Transcripts For MSNBCW MSNBC Live With Velshi And Ruhle 20200319

Production act, that is a law that was enacted in 1950 during the korean war. It gives the president the authority to mandate that private industry produce and manufacture certain things for the national defense. The president and the white house lurched to the invoication of this. As weve heard, he hasnt triggered it yet. My guess is that when they announced that they were going to be invoking, the president probably heard from his friends in private industry to say please hold off on this. And i think that what is required here is not so much the invocation of these things but what is it were actually going to do to surge mask equipment, test kits, hospital beds to state and local communities to address this very, very serious crisis . Kristen welker is at the white house. Of course, was part of that briefing. Kristen, we have a number of issues to cover, but i also wanted to just touch base with you on the state department announcing this professional alert which is stage 4 as i understand it, and its to come home or stay in place, but telling americans not to travel. You want to clarify if you have that there . And thats right. That is what we are hearing. What we have learned at this hour now. You saw President Trump got a question about that. He says hes going to be talking to the state department a little bit later on this afternoon. So he declined to comment but that is our understanding at this hour and certainly a significant move by the state department, andrea. And also, i want to ask you about your questions. Your last question to dr. Murthy, whether the vaccine, which is really the Gold Standard here is to get a vaccine and begin to immunize our country, whether it can be accelerated. Ive not heard anyone, official or unofficial medical field, saying it can be done quicker than one year. Thats right. And the challenge, of course, they are saying that the first phase of this was fast tracked but now youre in the testing phase. Really trying to determine what the vaccine will look like. Will it work . How much of it needs to be used in order to have safe dosage. So those are the sorts of trials that are now getting under way, and you heard the doctor essentially indicate, look, its going to be at least a year. Weve heard dr. Fauci say it could be anywhere from a year to 18 months. And so theres no indication that that part of the process is going to be fast tracked even as they try to get these other medicines tested to see if they might be used to treat the coronavirus. I think we saw a president who was defiant today. I also asked him about the preparation, the fact there werent enough tests on the front end of this process. You saw a defiant response by President Trump saying that he, in fact, feels as though the federal government was as prepared as it could be given the fact he was argue that this took not only the United States but the world by surprise. I also thought it was notable. Were seeing the statistic comes out of china. The fact they have zero new cases. But hard to confirm that given the fact that western journalists have been kicked out and you saw President Trump saying he, in fact, was not able to confirm those statistics but he hopes theyre accurate, andrea. And robert costa from pbs as well as the Washington Post. Robert, what are you hearing from the hill . What we know is that Mitch Mcconnell is now in charge with the administration of trying to come up with the next the third stage, which would be a large bailout plus more money for individual americans. And the president was asked about the bailouts because thats controversial with people on the right and the left. Will there be restrictions on stock buybacks, on executive pay . He said he didnt think that would be written into the law. He said he wouldnt be against it but didnt think theyd be able to. It takes a lot of people to tango when you create Something Like this. Theres a lot of pushback on the hill against some of the provisions being suggested. And were talking about more than a trillion dollars here. Here is the top line. In the last ten minutes, talking to some key sources on capitol hill, they like that President Trump is staying out of the negotiations at this point and telling reporters this afternoon that he is, quote, okay with conditions that would prevent companies from spending federal dollars on stock buybacks or executive pay because he said he was, quote, okay with those kind of conditions which democrats and some republicans have asked for. They believe this 1 trillion rescue plan is still very much in play but they believe that Speaker Pelosi and secretary mnuchin and leader mcconnell have to be at the forefront of negotiations and with the president being vague, they feel Like Congress can continue to drive those talks. We have at least one former member of congress among us, and that is joe scarborough. Joe, theres a whole issue of whether people can vote remotely. Now there is a constitutional issue about having a quorum, but cant they fudge that if they need to . We have Steve Scalise and other members of Congress Already being tested, some prove to have the coronavirus. Youll have issues with getting back together. Youre in a pandemic, and certainly there has to be a workaround when the very act of bringing 435 people together in a single room say Public Health risk, not only for the people in that room but to all the communities that theyre going to spread out to across the United States when they go back home to their districts to try to deal with that. So, yeah, they have to figure out a workaround. Theyve got to figure out a way to be able to vote remotely because theres legislation thats going to be coming at them fast over the next week, over the next two weeks and as the president said during the press conference, they may have to come back to have another stimulus package if the markets continue to collapse. And this is a white house that also believes, and you heard the president suggest it, but the white house believes that were going to know much more about this crisis and the depths of this crisis by the end of next week. Theyve got next friday circled to figure out what their next phase of planning is. Not only on issues of health but also on financial issues. So it doesnt stop here. Nancy pelosi is going to have to be able to get members voting, and theyre going to have to be able to do it in their home districts. Mika brzezinski, weve now seen the first few cases, one in maryland, one in new jersey, of children. Young children, becoming infected with the virus. 