Transcripts For CSPAN Washington Journal 04022020 20240713

Rafael espinal from Freelancers Union talks about the impact of the pandemic on the selfemployed. Washington journal is next. Good morning, this is washington journal, for april 2. We want to hear from you about your level of confidence in the u. S. Health versus to treat those affected by coronavirus. What you are seeing and experiencing in your community and we especially want to hear from you if you are a Health Care Worker in the field and you want to give your perspective on the u. S. Health care system possibility to treat coronavirus. In the easternu and central time zones, give us a call at 202 7488000. If you live in the mountain pacific time zones, its 202 7488001. If you are a medical professional, you can call in at 202 7488002. You can text us at 202 7488003. Tweet at cspan wj or post on our Facebook Page, facebook. Com cspan. On latest numbers coronavirus are available at the Johns Hopkins website. When it comes to the u. S. , as far as the numbers they have coming in with the total of total of confirmed cases, deaths in the United States due to coronavirus host those of the numbers across the United States. Looking at individual states and cities, new york is been profiled in the New York Times this morning, particularly when it comes to the New York Times , highlighting the fact that us of wednesday there were 83,000 confirmed cases in new york state, more than 47,000 of the cases in new york city, prompting that chapter of the American College of physicians asking Governor Cuomo to grant dr. s from liability over the forsions they make the need allocation of ventilators results in some patients being denied access. Just onets perspective, and Governor Cuomo yesterday in his Daily Press Conference talked about the latest number of cases and what it means for new york state. [video clip] there is a group funded by the gates foundation, thank you bill gates, that projects 93,000 americans will lose their life by the time this is over. The model suggests 16,000 new by the will pass away time this is, runs its course. Says 100,000, there are models out there that make these types of projections. To newuld that mean york . That would mean about 16,000. Frankly that would mean that new york is only 16 , roughly, of the number of deaths. Even understand that, since new york is so much higher right now. But what it does say to the rest of the nation is this is not just new york. Numbers,lieve these it000 deaths in new york, means he will have tens of thousands of deaths outside new york. To the extent that people watch him in kansas and call it a new york problem, thats not what these numbers say. It says its a new york problem today. Tomorrow its a kansas problem, new mexico problem. That is why i say to my fellow governors and elected officials across the country, look at us today, see yourself tomorrow. Lets address it in new york and cooperate to address it in new york because it is going to be in your town tomorrow. One of the aspects being covered is whats happening in rural hospitals across the United States. The wall street journal ticking up this from chris mayer picking up this from chris mayer. Host so, when it comes to the health care perspective, and your confidence in the Healthcare System during this time to treat coronavirus, that is what we are asking you in this hour. 202 7488000 four eastern and central town time zones. Mountain and1 four pacific time zones. If you are a medical professional and want to offer your perspective, 202 7488002. Texas, one of the perspectives coming in from Paul Mcguinness off the Facebook Page when it comes to confidence in the Health Care System. Saying host those are some of the perspectives coming in on the social media feed. You can participate there as well. Include your name, your city, and your state you call in this morning. We started out talking about new york. This is john, calling in on the perspective of the Health Care System and its abilities during this time. John, go ahead. Caller im good, sir. Host what do you think of the capabilities of the Health Care System at this time . I think they should open, donald trump should open up the big book. [indiscernible] about theidea insurance. Number two, very important. Been a report on the wall collapse. Always talks about how far it has been going, but he is talking about to obamacare, why do you bring that into the discussion . Caller why . Because i want answers about the wall. Not the wall. You mentioned obamacare. Why did you bring that up . Caller they are in court fighting it when the people that need the insurance, its the only way we will get it for the people. Why is he closing it and fighting it in court. All right, buzzfeed news, this headline posted yesterday about the president decided not to open the markets of obamacare during the coronavirus outbreak. You can read the story there on buzzfeed. Confidence in the Health Care System at this time, joe, hello. Caller love cspan, you guys are doing a great job. Capitalhe encouragement of the world. Our people here are following the rules and have a very good attitude, you know, with the keeping their distance. I exercise, i do it privately, i dont go around a bunch of people. We have a great attitude and feel like trump is doing the great job. Thats people, but what about the Health Care System . Caller we only have one case here, im extremely happy with whats going on, extremely happy with trump. We would love a j we love [indiscernible] prayingying every for everybody around the world. Host all right. Joanns next. Sleepy i. Eye. Caller i think this is a very concerning time for our country. As far as health care, i think we have one of the greatest Health Care Systems that there is. I think they are doing the best that they can do. I am concerned about the lack of health officials, the lack of doctors. For some places, the lack of get the protective covering and everything that they need to do their job. I am from a small, rural town and i had an appointment yesterday. My doctor was good enough to call me and say you are high risk, i dont want you to come in, we can do it by phone. So i had my appointment over the phone and i felt so great. Is local health care here doing a great job, but i want to bring up one of the point. When we see the pictures of masks you see people in and you see people spraying and the whole city. Their subways. We dont have that in this goingy, where we are around and disinfecting things. People are not listening. I feel sorry for new york, but the people arent listening. That city should have been shut down weeks before it was. People do need to listen. On your other caller where they said that people are not listening, we do see a little bit of that here in rural minnesota, but most people are following the rules. Thats the only way we are going to get it stopped. Faith in the health care and that the Trump Administration is trying to do everything they can. Im so thankful that they are starting to get medications. Host before we let you go, how close are you to a hospital we have one in town, i go to the next time next town. Its about 15 miles away. Its a very good trauma hospital. I dont know the supply on the ventilators and stuff, but i believe at this point when i was in the other day, before i had the call, i had to go into emergency. As i talked to them it sounded and looked as if they had all the supplies needed. But they only have so far two cases in the county. The state has more, but we are fortunate so far. Host thank you for the perspective. In pennsylvania this morning host we have set aside a line for health care professionals. Int is the case for will baltimore, maryland, identifying as i medical professional. What type of medicine do you practice, will . Caller surgical technologist of over 25 years. Im the guy that passes the surgical instruments to the surgeon. I have been doing that for quite a while. We are working under duress. I have Family Members for healthcare care workers. My son is also a surgical technologist. N95 masks are a big concern. We dont have them. We dont have the necessary sizes, a lot of them are not fitting properly. There is a lack of ventilators. Unfortunately i have a Family Member who is a health air worker that has come down with covid19. I think the Trump Administration ignored the data that suggested that we needed to prepare for a pandemic. He has not done a good job, as some of your collars have suggested. I also believe the virus could come back in the spring or mutate to some other virus. Host because you deal with surgeries directly, your , have a decided to cut down on those elected surgeries . Decided to cut down on elected surgeries . Caller i dont work in a hospital, i work in what they ambulatory surgical center. Sent to surgeries being facilities like the one im working in at this moment, but i dont know how long we will be able to continue to do that. Ands recently furloughed was told it could take back up next week. Well see. The hospitals are basically doing nothing. We have been cut back. Often doing surgeries, those elected surgeries at the hospital, they are coming to us. Host lets hear from joe, in falmouth. Good morning, pedro. I wish i could say nice to see you. Keep your hand on your buzzer there, you are not going to like this. Host you are on, go ahead, good morning. You called us. Caller im a retired firefighter. It is suicide to handle patients equipment. Proper the Trump Administration has lied consistently about the tests being available. Its coming back now. All of this that they are using is based on other things that. Re not scientifically proven so, you put these doctors out there with garbage bags on. With their wifes scarf, as the president so nicely said is just as good. Where aident said scarf, its just as good. Come on, come on, lets knock it off. Host ok. Mike, South Carolina, hello. Hello. Im relatively confident in the local hospitals, although they havent shared with the public what their supply of, for example, ventilators or masks is. At this point i have no alternative other than to be confident that they would be what we wille foresee here in the hilton head ocotillo South Carolina area. Host because that is a big vacation spot, i suppose you are noticing big differences in traffic there. Caller its a lot less travelers now. People staying away with the occupancy being very low because travelers are not coming from the north or from any place else to visit the area now, even though tourism is our number one business here. We are seeing far less travelers now. At the same time, the locals are concerned. Because the private hot as arent sharing what their supply actually is at this point. Is causing some of the local leaders to be concerned about are the hospitals prepared and at the same time for us locals, you know, we dont have any real alternative other than to realize the system will be able to manage the outbreak if and when it occurs. What is your proximity to a hospital or some kind of care center . From onem six miles hospital and about 10, 11 miles from another one. So, the proximity is ok. Knowugh, again, we dont what their supply actually is. I live in a community of about 16,000 older folks. We all have our own health issues. Immune weakened systems. If it hit here, it would cause issues for the hospitals i believe, but again they are not sharing what their supplies actually are. Host how often are you venturing out these days . I try to go every day and go to the hospital campus theres no people up there. I try to do that just because it is good for continuing health. Host that is mike in south concerns sharing his and confidence in the u. S. Health care system and you can call and do the same. The previous caller, the president mentioned the idea of a scarf. Politico picking up that story. On the depending fabric, a scarf is actually better. That goes against the cdc recommendations in lists for face protection. Bandanas and scarves are a last resort for Health Care Workers. Host you can pick up more of that at the cdc site. The president talking yesterday about issues concerning the daily briefing, you can see them on cspan every day, watch it live, see it online. Or the about this idea possibility of a national stayathome order being issued by the administration, given social distancing and the kind of thing. Here is his response. [video clip] governor has issued a stayathome order. You have all made it clear how important it is to stay at home, that this is a dire situation. Thats how you stop the spread. Why not take the power out of the hands of the governors and you just issue a stayathome order. States are different, states are different. The governor of florida, great governor, he issued one today. Thats good, thats great. But there are some states that are different. There are some states that dont a problem. F they are so great they dont have much of a problem. Thousands of people are positive. Thousands that might even think they have it, or hundreds of people in some cases. You have to look at states. You have to give a little bit of flexibility. Example, theyan dont have a problem, its tough to say, close it down. We have to have a little bit of flexibility. This is bill, saying host marie, columbia, south is aina, unidentified medical professional. Hello. What kind of healthcare do you do . Caller i actually am a nursing home nurse. Host ok, tell us about your experience. Caller well, our nursing home is a small nursing home. What we do in our nursing home is we survey everyone. With every employee who had to have surveillance done, they needed their temperature checked. It doesnt stop possible exposure when they are in the community. The employees go through this process. What is it like on a day by day and your level of insert around ,our Health Care Facility facilities like yours, to treat this during this time . Caller well, ours is mainly resource. We are really concerned about where we are going to get our next supply of resources now that the larger facilities are taking up all the resources. Whats the list of resources look like . What are you most concerned about not getting . Caller well, if we do have an outbreak, im concerned as to whether or not we will have ppes. Its one mask her nurse and our facility. Ok, lets go to freddie. Hes in South Carolina, in easily. Good morning. Caller host how you doing . Host fine, thank you caller how you doing . Host fine, thank you, go ahead. All of thehave medical experience that we need, but dont have a leader that has had a proper first aid class in medical. He needs to sit out. It aint about him. My comment is this. Why dont we just give, and i dont mean to say this in a racist way, but every illegal person that is picked up, give them a flu shot. We got 11 million, 12 Million Peoples here. Way. T to have some kind of everybody from everywhere that is illegal, lets give them a flu shot. Host that wouldnt do anything to change the coronavirus situation. Caller but it could, we dont know this. Flu and coronavirus, as far as the outbreak, what they do, its different. Caller how could you know it if you dont know . Who tested the illegal people anyway . Host ok, martin. Caller thank you, cspan. Host thank you, go ahead. Caller good, good, stay safe. A few things i want to say. One, i think a lot has to do with regardslity to the medical services available. Most of the concern in a new mexico right now is on the Navajo Nation. While they have an independent , they have Service Recently contracted it from outside. The social isolation im worried about in the sense of new york city and california. When President Trump provided the possibility of a quarantining of new york city the governors response was that this was a declaration of war. As a prudent that review of back kind of action. If it is going to spread now because of the epicenters. You