some farmers have had to destroy their products. How insecure is our food supply becoming in this country? Andrew Zimmern joins us next.

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O`DONNELL: Life in the time of coronavirus means crisis on top of crisis for millions of Americans who have lost their jobs and incomes, which leaves them worrying about how they can afford food if they can find food on the shelves of our markets while they worry about the possibility of actually catching this deadly virus.

The economic shutdown has dramatically increased the lines of food pantries around the country. 10,000 people lined up in San Antonio. Southern California, to thousands of - long lines in Southern California to thousands of cars lined up in Pittsburgh, Pennsylvania.

We all know that the unemployment application filings have dramatically increased and also dramatically understate how many people have lost their income and their jobs so far since the states have been overwhelmed with those unemployment applications.

A more realistic picture is drawn in a new Monmouth survey that finds that four in 10 Americans have lost income as a result of the pandemic. In that same survey, more than half of Americans say they are having trouble finding certain items in stores. Toilet paper and hand sanitizer are at the top of that scarcity list, but the scarcity list contains certain food items now.

And so, tonight, more people are worried about where their next meal or future meals are coming from than ever before. And the delivery of all of our meals now depends on a food supply chain from farmer to supermarket that has never been under more stress.

Andrew Zimmern is an award-winning chef, writer and teacher, and the host of the MSNBC limited series "What`s Eating America".

Andrew, thank you very much for joining us tonight. Let`s start with the food supply chain and what`s happening. We`re reading about farmers dumping crops, dumping products. What is happening in the supply chain?

ANDREW ZIMMERN, AWARD-WINNING CHEF & MSNBC HOST, "WHAT`S EATING AMERICA": Yes. We`ve gone in a short matter of weeks, Lawrence, from the shame of seeing those that could afford to buy food and eat depleting the shelves in our supermarkets to talking about if there was enough food.

A few weeks ago, I was on air saying there was enough food in the supply chain, but the first cracks would be distribution-based. And we started to see that last week. You shut down restaurants, you shut down schools, and the traditional pathway for a lot of those trucks from the wholesaler and warehouses now has to be rerouted to the places where people are actually picking up food - the grocery store, the community resource kitchen, where some other public or private space, which is doing community resource work, allowing people to pick up goods.

But remember, this is a health care crisis we`re in. And I talked a couple of weeks ago on the shows about the health care cracks that would soon appear. We saw that last week with reports from the farmers themselves that conditions on the farms, in the factories, on the fishing boats, in the crab houses, in the abattoirs, people were not practicing proper physical distancing. They weren`t cleaning properly.

A lot of workers are living in those places, four to six to a room, taking transportation to and from work as a group. And a lot of us were talking about the fact that if we didn`t protect workers in the supply chain, we`re in trouble.

Well, the reality is that`s where we are now based on the Smithfield processing plant shutting down in South Dakota. That`s a hotspot in that state from a coronavirus case total standpoint. Right? It`s about 40 percent of the cases in South Dakota are in that plant itself. It`s also responsible for 4 percent of the pork that`s sold in the United States. So we do - we do now have a supply chain problem.

You were talking with the doctor before about the necessity for testing. We need to be testing and re-testing these essential skilled workers. And we needed to have been doing it weeks ago. We need to get those frontline workers and food people, farmers, anyone touching our food in grocery stores, et cetera. People trucking it are essential workers now, and they need to be protected, tested because their working and living conditions are prone to transmit, not mitigate the virus.

O`DONNELL: Andrew, I`ve been urged to include people working at our supermarkets as part of the frontline troops who are actually keeping us going through this.

ZIMMERN: Yes.

O`DONNELL: I haven`t been thinking all the way back in the supply chain to what you just identified. Those are the forgotten heroes of this story.

ZIMMERN: Yes. Well, we`ve - we`ve kept them in the shadows. We talked about this in our premiere episode of "What`s Eating America". The immigrants and documented and undocumented workers, (inaudible) workers, the people who have been demonized by the administration for the last several years, we`ve actually disincentivized from going and participating in our health care system, even showing up at the emergency room.

These are people who don`t have health care. They don`t have paid sick leave. They are paying into our tax system. They are essential workers. They are skilled workers. But we`ve done everything possible to disincentivize them from helping out by taking care of themselves at a time where it is essential that we all be taking care of ourselves as a way to take care of the people in our country. I`m really, really worried about the workers in our supply chain.