5 years old in maryland, i think the child was. That raises all kinds of new questions. I believe theres a 6yearold in florida as well. It raises a lot of questions here. Youre also hearing more and more reports coming from france, from here in the United States of younger people, people not over the age of 70, who are being diagnosed with coronavirus and some of them having severe symptoms and some of them not doing as well as young people are expected to do. I think this virus has many mysteries to it. And americans have a lot of varied Health Conditions ranging from morbid obesity to lung and heart conditions which all weaken the organs. And in a way, much of our society is at risk of having bad symptoms at the very least. At this point, hospitals are really bracing for the worst. The numbers are going up. If you look at the data, were on par with italy. The numbers are doubling every few days. Its a very bad track were on, and theres nothing we heard in that News Conference today, not one thing, that addressed the immediate need as to where these numbers are going. It was all off in the distance or pie in the sky. There was nothing immediate. When mike pence was put out there to talk about masks because no one else had answers, he sort of went back to the branding opportunity of the two companies they were talking about. Theyre talking to 3m and honeywell about mass producing masks. None of that is immediate. Right now, our government is saying, do your best. Take care of it yourself. Health care workers, make your own mask. See what you can do to get through it. Governors, youre the ones who are supposed to do this work. There really hasnt been a National Mobilization with actual products that can help deal with this crisis. And to that point, dr. Murthy, the former surgeon general, ive got a note here from our colleague Heidi Przybyla who has been talking to people at the Hospital Association and saying that theyre complaining theres still no pipeline for money to get to the nations hospitals that they need. Some of them are losing in Washington State a Million Dollars a day. They need 100 billion, they say, and they need the funds directly. Theyve seen none of the money from the first two legislative packages. The rural hospitals are bigger problems. So what we are doing to get this equipment to the hospitals, to get money to the hospitals, to help them protect the Health Workers who are the front line of defense . Andrea, i think that story is representative of whats happening all over this country, which is that hospitals are struggling. Health care systems are struggling and doctors and nurses and front line workers are every day going to work and putting their lives at risk because they dont have the equipment to protect themselves. This is a serious pandemic. This may be the most serious pandemic weve dealt with in a century since the 1918 flu. But we know how to address it. Thats the good news. But you do so requires pulling out the stops. That means not just making sure were trying to make enough masks to meet demand today but recognizing where demand is going tomorrow and next week and accelerating now so we can meet the demands for tomorrow. It means seth up field hospitals, working with the department of defense to repurpose gyms and dormitories to convert them into beds we know were going to need in the days and weeks to come. It also means at an individual level weve got to, all of umake sure were washing our hands, make sure were not touching our face or touching each other when we greet each other. Stay home as much as we can. Recognizing that our contact with other people is what allows this virus to spread. If we do those things, then i believe that we can ultimately get our arms around this virus. Right now, weve got people in our hospitals who are putting their lives on the line and weve got to have their back. Heidi przybyla whom i just mentioned is here joining us as well, dr. Murthy. What were hearing from the cdc is 40 of the people hospitalized are in the 20 to 54 age range. That covers a lot of the people who were out there on the beaches of south florida. That age range, i should say, not those who were those who were hospitalized with this disease include many people who are not just the millennials. Thats right, andrea. According to we just obtained nbc just obtained by the american Hospital Association the funding that needs to happen needs to happen now. It will surprise Many Americans that to this day, despite two legislative packages that have been passed by congress and signed by the president , there is still no direct funding pipeline to these hpts. This is the way weve done it in the past. Weve filtered this money through agencies, state agencies, through hhs. That doesnt work anymore now that were in a pandemic, in a crisis. So two things need to happen. First, you need to authorize and actually activate that dpa so were organizing the production of supplies in an organized way. Not in a philanthropic way, but in a way that supply