know, the traffic that goes to and from those epicenters. Think, you know, whats needed, what was seen in china, what we are sort of seeing in italy, if you dont address the , thenters, you know contagion is going to spread. No matter the policies, the social isolation policies are not. Host do you have a sense there in new mexico, you talked about the Navajo Nation and such, do you have a sense of whats going on there as far as outbreak is concerned . Caller most of it, yeah, the initial cases were from people either overseas or to new york, in fact. Especially in northern new mexico. You have a lot of california transplants. Like in taos and santa fe. You had a lot of back and forth from there. So in terms of the care right now, its you know, its at a manageable level. Know, its been declared a state of emergency. We are under the same orders as everybody else. And a sense even though the number of cases are drastically less than other states. Ok. thats martin in new mexico, giving house giving us his perspective. Cynthia on twitter says news storiesthe that came out of florida yesterday was Governor Ron Desantis saying that he is going to put in place an executive order that would limit movements for those residents of that state. Here is part of his statement from yesterday. [video clip] we have the list of essential Services Detailed by Homeland Security. We are also using what has been ine by mayor gimenez down miamidade. They have been operating on essential services for a couple of weeks and they did us a good they did a good job in showing the way how to do that. Jared moskowitz and scott ricky to add if there is some essential services that we missed. You will be able to add that accordingly. Working on this, devoting a lot of resources to southeast florida. Obviously they have been operating under stringent measures now going on i think a couple weeks. This is another 30 days. You know, at this point i think that even though there is a lot of places in florida with low infection rates, it makes sense to make the move now. You know, i did consult with folks in the white house, i spoke with the president about it. He agreed with the approach of focusing on the hotspots. At the same time he understood that this is another 30 day situation and you just got to do what makes the most sense. You look at the front page of usa today this morning, it talks about different types of caregivers and how they are being affected. This story says that workers from dentists to general assistance,dical pediatricians and nurses, all being affected. By june an estimated 60,000 family practices will close or significantly from scale back and 800,000 of their employees will be furloughed as they see a decline in business due to the pandemic. That is according to the Health Landscape and American Academy releasedians report on thursday, adding that represents 43 of the 1. 9 Million People employed in Family Medicine offices, including receptionists, physicians, billing staff, and janitors. You can read more of that in usa today. Your confidence level in the Health Care System, hairy, connecticut, hello. High, im wondering if anyone has a plan for say we get a storm and we have power outages. How you going to run those respirators . Question im putting that question out. Maybe the Power Companies have a plan for this . Host why is that the top thing on your mind . Caller well, you can have all the respirators you want, but if you got no power, how are you going to run them . Will that was hairy, we hear from david. David, wisconsin, fall creek, hello. Im a union member and i have worked with Hazardous Materials all the time. These n95 masks that everyone is so concerned about . You need to realize their only dust masks. A handkerchief or whatever is as good, you know . Its the way the air flows around your face. You need to be in a full respirator to protect your eyes and everything. On dirty jobs, there was a special out from a few years ago that explains how your breathing and all the germs that you can get transferred from persontoperson. That should be a special on tv continuously right now and i would recommend getting micro on a channel to explain these things. Its, its more like a humidifier, the mist in the air that you need to be concerned with. Host how do you make that comparison . Caller its the seal around your face. These n95 masks, you breathe in and out, you can still feel your breath go past her cheeks and stuff. They are not a filter. They are over exaggerated. These homemade surgical masks everybody are doing is just as good as a 95. Put on anything with a face shield, this is going to protect your face better. You need experts to be looking in this, production and quality control, spc to explain bottlenecks and why it is taking time. The tooling and the fitting, the remanufacturing of products, it takes time. That is david in wisconsin. If you go to the fda website talking about n95 respirators and surgical facemasks, they add host if you want more on this, the cdc page has a lot of information there you may want to read for yourself on the effectiveness of masks and the way they are distributed. The last couple of days of the washington journal program, we had the opportunity to talk to members of congress who are not back in d. C. Just yet because of the virus, but talk to them about issues facing their state and locality. Joining us now on the phone, representative walberg, who serves the seventh district in michigan. Good morning. Guest good to be with you. Host could you tell us a bit about not only what is happening in your state as far as the numbers, but how we can bring that to the local level . Caller guest its been an interesting change. We were one of the last states with outbreaks and we have now mounted up to be one of the highest, jumping rapidly over the last several days with over , 337 thats. Also started out very, very slow with numbers and has been mounting up now, primarily in pockets. But we have 558 cases and 11 deaths. Are predominantly in the wash in our county area, ann arbor. There, university of michigan, with all the surrounding issues. Thats probably the reason some of the numbers are so strong there. My district also whats up to wayne county and the detroit and detroit, where it has reached significant proportions. So, it is a challenge at this point in time. Our hospitals predominantly are not being overrun yet. We have been checking with them regularly. The challenge comes with the rural hospitals. They have been told that they cannot do any elective surgeries. That is where the rural hospitals make their livelihood and have been able to stay open. Its a challenge for them and we are concerned about that at this time, that after this covid19 we still over, that have rural hospitals to carry on the functions necessary. Storylines wehe have an hearing over the last couple of days over ventilators coming from the federal government, and the ability of to gather ventilators on their own. What number has been received . What is the state doing . Particularly what are you doing guest ournt . Hospitals right now are not expressing concern over having enough ventilators. Going from the middle of lake erie to the state capital. Predominantly what im hearing, the major problem for is in detroit, wayne county specifically, those hospitals, like beaumont and henry ford, i dont know the exact numbers we have right now, but hopefully we are seeing ventilators capable of being overin local hospitals all the state not having a significant challenge. Knowingy could be moved that there are ventilators being by the Ford Motor Company now. And general motors, who are going to be producing ventilators and ramping those up significantly. We will have a back flow on those at, if there should be a out at the state hospitals at some point in time. The major problem we are seeing across the spectrum is for Health Care Providers and first. Esponders to have ppe that is still a challenge to some degree in the state. Course in the higher population areas. Its too early to tell, but what do you worry about in the sense of what it will do to the locality if this persists . Guest its a major impact, this being the Auto Industry capital of the world. We have all three that are connected here in my district. The biggest is the supplier component. And you have machine shops small factories supplying resources to general motors, chrysler, and ford, as well as , with the Largest Toyota research and Development Center being in my district herein ann that, that causes concern those entities will still be alive and kicking and moving forward, yet some of the small Provider Companies will have a difficult time. We are appreciative of the fact of passing the cares act this last week and getting that into onlyipeline, but that will have a limited impact on a number of Provider Companies. Manyully we wont see to that shut down, but relative to that is all of the suppliers in the industry, such as the restaurants and the local stores that are really hardpressed, some to put up open up again. It touches the families and impacts them, to be able to have an available force for the future. We are hoping that the people, and we are pushing it daily with halls,eleases, with town , pushing tolls increase distance. We are trying to get away from the term social distancing. We want people not to, give a phone call, use your Electronic Community electronic ability to communicate. We want to get through this as quickly as possible and see the rise in numbers in the state start of level off and go down, but still have a constituency and community of individuals that have kept in contact with each other and thus solve some of the problem that comes with this type of fear that is out there that we still have that that isship with people positive, building, and comforting during this time, strengthening us for the future. Host we heard Speaker Pelosi talk about a fourth type of bill to assist in this time. Some of it to health care, some of it to infrastructure. Would you advocate for another spending bill to help at this time . Host if needed, guest if needed, of course i would. But lets be careful. I never thought i would vote for Something Like a 2 trillion spending bill. Just one bill, 2 trillion, thats huge. It probably wont meet the needs of all. We probably should be evaluating. We need to make sure we are not sticking stuff in that has nothing to do with the coronavirus and the concerns of that to see what nancy pelosi try to stick in the last bill, with arts and the green new deal. The process of elections in the country, taking it over from the federal level. That is something i would never support. Hopefully the speaker will use common sense and say, listen, at this time lets stick to whats needed. The main thing is getting people healthy again, getting the economy back up and running, back to work, getting restaurants in schools open with normal life going on. Then we can fight the political things for the future. I would say to your question, which is a good question, yes and no. Yes for what is truly needed with the coronavirus issue, no two any political engineering that would go on with policy that doesnt connect. What do you think of your governors performance at this time . Im going to support the president and my governor in doing whats necessary. Its a tough time. Nothing that we do in government will be perfect. In this case we havent seen a pandemic like this since probably 1918. That was a total different world at that time. This is a different world. This is in International Pandemic impacting us. Im not quick to push back or condemn the efforts of my governor or my president. They put together a magnificent team. I think that we are doing the best that we can right now, looking for ways to enhance it and make it better. But i think the governor, certainly you could look and say she has made mistakes. Sure, but she also has a state with Major Concerns going on now that is a hub in manufacturing, education. We have people coming here from all over the world. That has made a major impact and she has never done it before. Im going to spend my time supporting the executive branch where i can, offering constructive ideas where i can. But in the end we have to Work Together to make it work. That is where i will spend my efforts. About governor whitmer, joehill reporting that biden said she might be on a short list of potential vp nominees. Guest now you are going to get me a little political and i will shethat well, it would be, would be joining a very weak ticket in the process and i guess i will leave that to joe biden to make that decision. Betterublican team has a farm team to work from. The team with Vice President hence, working with donald trump, has done a good job. I will leave that to joe biden to make his decision. Walberg, thank you for your time, sir. Stay healthy, thank you, pedro, physicals distance but lets stay in contact with each other. Host back to your calls about your confidence in the coronavirus outbreak in the medical facility and the coronavirus outbreak. It between him, and donald trump, thats why i have no confidence in the Health Care System. Also, let me make a couple of more quick points. Stick to the topic at hand. Why do you make that association . Lets start with that. Caller at the beginning of this month, page row donald trump, one person died. 15 people infected. Right now its over 240, pedro. Ok . Spent eight years in marine corps. When did america become crazy . People, we have to become serious. Back to the Health Care System, thats the topic, what is your level of confidence based on what you just said . As long as trump is in charge, i have no level of confidence. Let me explain why. He couldump said that walk down fifth avenue and shoot somebody and not lose support. Shot,now he has literally like i say, with their plan they set up to 240,000 people could die. Now hes going to literally kill 240,000 people. And, and, like hes not going to lose any support. Let me ask you, former withdents who that pandemics, people that died on their watch, which you say the same thing . Caller if obama had done the ,ame things that donald trump 200 and 40 people dying, i would be the first one standing in line hoping i could vote twice to get him out of there. One less point, i live in georgia, this is so important. Justovernor of georgia took the stayathome thing yesterday. He said he just found out yesterday that asymptomatic people can pass on this disease. He said that he just found this out. He just found it out . Im not a doctor. I found this out two months ago, two and a half months ago. Together, itse why with this current leadership i have no confidence in the Health Care System. All right, thats dan. Lets go to carl in a gusto, georgia. Augusta, georgia. Caller thank you for taking my call. The young men prior to me, he stole a lot of my thumb dirk. Im not happy with what went on in georgia. What happened was the governor acted like he just finding out about a lot of things. That makes me feel uncomfortable. Weve got a pandemic down in albany, georgia, and no one, really, knows how it got started. I was talking to some Family Members there and they said it can be at came about because of lack of information being passed on. So, if people dont know, thats what makes a difference. They had several funerals in the area. People now infected with the virus. People went to a funeral and affected with the virus. The amazing i can say, pedro, is we have been slow getting the word out to everyone. Thank you for taking my call. I appreciate it. When that guy called in and said what they were doing and i know how you all have been doing, its two different worlds. Ok, that was carl. It was the governor of georgia who said that he wasnt aware that asymptomatic people could transmit coronavirus. 