The trucks - we`re a capitalist society. The trucks will find their way to the places where it needs to go. Cucumbers will grow again, but we need to have people who are planting the cucumbers. We need to have people who are cutting the chickens in the chicken factories. We need to have people who are taking fish out of the ocean. Without people - it`s a very, very simple idea. It goes back 10,000 years. If we don`t have people producing the food, we`re not going to be able to eat.

O`DONNELL: Zeke Emanuel has a question.

EMANUEL: Yes. So I want to understand how you think we are going to keep the food going. And in this moment, are farmers going to be able to plant and have a reliable crop and also have a reliable marketplace come the fall, or is this whole system going to break down?

ZIMMERN: Well, you`ve actually mentioned four different places. And I want to remember, the pieces of your question is actually really, really complex. Right? So we already have fewer visas being given this year in the administration for those seasonal workers that are coming up, and we know that we have a very large percentage of Americans who are sick and more that will be getting sick. And we`re practicing physical distancing in this country.

So, ergo we`re going to have fewer workers on farms doing planting. Right? We`re not talking about giant agro businesses where machines plant the corn. We`re talking about what are deemed specialty crops, which is food for human consumption. Right? So we`re going to have a problem this season getting everything into the ground.

The people of the United Farm Workers that I speak to are very, very concerned about how we`re taking care of our farm workers and, by extension, all our people in the food system. We need testing and re- testing, and we need to keep these people safe. Otherwise, who will replace them?

O`DONNELL: Andrew Zimmern, thank you very much for joining us tonight. Andrew, we`ve got to get you back. There`s so much more to talk about in this subject. Thank you, Andrew, very much.

ZIMMERN: So much. Thank you.

O`DONNELL: And we`ll be back with some final comments, but first, many of you have sent heartfelt thank-you`s to nurses and doctors and health care workers all over the country. Tonight, we have thank-you notes to first responders, read by the people who received those thank-you notes.

(BEGIN VIDEO CLIP)

MAXWELL ADEY, FIREFIGHTER/PARAMEDIC, SAN DIEGO FIRE-RESCUE: Here we have some letters from the community showing their appreciation.

We love firefighters. Thank you for saving people. We are thankful for your helping hands. Thank you for all you do, Fire Station 35. We see you. We appreciate you. And you truly are heroes.

CHORUS: Thank you.

(CHEERS & APPLAUSE)

DEPUTY WALLY BRACKS, LOS ANGELES SHERIFF`S DEPARTMENT: I received this note from one of my little friends while she was picking up her school lunch. It says, "Thank you for protecting our city. Thank you. You are a rainbow."

SGT. PAUL SPINELLA, SUFFOLK COUNTY SHERIFF`S OFFICE, NEW YORK: Thank you for everything you have done for me and my family and my community. Thank you for risking your lives to help people who are sick. Really thank you for everything. Love, Emma (ph).

Well, thanks, Emma (ph).

OFFICER LUIS VASQUEZ, FAIR LAWN POLICE DEPARTMENT, NEW JERSEY: Officer Vasquez, thanks for your support. I`m glad this finally got to you. You rock! I hope you enjoyed it. Can`t wait to stand with you on the thin blue line. Thank you so much, Michaela (ph), The Cops Rock Girl. Thank you.

CAPT. SHANNON PAULSON, LOS ANGELES POLICE DEPARTMENT: I was incredibly touched and wanted to thank you for creating the support group during this crisis. I was hesitant to reach out for assistance as I`m usually the person helping and not asking for help. You did everything you could to make sure I received what I needed. There are not enough words to thank you guys.

UNIDENTIFIED MALE: Thank you very much. Appreciate it.

UNIDENTIFIED MALE: Let`s know if you need anything else.

UNIDENTIFIED MALE: I will. I will.

UNIDENTIFIED MALE: We`re here for you.

DEPUTY SHERIFF YVONNE DECARO, SUFFOLK COUNTY SHERIFF`S OFFICE, NEW YORK: Your actions will never be forgotten all of our lives. Love, Timothy Foreman (ph).

Together we will all get through this. Thanks again for putting your lives on the line. Forever grateful, Heather (ph).

UNIDENTIFIED FEMALE: Thank you, everyone.

UNIDENTIFIED FEMALE: Thank you.

UNIDENTIFIED FEMALE: Thank you, guys.

UNIDENTIFIED MALE: Thank you.

UNIDENTIFIED MALE: You`re welcome.