is meeting demand. And secondly, that the money gets to the hospitals directly so that they can purchase the ventilators, purchase the masks. I spoke with a Washington State Hospital Association representative who said the situation out there is, quote, dire at some hospitals. One rural hospital had one box left of gloves, andrea, that other rural hospitals are already starting to shut down primary care service, that they are losing money, and that they have very small margins because they operate on very small amount of cash on hand. And so once they start to have to shut down surgeries, shut down primary care. Thats how they make their money. So this is not something that can just be figured out by the private sector as joe and mika said. There needs to be a command and control here so were now talking about the third installment of a legislative package. The hospitals are saying, please. The medical infrastructure is what needs to be prioritized over any other kind of bailout at this time. We need to change fundamentally the way were getting monies to hospitals. And jeh johnson, you understand command and control better than most of us. What do we need to do to get the federal government on top of this . Its well and good to say the governors and the mayors are doing the job but doesnt someone have to take charge . Im not sure whether its the pence task force, the Jared Kushner parallel task force, fema as the president is heading there now. Who should be taking this on . First, fema under the leadership of craig fugate during the last administration really has become expert at deploying assets to the field very, very quickly. The president says hes not a shipping clerk. Well, in a crisis like this, the president is actually the shipping clerk in chief. The role of the federal government in a situation like this is to dispatch resources, to supplement support so that people at the local level, hospitals can have what they need to terms of beds, supplies, masks, test kits and so forth. Its up to those in washington to get those things to the field. And i hope as billions and billions are flying out of the federal treasury, the congress can fight every impulse it has toward earmarks, pork, things for favorite constituents and deliver this assistance to the communities and the people and the medical experts who really, really need it. Robert costa, what about all the reports that there are separate competing groups within the white house over taking charge as weve seen, the president being front and foremost but not so much with facts and figures . The Washington Post has an extensive story today about how Jared Kushner, the president s soninlaw and senior adviser, has his own socalled strike force working with hhs and other agencies trying to coordinate the private and public response. But mr. Kushners efforts have led to sweeping tensions across the federal government about who exactly is in charge. Is it Vice President pence and his task force . People also want to stay close to kushner knowing he can call up the president any time that he has access to President Trump so for many bureaucrats within the federal government who work on Emergency Response and health issues, they have told the Washington Post privately that they are deeply concerned that theres not a chain of command, that they fully understand, and that there are fluid political dynamics with kushner there who is involved with the Reelection Campaign and other efforts and thats complicated the entire response. Joe scarborough, your comment on that . It does you need a command and control structure with one person in charge. We dont have that here. We need a czar thats in charge. And where you dont have a lot of people going back and forth, and trying to figure out where the real power is. And thats what the first 3 1 2 years of this administration has been like, and thats what donald trump likes. He likes keeping people off balance. But theres no doubt there needs to be one person in charge. Theres a i think theres a more troubling issue that i saw coming out of this press conference and its once again the reconfirmation that donald trump and his administration believes that they can push this down to the federal to the state governments, to the governors, to the local mayors. Again, they talk about it being managed locally and supported federally. But thats what george w. Bush did in 2005 with hurricane katrina. We saw what a disaster that was. His brother, jeb, had ably run florida the year before and guided florida through four hurricanes effectively. But the next year, he found two governors who had not been through catastrophic hurricane and leaned on them too long. There are some issues that are just too big for 50 governors to handle. And this is one of them. And thats something i fear the white house still doesnt understand and something i fear that too Many Americans are going to pay for and something that theyre going to figure out weeks from now when its too late. By the way, theres new reporting in the new york times, robert costa, as well that the government was warned they were not ready for this. We know they had already shut down the pandemic office, the office that had been set up during or right after ebola to handle these kinds of issues in the previous administration. Theres a lot of blame being shifted back and forth, but at least in the past, the nsc was stood up and now in 2018 it was stood down. And now the warning is that there even been warnings and the administration ignored them. There are so many questions that remain about not only the administrations preparedness over the last few years for a pandemic, but about its response after this virus emerged in china and how they handled, in particular, the month of february. When i was at the capitol this week talking to House