31rgia, 46,000 4600 and cases of covid19. From valley college, new york, peter, hello. Caller how you doing, pedro . The system as is is doing the best they can under these circumstances. What did we learn from this . The main thing that people have learned is number one, government was not prepared for this type of pandemic. Hollywoods been making movies about this type of thing for the last 30 years and in our minds we kind of think this could never happen. So, i think there is a Silver Lining here. This pandemic is bad, but not as bad as it could be. What if we had a 30 or 40 death rate. It . Could we have handled i live in new york. Governor cuomo saying he needs more ventilators, whatever. From my understanding, he had an opportunity to buy ventilators years ago and didnt do it, instead bought solar panels. To doment has a tendency whats immediate and put off something that they think is not immediate. Our supply chains, where we get our prescription drugs from, 20 countries supply us. Out of the 20, 10 have already said they would hold back important drugs for their own use. I am hoping the media will play their part, like they do with climate change, which is a longterm problem. Im hoping the media will stay on this and keep the American People aware that we need a plan. I mean, the military does war games practice for emergency situations. We need to be prepared and we need to have the federal government and state governors Work Together to establish a that when something really thehappens, how do we keep economy going . How do we protect the most vulnerable . Host gotcha, gotcha, gotcha. Dwight, North Carolina. Go ahead. Caller yeah, how you doing . Host fine, thanks, youre on. Caller i want to ask you a question. Do you think that trump is doing a good job . We are going to turn around and ask everyone the same question about the Health Care System and if they are doing a good job. Caller i think a help your system is doing the best they can. Base that on . You caller [indiscernible] host ok, spencer is next. Good morning. Caller hey, how you doing . Host fine, thanks. Caller as a husband of a nurse and other Family Members that work in the Health Care System, i want to say that this ppe shortage is a catastrophe. We are still not able to get to dollar masks to protect the frontline healthcare workers. Dont hear any of the political leaders mention the fact that more for nurses and doctors equals less ventilators needed. We have got to protect our nurses and doctors. In rural maine, hospitals are already understaffed, but they serve many, many different towns. We will have one hospital with 500, 600 employees serving many towns. We are just sitting here, waiting for an asymptomatic person, staff were patient, not just patients carry this, to come into a hospital and spread it throughout the staff. But we do not have we are being told we dont have the ppe for Staff Members in the hospitals to wear masks throughout the day proactively instead of reactively. It is absolutely outrageous in america that we cannot get an out an unlimited supply of paper masks to the nurses. My wife is a nurse. I had n95 for her a couple of weeks ago that she wore to work. She has an underlying respiratory issue and she was told to take it off. This is ridiculous. More ppe means less ventilators needed. Think about it, america. What about the governors ability to gain these things . What is she saying . Lack of whats available in the supply chain . Costs . What are they finding . All, i dont of see the governor or anybody talking about it enough. The last thing that i saw was that the state of maine had received 5 of the supplies they had requested. Talking about paper masks and face shields here. People sick, less ventilators. What happens to rural hospitals if you lose four or five nurses with one dr. Question mark they become ineffective, cant afford to do it. E have to be proactive the state of maine needs more ppe so that hospital staff can be protected before the outbreak. All right, one more call from chris in salem, oregon. Caller i have always had insurance for the last 40 years or so, but i have always had illerns over people getting and dont have insurance. I feel sorry for the family that is going to have to pay for them. It comeshe bill when out. Im afraid its going to be a big bill. The ones that are calling in that are saying that they approve of the Health Care Going , i dont know how they see it that way. Its just sad. I wanted to say that my heart goes out to all the nurses and doctors that are going to be affected by this. I watch the news. I see the nurses crying. I see how hurt and scared they feel and are. Its sad. I just hope that everybody gets through this safely. 200,w theres 100,000 to 200 50 they said it might affect. I hope its lower than that. Host that was chris, she will be our last call. We will continue on in this discussion of health care and how they are doing with this. Specifically, hospitals. We will have more information on how hospitals are doing with shannon much more, who is going to give us a sense of whats happening with hospitals around the country. Later in the program we will be joined by William White william reinhardt. We will talk about the roles of federal regulations and the web of regulations that may have. Ampered the early days we have in showing you day after day governors as they have been giving assessments of their states and the covid19 response and outbreak. Yesterday it was mike dewine, discussing a new order otherknow ohio, like states, have not had as much testing as we would have like. We have had to ration that testing or target that testing. Will be issuing orders today to accomplish a couple things. Both will help our testing turnaround time to reduce of people who are sick, they need to get the result as quickly as possible. I have talked about this before, but today, we are turning this into an order for our hospitals. ,he doctor assigning in order directed at all hospitals that do not do their own testing, which is the majority of hospitals. Those hospitals that send their specimens to a third party. The doctoroday, signed this, you will be required to send this to another hospital that is doing testing and can make a quick turnaround for you. We have already confirmed, for example, that ohio state, cleveland clinic, University Hospitals in cleveland, and metrohealth in cleveland all have capacity. They all have capacity and are willing to take your tests, so you need to be in contact with them. Some of these labs have a very significant unused capacity each day. It has not really been fully utilized. These labs are able to turnaround results much more quickly than the private labs. Beginning today, you will be able to send those to the private labs. The private the problem has been turnaround, which is four to five, maybe sometime six days, which is unacceptable. Unacceptable for the patient and for the rest of us. Knowing when someone does or does not test ossie davis information we desperately need. Let me also say the Ohio Department of health itself will continue to analyze tests, and these, for the most part, and there is order already the protocol the hospitals know, but for the most part, these are includingatients lives and Health Care Workers who are showing symptoms of the coronavirus. That criteria does not change. The department of health in ohio is certainly open for business and to do that testing. We would anticipate there may be other hospitals who have capacity, and as soon as we know those hospitals confirm capacity and can do testing, we will post those and let you know about that. Announcer washington journal continues. Host our first guest of the morning joins us from washington dc, shannon muchmore, the editor of healthcare dive, here to talk about the state of hospitals during the coronavirus outbreak. Morning to you. Guest good morning. Host a little bit about healthcare dive to begin with, what is it . Guest it is a daily newsletter, an online publication, and we have, every morning the newsletter comes out geared toward Health Care Executives with stories and analysis they need to know. Letters, one more focused on Insurance Companies, and the others are on health issues. Host since this goes to executives, i imagine many executives are on the boards of hospitals or are running hospitals. Could you give us a sense of where they are maintaining during an outbreak like covid19 . Guest it depends on where in the country you are talking about. Hospitals in new york, for example, they are overrun in a lot of ways. They are running out of equipment in some cases. They are running out of personal protective equipment. We are hearing about the masks, the gowns, and theyre trying to find a space anywhere they can. There opening up feels hostile field hospitals, some cases. Those in the hospital tends. Tting areas have you will allow places serving us hospitals like dorm rooms, hotel rooms, where patients are treated and triaged. Some areas that are not hardhit, they are trying to prepare for when they become the hotspot, making sure they have staff available, making sure they have a good wind, running through best processes, stopping elective procedures so they can be ready. It depends on where in the country the hospital is located. Host in general, as far as the hospital operation, how much is devoted for the outbreak and what else is affected because of it . Guest most hospitals have stopped all elective procedures, something that is not necessarily higher to happen right now. Any surgery, for example. People have had those across the country postponed because depending on where in the country, this is all they are doing really. Emergencies still happen. People have trauma, people need dialysis treatment, cancer treatment, so it cant be the entire Health Care System turns over entirely, even though it is taxed so much by the pandemic. Also, they are no longer doing anything they can really put off. The issue there is those are the procedures. That is what they count on to keep the doors open, payroll going, so that is a big issue they are dealing with, trying to keep patients that dont need to be in the hospital away, but that is instruction to their that is in opposition to their finance. Host i suppose they have to make decisions on who gets treated first. What are the decisions hospitals have to make at this time particularly . Guest some of them are important and difficult choices. There is a shortage of some have a shortage of ventilators. Some put multiple patients on a ventilator. That is not necessarily recommended but they simply do not have the rep the ventilators. Some may say the choice of who gets life equipment and who doesnt, and thats not a choice you want to make, but across the country, there may not be much theylls much else they can do. They have been discussing these issues and it comes down to the provider there in the room on what they can do, and that is part of why we see such a huge emotional burden on these clinicians. Some of them have to make life and death decisions for patients. Host as far as those choices being made, what are the liability concerns about doctors in this situation . Guest its not entirely clear right now. The doctors are doing their best. Have guidelines. This is a state of emergency and we will see that shakeout later. There will probably be more coming on and losses potentially, certainly something to happen. Right now, they are working on following their medical and ethical guidelines, and doing the best they can. Host this is shannon muchmore joining us, the editor of healthcare dive. Questionske your about the coronavirus, particularly about how your hospitals are handling it. 202 7488000 for the eastern and central time zones, 202 7488001 for the mountain and pacific time zones. If you are a medical professional, particularly if you work at a hospital, 202 7488002. You can also text us at 202 7488003. I know you dont speak for every hospital, but are there concerns about people not showing up for work out of concerns of getting sick. Guest i have heard anecdotally about how the health care ,roviders are the most at risk as we know from research and other countries, and they have their families they want to get back to as well. Some of them have underlying conditions that make them especially vulnerable. That is something i have heard about, but by and large, mostly what im hearing is clinicians are ready to do their work. This is what they signed on for, and retirees, some are coming back. Medical students, in a few cases, are graduating early so they can start this effort. You will hear reports of that, but i think the biggest case is definitely if anyone has the ability to help with this outbreak is showing up and doing the best they can. Host we had a previous caller before the segment to the color talk about the plight of those that do not have Health Insurance during this time caller talk about the plight of those that do not have Health Insurance during this time. What can people do about that . Guest theres not a lot they can do right away. Obviously they will treat patients that is required, stabilizing patients. They want someone that will be able to cover their reimbursement, so, especially as we see the economic fallout, more people will lose their jobs and they might lose their Health Insurance coverage. That will be difficult for hospitals, because they might have to write that off as charity care. Meaning they dont get reimbursed or they will do their best to get reimbursed by the patients. Sot can be very difficult, the more uninsured people they deal with, the more difficult financial picture that is for them. Host talk about the centers for medicare and medicaid end about the flexibility they are giving at this time to hospitals and about the flex ability they are giving at this time to hospitals. Guest they have done a lot in the past couple weeks. There are new areas that can basically function as hospitals, so Health Centers are under contract with all rooms with dorm rooms and centers where a lot of those elective procedures would normally take place and now function as hospitals. There are now new telemedicine guidelines. No longer does a patient and a doctor have to already have a relationship to begin a virtual visit. A doctor can Start Talking to a patient through their phone camera and talk to them about the needs they have, so they can get treatment without a patient having to go to a hospital or Doctors Office and potentially expose themselves. That might just be a phone call for someone who might not have a capability to video visit. They want to free up all of the treatment that still needs to happen in some form, but should not be done in a clinical setting. Host first call from you for dayton,s from ohio. Kathleen, goa go ahead. You are on with our guest. Guest first, i want to say thank you to our Health Care Workers. They are the First Responders and we should be supporting them anyway we can. As well as grocery store, people any way we can. As well as grocery stores. And places that dont have a way to wipe your hands when you go in. I have been into walmart, no way for people to wash her hands and they are not even wiping down cards. I cannot believe there is not more Media Attention on there. Host this is dedicated to the hospitals and the like. About thatquestion directed toward our guest . Guest i just heard a local reporter from dayton, ohio, at governor the winds Daily Press Conferences, which are important and we are appreciate if he does this, however a local reporter from dayton ohio dayton, ohio asked him if hospitals could release information about what is going on within those hospitals, and there seems to be questions about that as well as we locally had a hospital premier Health Network teardown hospital. 