LT. LATASHA PIERRE-DAVIS, PARAMEDIC, FDNY: FDNY heroes, thank you for once again rushing in when New Yorkers need you the most. We thank you, and we love you.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

O`DONNELL: There is some encouragement tonight in the coronavirus statistics we are seeing in New York and the frontline report we got earlier in this hour from Dr. Eric Bressman from New York City. And that encouragement is that that indicates that social distancing is working.

That means that if we really are slowing the spread of the coronavirus, it is thanks to you. It is thanks to everyone who is staying home, everyone who is being ultra-careful when they have to go out for groceries, wearing a mask, gloves.

And so all of you, who have been observing all of the rules, deserve a congratulations tonight because what you`re doing seems - seems to be working.

Dr. Zeke Emanuel, your final thoughts tonight.

EMANUEL: I want to tell you a story. It begins with something that we think of as just a catch phrase.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: OK, Houston. We`ve had a problem here.

UNIDENTIFIED MALE: Say again, please.

UNIDENTIFIED MALE: Houston, we`ve had a problem.

(END VIDEO CLIP)

EMANUEL: That alarm was sent by the Apollo 13 astronauts back to Mission Control 50 years ago tonight, almost at this precise hour. They were supposed to be going to the moon, but an oxygen tank exploded. 200,000 miles above the Earth, they had lost most of the power and water. They used a lunar module as a lifeboat. But it was designed to support just two people for 30 hours, not three people for four days. There simply wasn`t enough oxygen.

Together, the astronauts in the air and the engineers on the ground devised an ingenious solution, a jerry-rigged filtration system, so the three astronauts could breathe again. They used plastic bags, cue cards, hoses and, of course, duct tape. And it worked. We remember the Apollo crew and the engineers at Mission Control as heroes, not because they succeeded at a lunar landing but because the astronauts returned home safely.

Right now, none of us is going about daily life in the way we intended. Whether you`re aiming for the moon or a chance to raise your hand in third grade math class, your life has been interrupted by a viral explosion. In some sense, we`re all far from home. But we`re also beyond fortunate in another sense.

Apollo 13 was called a successful failure because the men and women at Mission Control never gave up. Today, we have the smartest doctors, nurses, and scientists, all working to get us back to normalcy. Their efforts already are herculean. By the end of this crisis, we`ll think that their efforts were miraculous.

As we heard again tonight, we`re in this for the long haul. A vaccine will be more than a year away. In that time, we can all be heroes, each in our own individual way. The working from home, hand washing, avoiding large crowds, wearing masks in public. What we are doing every day is working hard. We`re flattening the curve.

By staying strong now, we`re getting ready for the next steps, a path forward to getting social life and the economy going again. The work will be difficult and slow. At times it may be scary. But I know Americans are ready to do their part because we`ve already shown that. By all working together, we too can return home.

O`DONNELL: Thank you, Zeke.

And in tonight`s "Last Word", I want to reemphasize a couple of points that I made with Governor Ned Lamont of Connecticut earlier tonight.

First of all - and this is something you`ve heard me say weeks ago at this hour. The President did not close a single place of business in America, and the President cannot reopen a single place of business in America, not one.

Several governors have used their legal authority to issue emergency orders for all non-essential workers to stay home in their states. And only those governors have the power to remove those orders or to gradually and very carefully adjust those orders to legally allow more people to leave their homes to go to work. But even if that happens, it will still be up to the company that you work for to decide whether to open that workplace again for you to return to. No one in government can order any of those businesses to open.

Governors do have that emergency power to close those businesses. But as you heard Governor Lamont agree with me tonight, governors do not have any power to order any business to open. Unfortunately, the President of the United States is going to continue to pretend that he has, what he calls, total authority about this. But he actually has no authority at all. None. No one in government can order a business to open. That`s why it`s called private enterprise.

Zeke, one of the things that the President doesn`t seem to understand is that the reason a lot of people are staying home is that their companies have told them to stay home and told them to stay home before any governors told them to do that.

EMANUEL: Yes. And many of us think that San Francisco has done remarkably well because many of the big tech companies sent their workers home before they were told to. Same thing in Seattle, with Amazon and Microsoft. And they have to decide that it`s safe enough to bring their workers back. And I`m not sure that`s going to happen just because the President decides it`s the right time or he`s going to do it.

O`DONNELL: Zeke Emanuel, thank you very much for joining us for the hour once again tonight. We really appreciate it.

"THE 11TH HOUR WITH BRIAN WILLIAMS" will be up next.

(COMMERCIAL BREAK)

BRIAN WILLIAMS, ANCHOR MSNBC: Well, good evening once again.

  THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.                                                                           END