Democrats on background, they are already looking ahead, some of them, to the investigations to come about whether this administration took the necessary steps to prepare not only at the executive branch level with the National Security council and pandemic preparedness, but at the federal level across agencies. Was there seriousness in regard to the tests . What did the white house know and what did it not know and how can they communicate about the pandemic throughout february, late january and early march. There are questions congress will be asking once this initial crisis is over. Hopefully. And then it will become a question of what happened and why. We just want to repeat that the state department is expected, according to nbc news, to announce lifting this to lifting the travel guidance to level 4. Thats a travel warning. Im reading from our notes here telling people who are traveling abroad, americans to make their way home now. We know from the president s comments, and ive been hearing questions and really help emails from people who are stuck in peru. Some 300 americans traveling with canadians in peru. The americans have not been brought home according to the president s own acknowledgment today. Efforts will be made to bring them home militarily. The people involved, the americans say that canada sent a plane for them and took the canadian travelers home. So americans are being warned now not to travel abroad, to come home if they can, or to stay in place. As we continue to hear this, jeh johnson, this is a management challenge from the top down. Were not seeing that yet. One case that i want to ask you about is the two hospital ships. The president announced it with great fanfare yesterday, the comfort and uss mercy. We understand theyre in maintenance and will be for days if not weeks. Right. As i said earlier, theres a tendency to rush forward with big news about ships, about declarations of emergencies, invocations of wartime authorities, and then you take a hard look at whats going to happen on the ground and you find out, well, its not going to be available for weeks or its only for this kind of patient and not that kind of patient. I hope the American Public will start asking the hard questions about, what is it youre actually doing for us and how is it youre actually helping us through this National Crisis right now . And what you cited is a perfect example of that. Now weve also just learned to all of you that italy has now surpassed chinas death toll. 3,405 people have died in italy. And this is a country, as was explained on msnbc last night, mika, by rachel maddow, italy had a highly rated medical system. Their Health System is one of the best. Its a high, welldeveloped Health System, especially in lombardy and yet they were unable to respond and now for the death toll in italy to have of course, we dont know what the real numbers are from china because even our Intelligence Community tells us that we cannot trust the numbers coming out of china, but in any case, this is horrific from italy. Its horrific and also its a foreboding for the United States of america if a country like italy with toprated health care, top Level Health Care is dealing with this crisis right now where they are breaking records in terms of deaths and were hearing reports overnight from nbcs matt bradley that they dont even know what to do with the bodies. There are so many. Thats where we are. This is a wartime footing that we are in right now. And what we heard from the president s News Conference today, we did see two days ago a dramatic change in tone when the president came out and said, you know, no groupings of people of 10 people or more. And, really, kind of gave some clear directives for families and for americans across the country. But today weve got this sort of rambling set of possible circumstances that they might be able to set up in the weeks and months to come. He seemed detached from the actual crisis at hand which, in the days and weeks to come, could be costing hundreds, thousands of american lives. Before we leave you, just briefly, dr. Murthy, are we at risk here in the United States, with the young people still partying on the beaches in florida, incredibly, and florida not closing them down, are we at risk of reaching that level . Unfortunately, we are. And we are in a trajectory, a similar trajectory to italy. And thats why you saw a few days ago also the study that came out of england that showed that if we do not do something dramatically different, we are on track to lose 2. 2 Million People here in the United States to covid19. Thats not 2. 2 Million People infected. Thats 2. 2 Million People who may die as a result of this infection. This is why it is so important, even as we press and urge our government leaders to come together and to pull out the stops to get supplies and testing to where we need it, its also so important that each of us as individuals take the action that we can take in our own lives to limit the spread of this virus. If we look to countries that have done it well, its been an aggressive combination of both governmental action and also mitigation efforts and behavior change. People staying indoors, limiting their physical contact with other people, washing their hands frequently. Its these measures we need to rely on more than ever. If we do that and mobilize our government, then i believe we can ultimately conquer this virus. But it will take time. Dr. Murthy, thank you. Joe scarborough, meek brzezinski, robert costa and jeh johnson. Kristen welker, of course, my colleague and friend. That does it for this edition of a different Andrea Mitchell reports. Coming up next, Chris Jansing picks up our coverage on the coronavirus. On the coronavirus. Fort of home. If it ever makes it there. Spend 30 and get free delivery at red lobster dot com. aurelia i was just frustrated i almost gave up. Company. If it ever makes it there. With miracleear, its all about service. Theyre personable, theyre friendly. Im very happy with them. vo we provide you with a free lifetime of aftercare, meaning free checkups, cleanings and adjustments. wiley i see someone new. Someone happy. 