577 room had a time where americans are about the things you have to deal with immediately with this pandemic, however, if any time could look at how screwed up our Health Care System is, your guest said when you asked about people without medicare or medicaid, there was a question as to whether they have to deal with those patients. At a time where we should be examining our Health Care System and pushing for singlepayer, it is ludicrous. We are allegedly the richest and most powerful nation in the world, and look how im sorry, i dont like the way some of the dems pushed trump around or picked on him recently like rachel maddow. However, his supporters cannot see how he has failed in his slow response and the lack of the inability to get testing. Host you have put a lot out there. We will let our guest pickup what she which is what she wishes. Guest certainly this crisis has exposed weaknesses in the Health Care System. People inave heard various parts of the Health Care Industry believe there are silos and areas not talking to each other. We have a crisis when we have a crisis, not talking to each other is problematic. Hospitals not necessarily releasing their information. There are privacy laws they have to follow, so they cant say release information that might identify a person and their medical condition, but they can say heres whats going on. Some hospitals are and others are not giving that, and transparency is important. Especially with telemedicine, data sharing is something hospitals are still working on, being able to give information to other providers and Insurance Companies. The lack there is really showing, as well as the gaps in coverage. When the worst of this crisis passes, there will be a lot of looking at how this could be handled at federal and State Government levels but how the Health Care System is better set up to communicate within the public, to each other, and to respond better to these types of situations. Host from jacob in ohio. You are next. Hello. And i i am 20 years old was wondering if this is going to get better or if this is the new normal, like the flu . Guest this isnt the flu, to be sure. This is different and there is a lot we dont know. Who knowsink anybody about epidemiology like i do can answer that question. This will be different for a while now. Hospitals will have a different operating. It really depends on how the country responds to social distancing, it depends on how testing is ramped up, and how drug developments in vaccine development, all of that. People are working really hard on it right now, but all of those questions still remain. I think we have to do our best to follow Public Health guidelines. That is all we can do for now. Host ralph in hillside, new jersey. Hello. Guest how are you doing, pedro . Host fine, thank you. You are on with our guest. Guest my question is twofold. I first really appreciate all of the Health Care Workers and workers we have going out there and doing what they do for the country. My heart goes out to them. Especially when it comes to the ppe, my heart really goes out to them. We have already had 285 million n95 masks exported out of this country because the defense protection act has not been used properly. There should be set prices on ventilators. Andet prices on n95 masks, there should be no way u. S. Companies are able to export that Vital Equipment for nurses and doctors and hospital workers. Also, the democrats are trying to get the treatment after the testing covered for all americans. That was one thing they were fighting for in the bill. I would think that would be helpful to a lot of americans, because that would they would get that done. After the testing, the treatment will cost americans a lot of money. It might even bankrupt some of them. Host we will let our guest respond to that. Guest as for pbe, certainly hospitals and providers have been saying for a while that the defense production act could be used. They have been calling for help in obtaining these supplies and have been sounding the alarm for a while now, trying to get a hold of them. They have been asking for more action on this. We have been seeing Health Insurance companies and making news make new statements about what they will cover. They started with saying no costsharing for testing, they wanted people not to worry about the bills, citing if they were telephone, they should get tested. Now, more and more of the inter Insurance Companies will waive deductibles for any treatment of covid19, and the more they do that, the more hospitals follow at a statement recently putting a cooperation for Insurance Companies like expedited payments, which medicare has started to do to get money flowing so hospitals can secure the staff and equipment they need. Coverage is ongoing. It is still an issue, but interest Insurance Companies are responding. Host when it comes to the search for personal protective equipment and the like, are hospitals first in line for those competing for the same type of resources . Guest not necessarily. Are used for construction but therethey are are guidelines that have been for thoser use respirators in hospitals. People were buying these surgical masks at the beginning, beinge supply chain still hit in a lot of ways. Where mass areas production is so focused was china, which was hit early on. This has been an early pain point. Governors are out there trying to request from the National Stockpile and get to the hospitals, so there is a frontline consideration right now, but at the beginning, that was always clear that not necessarily. To physicalt comes beds, how are hospitals accommodating the influx . Guest they are building more areas. That shortage, in particular icu beds, is an issue. There was an examination where not necessarily every area is a population represented by hospital beds. Some have the have a certain number of beds for the population available and some areas dont. The areas with the lower ratios, those could be hit when they become a hotspot. That is why cms relaxes regulations, saying put beds in the dorm rooms and start treating people there as much as you can to help isolation, and try hospitals are trying to get people who dont absolutely need a bed out of the hospital as immediately as they can to free up beds for the incoming covid patients. Host we will go to dan next in west virginia. It morning. Guest good morning good morning. Guest good morning. N95 masks forose years, and what i found is that they are paper, and the condensation from a person breathing inside of those masks helps break it down quicker. Perhaps people could use a thin piece of cotton between their absorbencyhe mask to the condensation from breathing. That may help those masks keep their form longer. Thank you. Guest one thing about those masks is the fit on the face has to be very specific. There have been clear guidelines on how those have to be fit to properly protect providers. Certainly, right now, they are having to go beyond those guidelines, having to reuse them for they were never meant single use. They have to be careful about those being properly fitted. There are a lot of things that a doctor or nurse may love to do for comfort in the situation they arent able to do along with protecting themselves and patients. Host do you have a sense of the normal cost of the mask versus what hospitals and the like are paying under the circumstances . Guest im hearing prices are all over the place, and it is certainly not what they would normally pay. I do not have dollar figures. Host joshua is joining us from raleigh, North Carolina on with our guest, shannon muchmore of healthcare dive. Go ahead. Guest im not from west virginia, im from North Carolina and raleigh. I think our governor has done a fantastic in raleigh. I think our governor has done a fantastic job. The 18th, 2019, ecdc and World Health Organization, the cdc, World Health Organization, john hobbs ends, ran an event like this called event 201. They did a working scenario where they discussed the medical countermeasures, the trade and it, a, the disruption of finance collapse at that point, communication discussions, and how our networks will be affected. I was wondering if they share that finding with our private sector in hospitals, and why we werent more prepared. Guest i dont know specifically about that report, but certainly there were government reports scenarios,hese exact running out of beds, studiedors, people who this new this could happen. Hospitals prepare for emergencies. That is a requirement and they run drills, but there are lots of potential emergencies. It could be wildfires, tornadoes, and sadly a lot of them have been Running Drills for Mass Shootings should that happen, as it has at hospitals. So they have drills and options, but what is going on true right now is truly unprecedented. Not to say it couldnt be predicted but the extent of what it has gone and what we are facing now is not something hospitals were necessarily preparing for explicitly. This is something that will be a Lesson Learned going forward, but a true it truly is nothing like we have seen before. Host there was a fourhour desk top or drill desktop drill or exercise that you can find out online which the caller described. Dominic in new york. Hello. Dominic, hello . Guest hello. Caller hello. Host go ahead. You are on. Caller [indiscernible] i dont go out. Beginning [indiscernible] in the morning, when i get up, [indiscernible] dominic in newis jersey. Lets go to pat. Good morning. Caller good morning. I want to share an experience with you. , and afriend is a nurse in one ofchaplain, the hospitals in the United States, so i got the great idea about praying for her. The church is open seven days per week, 24 hours per day, and you can go there and pray, so i went inside last night, close to midnight. They have a Security Guard there , day and night. And there was a catholic monstrous, bright as it could be. I started praying, for about maybe an hour so, and i came out and there was a kid that was riding his skateboard on the side of the street, the sidewalk. Odd, somebody is about maybe early adolescent. Host im sorry to interrupt, how does this deal with the hospital topic we are talking about, please . Keyword is host ok. This process is providing comfort through religious services. Guest i know providers are thankful for everyone thinking of them and helping them. Youve probably seen doctors Holding Signs to say i came to work for you, stay at home for me. Certainly nurses and doctors and other staff on the front lines, those cleaning the hospitals, providing security, they are doing their best, and the same goes to everyone out there sending their thoughts and really appreciate to vote their effort. Host jeffrey is next in charlotte, North Carolina. Good morning. Guest good morning. This is the thing that confuses me. This epidemic in china. We were watching people die over there by the millions, and we watched it spread across europe. Im looking at a couple countries over there, where they get infected. Rs they had more like selfcontained, almost like masks that hadce filters on them. I dont know if it was hong kong or one of the cities there but no doctor got infected. We watched this thing over there, and we werent prepared here. At what has amazed occurred here. Now, we are giving our doctors little facemasks and gowns. It takes a lot more to train a to get one it does of these suits prepared, which we should have done months ago. I was a cancer survivor, and i just got through with my treatment about one month ago, just before this thing hit real bad. Know so glad, because you when you get the radiation, your immune system goes way down. I was so happy to get out of there before this virus hit as bad as it did. Watching those courageous nurses and doctors, and even the administrators and andptionists, talking holding these patients, it was gods ike i dont know how the greatest country in the world has more troops, guns, and ammunition to fight for anybody could be not prepared for this. Host jeffrey, we will let our guest respond to that. Guest the important thing to remember is that hospitals are businesses. The same way a hotel would not build 100 more rooms than it thought it could fill. Hospitals dont have more beds than they think they are likely to need. They dont have more equipment, more staff, those are all expenses. Need ate only what they pete time for flu season. They dont have a lot of extra at peak around, need time for flu season. They dont have a lot of extra material around for volumes they dont prepare for, because they dont have that extra space and capacity lying around when they dont need it for years and years. T shannon muchmore is shannon muchmore, is there a breaking point then when it comes to a Hospital System . Guest its hard to say, a breaking point. I think as these relaxations allow for more space to build up, more triage and treatment, start to see more ability to treat these cases, to separate those out, i think testing is also a huge issue. If they are able to ramp up testing better, a hospital, a triage, can know that the hospital needs to cap say needs to be kept separate from others. Getting that equipment, if that can be ramped up, if there are other ways of producing ventilators and what they need, that will be key. If they had the equipment they needed, they could build out the other areas like they are already starting to. They have those procedures, they just need the equipment and staff to keep them running. Host the website for our Guests Health care 00 health healthcaredive. Com. She joins us to talk about the state of health care. Thank you for your time this morning. Guest thank you. Host coming up, federal regulations and how they may have hampered the early days of the coronavirus outbreak. Joining us for that discussion is William Rinehart from the cassandra newbyalexander. Later on then the program, we are joined by a representative from the Freelancers Union. We talk about job losses among the selfemployed. First up, the virginia governor. Yesterday during his conference, he spoke about the continued need to follow stayathome orders and guidelines from the cdc. Monday, i ordered virginians to do just that, stay at home, except for necessary trips out for supplies, medical reasons, work, or to care for another person or animal. , andw this is difficult many sacrifices are being made, but the sooner we can put this Health Crisis behind us, the sooner our lives return to normal and the sooner our economy will rebound. That executive order lasts until june the 10th. As does our emergency declaration. Unless the situation changes enough for me to lift it early. I hope it does. That is longer than most other states. I want virginians to be realistic in their expectations. Ou need to know the truth no sugarcoating. I know this is hard. People are isolated. Youre worried, and many of you are out of work. Been toegy has always plan for the worst, and to hope for the best. Again, i know this is very difficult for everyone, and i want virginians to prepare themselves for the long haul. We are talking months, not weeks. To examine theue available models about when virginias cases were surged, we expect that will be sometime between late april and late may. Im already thinking and planning on how we can land this plane on the backside of the curve. Beginninge are at the of this virus. That is why it is so important for virginians to stay at home. If we can all stay home, we dont give the virus the chance to infect the next person. We slow it down. To expand on this a bit, the virus cannot live by itself. It needs people like you and me, refer to as hosts, for it to survive and spread. About isre talking making it as difficult as possible for the virus to latch on to a host. Latch onto a host. The cdc called social distancing a powerful weapon, so lets use it. Any of our live coverage to the coronavirus outbreak response, watch it at any time at cspan. Org corona virus. From daily briefings from the Coronavirus Task force to updates on the hardest hit states, it is all there. Use the maps to track the global spread and confirm cases in the u. S. , county by county. Our webpage is the fast and easy way to watch the unfiltered coverage of this pandemic. Washington journal continues. Host will reinhardt joins us from washington, d. C. , the Senior Research fellow at the center for growth and opportunity. He is here to talk about the coronavirus outbreak in terms of federal regulations. Good morning, sir. Guest thank you for having me. Host a little bit about the center for growth and opportunity. What is it, how was it funded, what is your perspective . Guest my organization is based out of utah. We are a University Research interested primarily i am very much interested in innovation, and how we can get people back to work, even in normal times, but more broadly, i am interested in innovation and how innovation austin butz up against galatian and how you can get things moving back again. Against att so relate regulation this time, during the response by the federal government. Guest i think what we have seen is that regulation really has made everyones job a little more difficult. We are talking there is obvious reasons to have these regulatory structures in place, but at the same time, it does create these problems in understanding quick responses. We have seen extensively understanding that the regulatory structure is difficult for everyone involved and understanding those is a problemgimes everyone has to deal with. Being able to understand it and quickly get something especially in a new or and then the in another event or hopefully in the future, we can deal with that in a better way. Host you put out a guideline when it comes to regulatory decisions made by the government during this crisis and walk through it. To show the folks at home a little bit, one of them starts after the initial report from january, having cdc provide guidance for testing. Take is from there and whys that important to understand when it comes to the regulatory role . Guest the cdc effectively created this guidance, even though it is technically guidance and not hard and fast policy, it became effective policy. At this time, the cdc was the testinstitution that could for the virus in february. Put in endedthey up being hard, fast rules. We now know, at least a woman in Northern California was not allowed initially to get a test, even though she eventually did get a test. Because she didnt fit the criteria. We have seen this happen over and over again, that the cdc hard rules not actual but becomes defective policy for a lot of hospitals. That has the effect of constricting a lot of testing, but this is hugely variable depending on the region you are located. Something i found that is super interesting, and south dakota for example, there was a woman that was tested quickly and even though she did not present many symptoms of covid, the reason is was there was wider access to the tests, even at this early stage. The cdc guidance is hugely importance because it hugely important because it sets the stage most of february and is the over arcing regime to control testing to a large degree. Host you highlight february 4, saying in two weeks, the number of cases rising to 20,000 worldwide. The secretary of hhs declaring a state of emergency, and the fda granting what you call the epa calls a covid19 testing kits. What is an eua . Guest officially, the secretary of Human Services announces a state of emergency, a Health Emergency, a Health Emergency on the 31st. The actual paperwork is not filed until february 4. Inruary 4 is also the moment which the fda effectively grants was called an emergency use. Uthorization to the cdc the reason why this is important to a larger degree is that the interesting that happens interesting thing that happens with the emergency use authorization is that it sets up a weird regulatory structure for diagnostic testing. This is something we could talk about more, but diagnostic testing is in this weird regulatory space where the fda has never been given explicit authority to regulate diagnostic testing. They have taken that authority, and that means the regime is pretty convoluted and it is somewhat hard to understand, even at the practitioner level. So when the ua and emergency is announced, and when all the paperwork is filed on february 4, that creates that has the effect of creating a higher burden for many of the states like new york state. Theres this is a niche in the law but the fda does not do very much enforcement of these laboratory these tests, generally speaking. As soon as this eua process is set up or once the emergency process is set up, it increases the burden for a lot of these local practitioners, so figuring that out, in the near future, especially when we are done with the crisis, the ua process will be a big issue. Even commerce is walking through some of these issues some of these concerns. The emergency use authorization process complicates matters importantly for local practitioners, and effectively stops them from putting out tests in a massive space. Mucht want to take too time, but to truly understand the last time we have had that was during zika, and the fda doesnt normally go after companies doing Laboratory Test kits, but during that crisis, they did send out letters to four different institutions, to different commercial testing laboratories, and i think when you talk to practitioners, especially people in washington and new york state, that memory of the increased burden and in regulatory review was to present for a lot of people. That kind of set in motion a whole bunch of extra requirements that these labs effectively needed to go through to expand testing. Host our guest previously served at the American Action form and at the progress of freedom foundation. With lliam rinehart who taught at the center for growth and opportunity. Is that affiliated with Coke Industries . Guest indeed it was. Guest talk to me about the role of regulation host talk to me about the role of your regulation. Talking about the role of regulation. 202 7488000 for the eastern and central time zones. For us 202 7488001 mountain and pacific time zones. Is the text line. There were a couple statements from the federal made on the federal response and i want to get your comments. We will air that for you. Three more counties sponsored sites have or are preparing to open, and i will go north to south. I have been in touch with each of them, and it is all good news as we continue to aggressively open up our testing redeeming in for symptomatic persons. In a perfect world, the federal government would give us all of the testing material we need, all of the personal protective equipment we need, and we could be like south korea. From moment one, we realize that was not the case. We did not have that level of material and support from the federal government, so we made test symptomatic people only, and that has an added benefit to the colleagues to my right because that is the most valuable data we can get, both positives and negatives, and judy will go through both in a minute. That allows us to best get our arms around this. Did thell reinhard, latter part of the statement or particularly the federal government providing these things, what do you think about that perspective . Guest there is something to the conversation. Interestingly enough, if my glance at the act is correct, none of that was included in the cares act or this most recent round of legislation. The question about marshaling the federal government to help with the resources needed is complicated, because, especially when it comes to south korea, what they ended up doing, and other countries as well, they marshaled the private and Public Resources to get tests out quickly. I think what i have found is that this approach, which engages local practitioners and local Health Care Workers, while also figuring out the resources the federal government has, will be the most effective move forward. In some regards, in other countries, especially south more ready are far for this outbreak. They were running some of the simulation tests at the end of last year. In part, i dont know if it is exactly the best thing to compare us to south korea and some of our response efforts, but i think there is a clear question or a series of questions we will have to answer regarding the fda, because as i mine shouldnt as i mentioned, you had the fda grant a you send authorization to the cdc tests, but it is not until february 29 that they have that there is this time period, this lag where the fda is not going and authorizing other sorts of tests and other sorts of commercial laboratories. We know, for example in singapore and south korea, and in germany and a bunch of other places, you do need to open up the testing and allow for local resources to be marshaled against the pandemic like this. Didink the New York Times something yesterday on this. I think the conversation about what happened during this time, this month of february, will be a key part of ensuring Something Like this does not happen again. I hope it does not happen again in my lifetime, but understanding how the fda and theyreinteracted and very clear successes, understanding that larger story is the p some hoping to help to understand and put that out is the story im hoping to help understand and put that out. Host dottie is on with our guest. Go ahead. Caller thank you. I enjoy watching cspan to begin with. Good morning to everyone. I was wondering why no one has mentioned money. Money carries so much terms so many germs, but i have never heard anyone talking about it. Host ok. Guest so i dont know if money is a carrier of germs. The majority of what is discussed is through personal contact and through, effectively, air pollutants. Im not sure about money, but that is obviously an area that will probably come out at some point and we will have a better understanding about the transition transmission rates with money. I dont know if anyone is clearly looking at that now, but it could be an issue as time goes on. Host from new jersey, charles. Hello. Caller good morning. How are you doing . Host go on. You are on go ahead. You are on. Caller as of right now, you are letting all of these foreigners come into america to work on these farms. We will have hundreds of them coming in right now. This is what will cause the rise in sickness. Why dont you say that . Host ok, charles. Theneinhart, to the idea of how the federal government is operating now versus say the beginning stages of the virus, would you say there is more freedom within these walls, the cda cdc, fda, to operate than when it first started . Guest when things first started moving in the beginning of january, middle of january, i do not think anyone recognized how big of a problem it would be. Thats why i said earlier, in some regards we were quick out of the gate. One of the states not mentioned here is that on january 18, we had some of the first testing. It seems we were in fact able to test for the coronavirus early, wuhan being one of the first countries to do so. Response has been some solid and some places, but i think what we will see, as you mentioned, is really this broader question about what will happen in this missing month. There are a lot of other concerns. We talk about ventilators, the ppes, masks and other sorts of systems to protect Health Care Workers. To say things the fact that they could be is clearly nothing case, but at the same time, we talk about a quick moving virus that, in any normal situation, is difficult to manage and deal with. Host lets go to brenda in new york. You are on with our guest. Caller good morning. I am a licensed medical technologist in new york, and having work and gone through numerous federal and state inspections, and i also worked for u. S. Army hospitals in germany, and i found in new york state, the ability to actually use a test was much more highly regulated than a federal guideline or army guideline. Im curious if you have any information that the delay in new york state was due to the fact that new york state laboratories were not allowed to use the tests until they met extra criteria in new york state. Guest from i understand, that is interesting because i would love to dive deeper into some of those questions. From my understanding, new york state was trying to get their test up and running but they emergency use authorization until january 29, if i recall correctly. This is also mentioned in the regulatory timeline i lined out. They were not able to test until february, february 29. The overarching regulatory structure for new york state, i know states have their own requirements and new york has been one of the epicenters of this pandemic, but as far as the overarching new york regulations on its own ability to get out testing, from my understanding, it was actually this relationship between new york that was the fda really at the crux of the problem and the reason why it didnt go out faster tests didnt go faster. Host we have a viewer on twitter that says reducing federal regulations is code speak for using restrictions on businesses at the expense of Public Health and the environment. Guest i dont necessarily think what we are talking about is necessarily easing. We are talking about clearing regulations, not easing Regulatory Burdens. At the end of the day, what the fda effectively did is said you can run these tests, and what we will do is work away through this emergency use work our way through this emergency use allow this we will test as we go through the full process as it takes five to six days to go through an emergency use authorization process. This has occurred over multiple different multiple different administrations. This was something that was also created during these he got crisis, and the idea of effect crisis. Crisis zika to reach the high standards in this Regulatory Burden is something that i think everyone generally agrees needs to happen at a quicker rate. A lot of the things talked about here i havent mentioned. One of the problems Washington State had, for example, when they were trying to get a test approved by the fda, they had to send in hard copies of their application, so they had to send in, effectively, they had to overnight binders of information to the fda to get approved. Whereas, in any other normal situation, you could think it goes through the portal and you have these other materials attached. You dont need to have a hard copy sent into the fda. Those sorts of things have changed. The fda has gotten rid of a lot of those requirements, and it was that sort of thing, what im talking about here, basically duplicitous regulatory requirements, instead of the health and safety requirements, which i believe everyone is trying to strive for. This regulatory structure is quite complicated. The fda has not done much enforcement over the years. It is punctuated by a couple warning letters on diagnostic testing in like 30 years of regulation, and the agency has been criticized for some time for this. There have been a number of legislative proposals, a lot of conversation at the agency, so this is a longstanding issue but it has been exacerbated by this pandemic. Vaccine inng about a the context of a question from a viewer on twitter, saying how will regulations affect the Clinical Trials that will ultimately lead to a vaccine. Guest this is something a colleague of mine at rit has written extensive about. Honestly, vaccines take a long time to get fda approval. I think given how important this is, i think it will have to be sped up. The question is can we get a vaccine and is it effective, but then how do we ensure that both consumers and individuals are protected in their health but also that we get this out to individuals ice quickly as possible. There are ways as quickly as possible. There are ways to think through this, but that is something we need to