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But they would have never even known it existed. If it werent for the power of targeted tv advertising. Its smart. It grabs peoples attention. It works. Its why Comcast Spotlight is changing its name to effectv. Because being effective means getting results. Good afternoon. Welcome to a special hour of msnbc focused on the coronavirus pandemic. Im Chris Jansing. Im joshua johnson. Our experts are back to answer more of your questions about the outbreak. Keep the questions and stories coming. You can use msnbcanswers on twitter, facebook and instagram or email us talk msnbc. Com. Our answers will be based on what we know right now, and that is always changing. Nothing we say can subsdut for the advice of your doctor or Financial Adviser on your specific situation. But lets get to what are a lot of headlines. The big one just coming out in the last couple of minutes. Italy has now surpassed china in the number of deaths from coronavirus. 3,405. And the state department is poised to announce a level 4 travel advisory mandating all americans abroad either return to the u. S. Or prepare to shelter in place. We have confirmed that here at nbc. And the Coronavirus Task force briefing this morning, the president spoke about Clinical Trials under way. They are doing great with the vaccines, but theres still a long process. But the therapies are something we can move on much faster potentially. And the treatments that will be able to reduce the severity or duration of the symptoms. Chloroquine or hydroxychloroquine. This is a common malaria drug. Its also a drug used for strong arthritis. Its shown very encouraging. Very, very encouraging early results. And were going to be able to make that drug available almost immediately. And thats where the fda has been so great. But then the fda commissioner stepped in and cautioned, no, it is not approved for use for coronavirus and it must be tested. And when the president and Vice President were asked about the availability of masks, the answers remained unclear. The cdc put out guidelines for hospitals that are dealing with a shortage of masks to use them beyond their shelf life, reuse them instead of getting new ones and in a worst Case Scenario, use a bandanna instead of a mask. How is that acceptable at all . Well, i havent seen that, but i will let mike answer that question. Im happy to, mr. President. I cant emphasize enough the incredible progress that was made with the passage of the legislation. Were seeing a dramatic increase in production. Meanwhile, new York Governor Andrew Cuomo reiterated that he would not lock down new york city. Cuomo has argued that doing so would be ineffective and practically impossible. New york citys confirmed cases nearly doubled overnight. Meanwhile, confirmed cases worldwide have topped 200,000. China reported no new locally transmitted infections for the first time in this outbreak. In the u. S. , more than 8,000 people are known to be infected. More big cities and major metro areas are telling residents to stay home. And also two members of congress are now known to be infected with coronavirus, representative ben mcadams of utah and Mario Diazbalart of florida. Lets bring our Coronavirus Crisis time in. Dr. John torres, dr. Natalie azar, nbc news science contributor and virologist dr. Joseph fair. Lets go through some of the confusion about what we heard at the press conference today. The president saying that, yes, we have these drugs, for example, an antimalarial drug that can be used immediately to help treat, help mitigate some of what were seeing with coronavirus. The fda commissioner then stepping up and saying this has not been approved and a lot of doctors already concerned because, a, you cannot be assured if you go to your doctor or hospital it will be available or, b, what its efficacy is. Whats your reaction to this, what seems to be, conflicting information. Well, i can speak to at least the drug part. And, you know, often with new viral diseases, especially if they are new to humans, it will go through currently existing drugs that have shown efficacy in other treatments of other diseases. For example, a treatment for ebola. Tested for a treatment against coronavirus et cetera. One of the drugs thats shown early promise was one of those. So its not uncommon that we would go through and look at other drugs for other diseases to see if they have some effect on coronavirus. I cant specifically speak to the effects of this particular drig drug, hydroxychloroquine on covid 19. Id have to leave that to my medical colleagues on the panel. But we would see that go through and test it at least in the laboratory and then want to test it in humans from there. The fda commissioners words are true. They have not approved this for use for covid19 so that would be breaking, you know, fda regulations to go ahead and prescribe it for covid19. Natalie, it seems like you want to jump in here. Yeah, yeah, so im kind of gathering information from a lot of different sources right now, but as it stands right now, i understand that the university of minnesota is actively enrolling participants who fit this criteria. They would be individuals this would be not for treatment but something called post exposure prophylaxis who have high or moderate exposure within the last three days. And their plan is to fedex the medicine overnight to start on day four the religionial being the average incubation period