think about nearterm. It ishis eua process, something the fda has effectively say it said yes, we will consider a fasttrack for vaccines. This is the overall track package and declaring an emergency and Public Health and setting up these processes to allow for a quicker time, because this is such a huge and important Public Health crisis. Host idaho, vince, you are next. Guest thanks, caller thanks, pedro. Is reinhardt, my question for vaccines outside of covid19 like the vaccine or testing. Theres a lot of regulations that might come into play here that deal with activity that could be lifted or reduced. For example, the new England Patriots just picked up like one Million Masks in china. When you read the article, it was all craft. Could only talk about how much red tape he went through to get it here. Exng an ex engineer, engineer, during situation like this, are there ways to expedite that . Guest yeah. This is something i think the fda is clearly looking at right now and other agencies are looking at. Of the, right now, one major problems we face in the , specifically with masks and ventilators. There is a lot of work being done on this. Is some regulatory releases being considered, but a lot of this comes to the fda effectively regulating these masks, and in many instances, you will practically have the same masks, but because the way the manufacturing process self regulated is self regulated, you can have the same masks, but it has to go through a process which is effectively regulated correctly by the fda. Theres a lot of conversation in trying to fasttrack those processes. A lot of this comes down to liability. A lot of this comes down to who is to pay. This is what this government said recently, that they will take on a huge amount of liability burdens. These masks were originally for other are shifted to medical uses. Part of this is honestly just complex. We have these rules in place to help protect consumers. But during times when there is stress and supply chains, which is what we are dealing with right now, there is a need to quickly change and quickly move and really, that sort of friction is something im hoping to help, and i think is really critical right now. Even in a nonpandemic setting, this is something we really do need to be thinking about pretty holistically. I work in technology and innovation policy, but this also happens in housing regulation and health care regulation. This is just something we are going to have to have a larger conversation about, having these conversations even now. Will just beime, i honest, there are no easy solutions right now. Host when it comes to the matter of supply chains, what would you look at regulatory to make it easier for supply to exist in the u. S. Versus pending outside sources . There is no easy solutions for this either because everyone is under the stress of trying to figure out ventilator supplies. I know this has been something the New York Times has reported on. I am trying to do a deep dive into the question of ventilators and supplies. A lot of suppliers for this, it is a pretty expensive market. These things are quite expensive. There are a whole lot of medical liability questions that have to be dealt with. Ramping up supply is not an easy thing to do in any other situation. Of ang up quick supply product in any other sort of instance is difficult. We are facing a huge demand that is needed at a very quick time. Please supply chain issues are just going to be endemic because we are changing demand. That really is something that for better or worse, we are going to have to deal with. Host you have heard the president s critics say if you were to push something into effect such as the defense production act, it could have alleviated some of the issues we are dealing with now. Would you buy that argument . In part, probably, but also, a lot of companies have been willing to change some of their supply chains and production methods to actually do this. That again, takes time. Even with ventilators, one of the things the strategic supply of ventilators was meant to do was not actually to not just to have a strategic supply, but also to be able to ramp up production quite quickly in the event of a pandemic. Contracts original had really meant for a 2 or 3 month ramp up when we actually need a couple of week ramp up when it comes to ventilators. Some of the supply chains when it comes to masks, im not as well versed in. I would imagine it is similar. We are talking about a huge demand unlimited supply. You are still facing the problem of retooling, ramping up production. It is not easy to do as we are trying to do. Host in pennsylvania. Caller i dont have the internet, so i am very restricted. The first time i have called any place. Pennsylvania had a lot of testing. 2300 came back negative and 200 were positive. Right now, they have tested 47,000 and 5000 are positive. There is a huge discrepancy between 47,000 and 5000. The second question is, do you have any idea who i would call . And had the virus acted like an antiinflammatory in my lungs. Where would i go to recommend to please find out about this in the Research World . Guestwe will let our take your thought. Guest when it comes to testing, one of the rules of thumb is what you want to look for is effectively a 1 positive rate. We are still really not there. Wide positive rate is enough testing to understand that you are effectively catching everything. That is also still the problem we are facing today is that the positive rates are still pretty high. You really do need to get them down to a pretty low level to effectively have a broad understanding of if you captured everyone infected. I would talk to a doctor or even the local Health Care Practitioners and people in your community. That area, i dont know as particularly well. You could also send some of this information to the fda and cdc. They do have online and tollfree numbers for this sort of information. Again, i dont know too much about that sort of question about your own individual health. Host one more call from don in sacramento, california. Don . Go ahead, you are on. Caller i am wondering what happened to the chosen one. He is supposed to be so smart about everything. Why did he end the program that obama had that would have handled all of these situations that we have now . Why did he end that before he even made up a new program that would take over . You know, is this the calm before the storm that he is talking about so that he can win the election . Like he says, win by any means necessary, even if it is killing all the people in america because it is definitely killing a lot of people that he says he can get away with doing. These supporters of his, i dont know how in the world they dont see this man as killing everybody. Host ok, we will leave it there. Guest i know there has been concerns about the National Security council and kind of the bioterrorism. I know some of that stuff was merged together. Honestly, personally, i think a lot more of the questions that we have should be for the fda. Credit, the testing they proliferated and first started, it is just very difficult to do this testing regardless. I dont put much blame on the cdc for some of the testing failures because it is difficult to do this even in nonpandemic times. As far as the fda is concerned, i do know, i think that is probably where i would actually put a little more blame. I think there is going to be some very tough questions for leaders, especially when it comes to this missing month. What happened . Why isnt that we were looking for other suppliers . Why didnt we go to local Health Care Practitioners . We had a caller earlier who is very much a not round and doing that work. Why didnt they rely upon the resources that we really have to do this to do a Pandemic Response . Jack, i think is going to be something we are going to have to figure out in the next couple of months. Where did we feel and what can we fail and what can we do better . We need toor worse, figure out a plan for the next month instead of really trying to keep a whole bunch of blame in the past. Other than that, i think the clear take away is that there are these sorts of frictions and sorts of problems that are created. When youre talking about a complex system like medical regulation and health care in general. Host the work of will rinehart can be seen not growthopportunity. Org. We thank you for your time this morning. Guest thank you very much for having me. Host for the next 20 minutes or so, we return to the question we started with about the u. S. Health care system, its ability to handle the coronavirus outbreak, your level of confidence in it. For those eastern and central time zone viewers, here is the number. Mountain and pacific. If you are a medical professional, call us. We will take those calls when washington journal continues. Has been, on q a, he on the front lines as a prominent member of the white house Coronavirus Task force. When you are dealing in the interface of politics, policy and medicine, the thing that i have found to be very effective is beacon system, be totally honest, and dont tell people things that you think they might want to hear. Tell them the truth that is based on evidence because even though politicians, be they in the administration or congress, may not be happy with what you tell them because it disappoints them, they will respect you if after a while, it is clear to them that you are telling them the truth based on scientific evidence. Fauci,rofile dr. Anthony director of the National Institute of allergy and infectious diseases. Looking at his personal life, his relationships of past president s, and his career fighting infectious diseases, hiv, sars, h1n1, and now, the global coronavirus pandemic. Watch a profile of dr. Anthony fauci, sanded 8 00 p. M. Eastern sunday at 8 00 p. M. Eastern on cspans q a. Washington journal continues. Host again, your level of confidence in the Health Care System. That is what we are hearing from. Here are the numbers. Headlines from this mornings papers when it takes a look at Health Care Related measures, it is the department of Homeland Security officials saying their stockpile of protective gear available to states, and those on the health care front, nearly gone. That story is in the Washington Post this morning. If you go to the pages of the washington journal, doctors caught in financial vice, talking about some of the issues we talked about in an earlier segment. The World Health Organization in its regular press briefings gave their assessment of coronavirus cases around the world and where it stands. Here is the director of the World Health Organization from yesterday. [video clip] as we enter the fourth month since the start of the pandemic, i am deeply concerned about the rapid spread of infection. Over the past five weeks, we have witnessed a near exponential growth in the number of new cases reaching almost every country, territory and area. The number of this has more than doubled in the past week. In the next few days, we will reach one million confirmed cases and 50,000 deaths. While the relatively lower numbers of cases have been reported from africa and from wetral and south america, realize that covid19 could have serious social, economic and political consequences for these regions. That we assure these countries are wellequipped to detect, test and isolate entry cases and identify contacts. I am encouraged to see that this is altering in many countries despite limited resources in. Resources. Many countries are asking people to stayathome and shutting down population movement, which can help to limit transmission of the virus, but can have unintended consequences for the poorest and most Vulnerable People. I have called on governments to put in place social welfare ures to ensure Vulnerable People have food and other Life Essentials during this crisis. Host you can see more of that at our website at cspan. Org. You can also find out what governors across the nation are saying about the condition of their state. We take those in on a daily basis. Websiteavailable on the as well as the president and task force on their daily briefings. You can see all of that at the website at cspan. Org. We will talk about the Health Care System and coronavirus. Just to show you this headline. Unemployment figures. New figures for the week topping 6 million. Also adding that that new figure does not include selfemployed workers, a topic that we take on in our next segment. The Health Care Systems condition to take on the coronavirus. We start in illinois with tammy. Caller hi. I have got a question for you. I am in Home Health Care. I am a personal assistant. I havent been able to get any information whatsoever even on policy changes due to coronavirus, which im sure there are. Also, do i even qualify for unemployment . Host as far as the Home Health Care concerns, how has it been in light of the last few weeks for you . Geter like i said, i cant information on policy changes due to coronavirus, and i cant find any work right now. Host ok. I dont know if i have a direct answer for you, because i dont want to give you wrong information. We will see if we can find something that relates to that for you. Robert and washington, d. C. Caller thanks for taking my call. I have no confidence in the meditation at the moment. I gentleman had called early this week on monday. We need to deal with this on a scientific level. [indiscernible] generators and ultraviolet light. [indiscernible] you pass through for maybe 20 , viruses, things like that can be neutralized out of the air. There need to be stations where thatn have ion generators put Something Like electrical charges into the air and attacked as to whatever particles that is in the air, whether it be dust, dander, pollen, viruses, germs things like that viruses, germs, things like that. Host ok, lets go to washington, d. C. Really efficient. I have two questions. [indiscernible] and remove this virus from the party immediately. [indiscernible] from 2001 until now. Very different. They are using different antibodies. [indiscernible] the paper masks that i put inside these i disinfect the inside and them into myean body. And after 10 minutes, everything is completely gone. Host he brought up the topic of mask in the topic of masks came up also during the president s Task Force Briefing yesterday. Commresident making ents about whether to wear masks or not. [video clip] trump i love the sterilization of the masks. Ohio company, you can sterilize the m 95 you can sterilize that mask for up to 20 times. Think of that. Up to 20 times. We are throwing them out. They are very expensive masks. They are throwing them out. I kept saying, one of the first questions asked to dr. Fauci was , why arent they sterilized or cleaning the masks because i didnt nobody else knew it either. Now, we have a company, and i guess a number of companies, one in ohio, a great one, that makes equipment where you can sterilize a mask up to 20 times. What about the public . Should we be Wearing Masks . Trump a lot of. People dont like it some people dont like it because you are taking it away from. I dont see why some people dont like it for other reasons. I dont see why it hurts. It doesnt have to be a mask, it can be a scarf. I dont see where it hurts. I think frankly, if people wanted to do it, we dont want to do anything that is going to take masks you are talking about a tremendous amount of masks we dont want to take them away from our medical professionals, but i certainly dont see it hurting. What i do see people using now is scarves. Depending on the fabric, i think, and i certainly, a scarf is actually better. Host we will bring you the Task Force Briefings as they are scheduled. You can see, 5 00 this afternoon, the latest one from the task force. All of those preserved on our website at cspan. Org, including Everything Else we have taken and when it comes to the topic of covid19 response. One of the sections of the wall street journal this morning has a look at how life is for those under covid19. One of those profiled is stephen writes about his personal experience in the wall street journal saying stayathome orders have confined him to his home. It goes on to say he arrived home for a two week break on march 8. Four days later, the Supreme Court announced it was closing its buildings to the public. Time a pandemic has interrupted proceedings since the spanish flu pandemic. Law clerks are working with their bosses via phone and email to write opinions for the previously argued cases. More of that profile on the wall street journal this morning. Rachel in Fort Lauderdale talking about the u. S. Health system, its response to coronavirus and the level of confidence. Go ahead. Caller good morning. I am a retired registered nurse. Many years in the field. I feared thisy, day might come. Years, when i was working, we were always shortstaffed. We always had a shortness of supplies and equipment. Trouble, just on the brink. Now that this has happened, im not surprised that the Health Care Field is struggling. It is a sad thing. It is a very sad thing. One thing i would like to bring to attention that i have been thinking about, and this hasnt been discussed enough out in the media and with the health care professionals, i think it is a real good time to educate the public on advanced directives and exactly what they are, who should get them, probably everybody. It is just a real good time for the media, doctors and health care professionals, in general, to give us a real good education on events directives. Host chris is next. I have been a registered nurse for 38 years. I just got back from vacation, went back to work fulltime last night. I work at a Major University in the washington, d. C. Marylandvirginia area. As soon as i got on the door, they gave me a mask to put on. That is to protect the patients from us. I found out that from march 10 to march 20, the fda was ordered, the cdc was telling people that we only needed to use droplet precautions. After 10 days, they changed it to now airborne precautions. During that 10 days, we dont know how many people were exposed. This, to me, from looking at our hospital, i think our hospital is excellent. It is doing everything they are supposed to do. I had been off of work on vacation. They had a whole book for me to read. I could look back and see what the government has been telling the hospital to do over the last month. I could see this all on paper and it was shocking to me. We have supplies now. We are ok now, but i am really i can see a wave coming. We can all see it. Host how much of your hospitals daytoday work is related to covid19 . Caller what they have done is they have cleared out all of the rooms. Ok. Beds. Floor, we have 20 of those 20 beds, six of them were coronavirus patients. They are turning regular rooms into airborne rooms. Ok . Which is not an easy task. Is many ofcerning, those patients in those rooms homesmented, from group where they are mentally challenged, they have psychiatric problems. Really, very difficult patients to deal with in isolation rooms. I know that several nurses were exposed this week because one of the dementia patients decided he was going to come out and walk in the hallway. This is just the practicality of the job. We are saving our n95 masks because they are going to try to reuse them. Fda is saying that they are newng to try this experiment on these n95 masks so we can reuse them. But then after hearing it was ok to just use droplet masks and then changing 10 days later, that is a real concern. We dont really know what is going on. Host what is the ventilator situation look like . Caller i dont work icu. I think right now, it is almost like an eerie quiet on our floor. Moving ofre nurses in the icu, my facility, i think is excellent for nurses. I think what they are doing is actually rotating the icu nurses out to give them a break right now. Host ok. That is chris and college park, maryland, a medical professional. Brenda is next. Caller before i make my comment, i would like to thank my governor for his strong, immediate actions. If you look at the trajectory of the state, we are slowly rising. We do not have apeak. I think our president would be wise to listen and learn from him instead of calling him a snake. Onto the confidence of the Health Care System, i have every confidence in its workers. However, i would like to build on what your guest said when she said that because health care is a business model. Thats right. I do not want capitalism and our Health Care System. This is the problem. States ofu now have bidding against federal. Municipalities against state. This is not the way it should be. The president himself saying he is holding onto supplies for what is to come. What does that mean . This should have been nationalized from the beginning to where we have broadbased help, and whatever our states know how to follow. Like everyone, this is a very emotional issue. Folks. Bout this, capitalism is fine for many things, but it does not belong in our Health Care System. I hope what we can do when we come out of this is reorganize thepriorities and know that safety of our citizens is , and thank you so much. Host gotcha. Lets go to paul in canada city, missouri. Caller hi. I live in kansas city for 35 years. I tried for 35 years to say this to the American People. America supposed to run the whole world, not look at the world how to get healthy. How to get healthy. This should never happen. Donald trump is right. We should never drink, we should never smoked, we should never take drugs, we should never eat meat, we should never waste our energy. That is why we dont have a muniz asian. If we do that and what ash immunization. If we dont have that if we dont do that for one week, all of this will disappear. Host last call. Caller ive been trying to keep up with everything that is going on here with this coronavirus. I hear what the president is saying, and i see what the president is doing. The defense protection act. That should have been put in over five or six weeks ago. These are trying to help medical professionals and the people who are contacting contracting this virus, why not put in the defense protection act . The other thing, the Affordable Health care act. He is trying to do away with that while we have this virus, which is one of, the most i guess, in america, a healthcare crisis. You are trying to get rid of the Affordable Health care act. Not, he is looking, to me, is he trying to save as many people as he can, or talking on doing absolutely nothing . Host that is tim and alabama finishing off the calls for this morning. By the way, if you havent seen it yet . In the evenings at 8 00, you can watch our primetime program. Same kind of idea of taking calls and having guests. One of those guests for a doctor withram, the university of minnesota talking about the latest in covid19 response in giving his perspective. Again, that is 8 00 tonight on cspan. One more segment for you this morning. We will be talking with Rafael Espinal, president of the Freelancers Union. He is going to be talking about job losses among the socalled gig workers. First, we are going to show you a press conference from the state of new jersey. Governor phil murphy talking about the impending shortage of mortgage space. [video clip] the chief medical examiner has been on this. He has been working with not only the Funeral Directors, but secureocurement to refrigerated trucks if we need them. What is happening is some Funeral Services are delayed. Families trying to determine how to honor their deceased loved some and it is causing backup in that regard. A quick followup on the capacity for the dead. So this would be a refrigerator truck type need . That is correct. Just to one other piece about i think was in the key that the state medical examiners office, i think yesterday issued, basically authorization for medical examiners to release decedents without results back on the coven because there was a lot of holding on and we are trying to alleviate the stresses on hospitals. To the commissioners point, with regard to working with Funeral Directors and having them work sidebyside with us to address that. How quickly do you expect that will have this need, the storage need . I dont have a specific day, but soon. Let me just use that as a jumping off point. A point to anybody out there watching those who might not believe this is real. The fact that we are having this conversation, folks, this is real. The number one thing we can do, the 9 million of us, is to stay home. Social distance, wash your hands with soap and water, help us break the back of this virus, flatten the curve, and allow us to have a Healthcare System, and frankly, a society and an economy that can handle this crisis. I will just say this. Donow, as we look out we have an offender leaders . No. Do we have enough ppe, beds, healthcare workers . No. Do we have a plan for each of those . Yes, but we need a lot of things to go right across all four of those dimensions. We are not where we need to be or will have to be. Washington journal continues. Host joining us from brooklyn, new york is Rafael Espinal. Good morning, sir. Paint the picture. What is the Economic Impact so far and what kind of jobs are being affected under the freelancer umbrella . Guest i would start with this. Across the country, we have over 57 million americans who have reported to have done freelance work over the past year, contributing to over 1 trillion of this countrys economy. We have millions and millions of folks who have lost their jobs because of this pandemic. We have to also note that the reason there has been such a loss of work in the freelancing world and gig world is because of the closure of many nonessential spaces and venues in which freelance workers depend on to be able to do their work. Unlike traditional employees, freelancers cannot depend on that biweekly or weekly paycheck to come in the mail unless they are actually performing work. Their income has been drying up over the past month, even earlier on before the closure of the spaces because once the government started making reisman nations governments started making recommendations for social gatherings, that is when i started losing their work. They really are in very dire financial straits right now, especially as we are in the beginning of april when everybody has to pay their rent, utilities. We are talking about a real dire picture because of this pandemic. Host you say that even as new unemployment claims, 6 million from last week. That doesnt even include selfemployed within that number. Guest exactly. We are hearing from our members, freelancers, that they have all been calling their local department of labor agencies to be able to apply for unemployment checks, but they are having such a hard time getting through because of how much traffic is being driven into those hotlines and websites. For statesimportant to figure out how they are going to deal with the high volume of calls so that these workers can have access to that insurance. Host we saw the congress on president xi and the cares act andntly president congress signed the cares act recently. They cares act, i would say, was a big win for the community. Freelancers, historically, werent able to qualify for Unemployment Insurance. Because of the cares act, there was a provision written that for the first time, expands Unemployment Insurance to freelance workers. That insurance, on the federal aid point, will guarantee workers at least 600 a week. Of course, they will have to qualify within their own state. States have their own Unemployment Insurance programs that could potentially give them a few extra box. It is a win because now we have a way in which these workers can have access to cash flow into their homes. The smallaw also, Business Administration making the ability for loans and the like to Small Business. Do freelancers call fall under that categorization . Guest there are a lot of loans created through that bill that freelancers could qualify for. There is still some complications because some of these loans require you to have a business account with a local lender. Workers wholot of freelance that dont have a business account, that depend on personal accounts. They are facing complications when they call their banks and trying to apply for these loans. I hope these are complications that we can find solutions for. I think it is also important for municipalities to play a role and figure out ways they can act as a lender and help these workers. Host our guest joins us until the end of the show. He is Rafael Espinal of the Freelancers Union. If you want to ask him questions, you can call us. As far the types of jobs, if you say freelancer, i think people think uber driver, but it goes further than that. Guest it goes further than that. We have to remember, the media world depends on freelancers. A lot of musicians, performing artists. Folks who decided to make their own businesses at home, accountants, lawyers, doctors. Reallyelance economy spurs across many different industries. It goes further beyond dan just uber drivers. This blows over, we see industries return to normalcy, does that play out in the freelancer world too and are there Lessons Learned that could possibly help us . Guest that is the hope. The hope is that we would be able to get back to some sort of normalcy. The reality is, numbers and data showing that a lot of Small Businesses that freelancers depend on will probably never reopen again. When we talk about longterm financial impact, the only real ways in which freelancers can get real cash flow is through this pandemic unemployment and ass assistance. When they are facing on the other bills, we are concerned with if work is going to be available for them. I think that this tragedy has really created an opportunity to see the lack of a social safety net for freelance workers and gig workers across the country. I hope it starts a real conversation not only on the federal level, but also on local minister polities about what sort of protection we have in place to make sure we dont end up in the situation again. Host do you find it is a bipartisan conversation . Guest i would say for the most part, yes, but when the stimulus package was being passed in washington, unfortunately, there was a handful of Republican Congress members who try to block the bill. I would say for the broader iews, a lot of republicans, think, are supportive of folks starting there on his messes. Democrats believe in the responsibility his messes. Democrats believe in responsibility for those facing dire straits. Host the Freelancers Union, why does it . Guest the union was created a little over a decade ago with the intention of organizing freelance workers in new york city and across the country. We operate as an organization that is focused on creating advocacy is for freelance advocacys for freelance workers while also providing services. I encourage everyone who was a freelancer and a worker, joined the union. It is free. We hope that we can build the basis of that we can approach these issues in a unified voice. Host our guest has had experience in the city council. He is joining us from brooklyn, new york to talk about the freelancer situation and covid19. Our first call is from edison, new jersey. You are on with our guest. Go ahead. Caller hi. Doing desk preparing work. Im losing my customers. Do i qualify . I am a senior. Number one, i would like to find out if i qualify for the 1200 stimulus package, and also, can i apply for unemployment or Something Like that . How can i get the 600 . Guest i would say yes. It is important that you look at what the rules are in new jersey and providing Unemployment Insurance to independent contractors, but the goal of the cares act in washington was to make sure that anyone who lost capable who works was of applying for Unemployment Insurance for the first time. I encourage you to apply. It is important that your lease go through the process. At the end of the day, it is very likely you will. Host michigan on our line. Caller hi. What i wanted to know is, even i we dont pay taxes because we dont have high income, we are retired, like i am on disability, do we get anything or not . When he first started, he said all adults would get the 1200. Guest you will qualify for the 1200 check. Given your situation, i cant speak to whether or not you will qualify for the unemployment check. Again, i encourage you to apply. Host as far as the states that are involved, do states carve out protections for freelancers, generally . Guest they generally dont. That was the issue coming into this crisis. Ar the first time, you have large workforce that was left without any source of income. The states and cities do not have any mechanisms in place to support them, which is what put them in the financial situation they are in today. Hopefully, after all of this is over, these are the conversations that will start coming out of states across the country. Host particularly to where you live in new york. That was one of the discussions recent weeks took welfare, two Governor Cuomo. Guest there is a huge conversation happening in new york about ms. Classifications of workers. Classifications of workers. A lot of gig workers are being misclassified because they are putting in fulltime working most of their days and hours for this one specific company. That we areaw looking to do in new york in which it would force companies to classify those employees who are spending the maximum amount of their working hours working for them as fulltime employees so they can qualify for benefits. Again, it is a law that also has made it difficult for freelance professionals who work fulltime as a freelancer and independent contractor and that is what they classify themselves as because it has also created a situation which is also which has also dried up work for them. I think theres a lot more confidence to go around that and we look forward to being a part of those conversations. Caller good morning. Selfemployed, you dont put money into unemployment, will you still be able to collect it . Guest yes. That was the goal of the cares act in washington as far as anyone who does not traditionally qualify for Unemployment Insurance to be able to qualify during the pandemic. Thought,it a general or at least a things you would recommend for folks in your union to prepare for days like this as far as setting something aside . I know sometimes that is not easy, but is this something you generally recommend to those that fall under your union . Guest absolutely. I think i recommend to anyone to set aside a certain amount of dollars for rainy days like what we are facing. The reality is, over 40 of americans are living paychecktopaycheck. Cities like new york and San Francisco have become out of reach for many. It is impossible for people to save money given this economic climate. That is why where we need to have this broader discussion of what our states and cities going to do to support workers and their residents moving forward. Host i imagine part of that is the topic of health care. How does a freelancer deal with health care and what does he or she faced now under the current circumstances . Guest health care is a big issue, especially during this crisis. The Freelancers Union, historically, was created with the idea of providing affordable Health Insurance to independent workers. The Affordable Care act has changed a little bit of the way we have been able to operate our insurance, but we do still offer insurance. I encourage everyone who doesnt have Health Insurance to go to our unions website to see our policies and plans. Host rick in massachusetts. You are next up. Caller good morning and thanks to cspan. Im calling on behalf of my son. Makes awoodworker who living at craft shows. All of the craft shows have now been canceled for good reasons. Would he be eligible for unemployment . Guest under the current rules, yes. He should be able to qualify for unemployment. Host when it comes to what you are hearing from particularly, which is the hardest sector hit . I imagine it is across the front, but are there some sectors that are hit harder than others . Guest from what we are seeing, those who are musicians and work in the performing arts, they have seen the highest rates of losing work which includes a survey. We have heard that over 90 of those who responded in those sectors have been hardly hit and are looking for ways to earn an income. The if you are among selfemployed and want to ask the guest questions, call. What is the potential for freelancers working in the field how much does he make compared to someone who works in a similar field, but for a corporation . Guest i dont have those numbers, but i know we have seen an increase in americans turning into fulltime freelancing. One of the reasons they mentioned as far as them doing that is they were able to make more money in that specific field of them what they were if they were working for a traditional employer. It has become an attractive option. I only see those numbers continuing to grow. I really do believe that freelancing is the future of work in the workforce. Of thishat coming out pandemic, we can have serious discussions about how do we increase and expand the social safety net to protect the workforce. Host according to specifics provided by your organization, a percentage said they chose it specifically. They chose to become freelancers. They made that. They made that decision because of many different reasons. Number one, workers who like possibility, number two, they saw they were able to earn higher income working for themselves performing the same tasks and duties as they would for an employer. There are many reasons on why they see this as an attractive option. It is also important to mention that every generation has seen an increase in the amount of folks who are freelancing. When we talk about millennials that are freelancing at a rate of close to 40 . Generation z, right now 50 . Again, i only envision the number continuing to grow. Host we all see certain people getting 1200 and a couple of weeks from the federal government. As far as other moneys in similar vein, is this something you are advocating for, more financial payout . Guest i think it is important for all freelancers to recognize that they will qualify for the 1200 as well. Week, 1200, a onetime payout, realistically, is not going to be able to pay the bills. There is a lot of organizations and grassroots on the ground pushing their states to suspend rents, for example. Brent, i think it makes up for at least 50 of peoples paychecks rent, i think it makes up for at least 50 of peoples paychecks in cities like new york. Host taylorville, illinois. Caller good morning. Wondering, i am a selfemployed piano teacher. I teach 26 kids a week. I was wondering if i could draw unemployment. Guest can you repeat that . Im a selfemployed piano teacher, teaching 26 kids a week. I was wondering if i would be able to draw unemployment. And we get pension medicare. Guest yes. You should be able to qualify under the pandemic unemployment assistance. Was to applyal assistance to any person who was performing work and to continue to work but has lost work given the current situation. Host a person applying, did they have to provide some certain type of income . Is this going to be generally paid out . Guest these are a lot of the questions that are still out there. Still a lot of questions out there because states have not been able to catch up with new rules and demand and the traffic they are receiving. Theyxample, in new york, are still figuring out what would qualify you as a worker. Youhe state of new york, also have to apply for traditional Unemployment Insurance first, be denied and then to allow you to apply for the pandemic unemployment assistance that was created. There is a lot of rules and regulations in different states. It is right now, a bureaucratic nightmare. Thepe within the next week, states will be able to get things together. Host san diego. Caller hi. I have been an independent contractor for 13 years since i got out of college. I live in san diego. It is a very expensive place. I make a portion of my income 1099. Oth w2 and half of the groups are paying me as a regular employee even though i am not working full time, and half of them are paying me as an independent contractor. My question is, if i apply for my do i apply for the state assistance and will simply applying for that assistance apply to the additional Unemployment Insurance i should get for being an independent contractor . Guest yes. You are in one of those situations that actually allow you to qualify for the traditional Unemployment Insurance that is offered in your state, but also will uo the extra you extra 600 passed through the cares act. There,f you are still our guest kind of hinted on it, but he talked about this California Law and what it would do for workers like yourself. What do you think of the law and how does it impact you potentially . When it came into law, what it did was, in my opinion, i thought i was being taxed, and i didnt like it because i was so used to being 1099. When i found out that this could kind of eventually allow me to apply for unemployment benefits, something that because i was 1099, i was always excluded from, it kind of interested me. I kind of thought, maybe i dont little bit and being all 1099. As a result, this pandemic happened. Ive never apply for unemployment before partly because im half w2 and have 1099 income. , i had of this pandemic gigs that were shut down. Am i supposed to show the Unemployment Office kind of my Bank Statements so that we can see how much i have made over the last quarter . How are they going to determine that i am not lying . Guest first off, you would have to go through the process in california. Im not too familiar with what it looks like right now. I encourage you to do that as soon as possible. I appreciate giving your feedback on the bill and you seeing benefits in your own home. It is something im going to continue studying and looking at moving forward. Host pennsylvania, hello . Caller good morning. I would like to ask if the 600 would be cares act reduced if your income were. Ctually less than 600 a week i understand that the Unemployment Compensation through the state would be determined first, whatever their allowance would be, and then the cares act would kick in, would it take you up to whatever was already understood as your anular weekly income up to additional 600, but not necessarily to receive 600 total in addition to the states determination . Guest this was actually one of the bay conversations that almost derailed the cares act in its final moments of passage. There was an argument whether or not those who make below a certain amount should qualify for the full 600 because, at the end of the day, they are going to be making more through unemployment than what they were traditionally through their work. At the end of the day, it was passed so that you can receive the folks is hundred dollars. Receive the full six hunter dollars. There is a big possibility you are going to be receiving more through unemployment denny what your traditional job. We see this vandy word through your traditional job. We are all going to need. The additional money to get by host frank is next. Caller hi. Business of a few employees. We all went on unemployment. I depend on heavily owned shows and events to sell my clothing on product. Everything has been canceled, so we are down to zero on income and revenue. I amply also applying for the ppp, the payroll protection plan, which also will pay for rents and utilities and on insurance and all that. If gigoing to ask you workers can also apply for this ppp. By the way, i talked to my banker that is our friend and also has been very helpful. He mentioned to me something that was pretty shocking to me. There are businesses that can apply for this ppp that are fully operational, meaning, they have not stopped working, they have all of their employees, but they still can apply for this and get their payroll paid for and rents and all of that. Ppp wasif this rethought a little bit, there would be some money for your gig workers on there. Guest i do believe that independent contractors can apply for the payroll protection. Workers have heard from who did not qualify because they did not have a business account open with the lender. In cities like new york, the city itself is playing the role of conduit to help in those situations. I encourage you to see whether or not your monistic polity is same, especially for those workers i dont have business Checking Account with the lenders. Host we think of self employed as just a lender, but how many of those selfemployed higher other people . Guest i dont have those numbers in front of me, but everyone who is selfemployed, i would consider them to be a Small Business within their own right. They do start to expand. They are freelancers because they hire these people to help them do the tasks that they have got into. Host as far as the days ahead, what is your best advice for those who work for themselves . What would you advise them to do other than apply for the benefits the federal government has offered . Guest i think that we should all be very mindful of our spending, of course. We have to budget on what our priorities are. I know, right now, a lot of us are facing rent bills, utilities. There are a lot of programs that are being spoken about and being put in place that are putting bills on hold. Consider health care, groceries as being your main host if you want to see more work, we thank you for your time, sir. That is our program for today. We have another program coming to you at 7 00 tomorrow. Do not forget at 5 00 this afternoon, the latest from the task force on the coronavirus update. You can watch a live and see it on cspan and listen to it on our cspan radio app. We will see you tomorrow. Thanks for watching. Announcer if you miss our live coverage of the governments response to the coronavirus outbreak, watch anytime at cspan. Org coronavirus. For daily briefings by the president to updates from governors of the states, it is all there. Use charts and maps to track the spread and confirmed cases in the u. S. County by county. Your fast and easy way to watch cspans unfiltered coverage of this pandemic. Up, California Governor Gavin Newsom gives an update on the Coronavirus Response in his state. House Speaker Nancy Pelosi will hold a Conference Call news briefing with reporters. We will have live coverage starting at 10 45 this morning. House minority leader Kevin Mccarthy following that. This afternoon, we hear from the louisiana governor as his estate sees an increase in coronavirus cases life at 3 30 eastern. Later, President Trump holds his briefing on the coronavirus with reporters at the white house. See his comments live at 5 00 p. M. Eastern on cspan, online, or listen with the free cspan radio app. In this headline from the associated press, u. S. On employment claims hit 6. 6 million, another record high as layoffs accelerate in the face of coronavirus. The reports show the number doubled from the previous week of 3. 3 million. Yesterday gavin newsom announcing that the states Public School building will make close as the pandemic continues. Remain closed. Also new guidelines for facemasks in the community. 774. That is the number that i received early this morning. The number of individuals in california that are in icu beds. It represents a 16 point for percent increase from the prior day. Why do i start with the number 774