is about 5 1 2 days. Remember, we always talk about 2 to 14 days. And they say this is open to anyone in the u. S. The intervention would be hydroxychloroquine for five days. This is for this would be enrollment in a clinical trial. Just a word on hydroxychloroquine because i find it interesting as a rheumatologist. All our patients out there the whole country of rheumatologists is probably very excited about this as to why this would work. Yes, we use it in lupis and rheumatoid arthritis. We never used it because it was an antimalarial. It had different pathways of inflammation it potentially affected which benefits our diseases. The idea here is that, you know, once the virus infects you, it likes to use the host, in this case, a person, to start making its own protein and nucleic acids and the replication of the virus requires a low ph, a low acidic environment. And the hydroxychloroquine can prevent this acidification needed for replication. Thats one hypothesis of how it could work. Yes, its a very safe medication to use for five days. Its a reasonably safe medicine to use for longer periods of time. As our patients know well, they are monitored for certain toxicities but this would be an amazing thing as a post exposure prophylaxis if it does work. Much more to discuss about what we heard in the briefing. We should dive in with audience questions. Well learn more in the days to come in terms of how were doing about masks, tests. There seems to be a real gap in getting all the test equipment and masks we need. We heard a question about people jerryrigging masks. But lets drive in with audience questions since our time is brief. Dr. Torres, edgar asked, whats the sequence of symptoms for covid19. A lot of questions about symptoms versus the detectable infection. Fever first . Cough . So what were finding out is covid19 as opposed to the flu, the symptom comes on slower purpose with the flu people describe it as somebody flipped the light switch and i went from feeling a little under the weather to feeling horrible, not able to get out of bed. With covid19, its more gradual progression. And symptoms can be all over the place. I start feeling achy. I start getting congestion and then start getting cough. A few days later, that will progressively get worse. More fatigue and then ill start developing fevers. N that fever starts spiking up. Thats when they say there may be Something Else going on here other than your common cold. But again, its not quite as fast of an onset as flu. Its a little more gradual. Lets keep going with a question from deb and maybe dr. Fair, you can answer this one. Deb asks, is it safe to walk outside with my 87yearold mom who lives alone as long as we walk with appropriate distance between us . I would love to keep her spirits up. Dr. Fair . Yes, absolutely. In fact, i would encourage her to do so. Also keeping in mind were getting into allergy season and things like that. So if theres any underlying conditions of allergic reaction to pollen and things like that, maybe want to consider because that may scare her more than anything else. More than anything, we need to keep at least every sense of normalcy we can at this time and we know as long as youre outside and keeping an appropriate distance, thats not a route of transmission for the virus. Id recommend it myself but again, ill defer to my medical colleagues and see what they think about that as well. Dr. Azar . Oh, yeah, absolutely. Not a problem. As long as im assuming this individual is asking because she doesnt live with mom so just be aware that, you know, even the daughter should or son, i guess, should be careful and not get too close to mom in case. Because they may not know their own exposure risk. But absolutely. We should have our seniors out there getting fresh air as long as theyre not too close to other people. There was a report today dr. Azar that had a lot of people concerned a 5yearold in new jersey tested positive. Her parents, one in their 30s and one in their 40s both tested positive and a 4yearold sibling that test results were pending. Theres a lot of concern about being told to stay within your family and then shaheed from michigan asked, kindly advise the best way to protect other family members in a household if one has tested positive. Right. Well, the first part of that answer really is that family clusters are not unusual. By the time someone knows that they are sick, theyve probably already exposed their family members. So for people who live in multigenerational homes who have older family members, i think now is a good time to keep distance, even if nobody is sick, which i know is difficult. But it is really, i think, recommended. But certainly if there is one only one known case, then the recommendation, as weve been saying, is to have that person isolated in their own part of the home, in their own bedroom and have one household member only being the designated one to take care of that person. The sick persons sheets and clothing should be laundered separately. Meals if possible should be given on plastic utensils or whatever, you know, dishes are used, utensils used should be dish washered right away and the person taking care of the sick person needs to be gloved and masked and sanitize hands on the way in and out. The cdc has excellent guidance on this. Dr. Torres, azar and fair, thanks to you. Stay with us. We have a lot more to talk about. This pandemic is hitting the travel industry really, really hard. How might all of this affect you and the job market. And what about those new regulations about americans who are outside the country . Thats ahead on msnbc live. California phones offers free specialized phones. Like cordless phones, phone ringing big button, and volumeenhanced phones. Get details on this state program. Call or visit and accessoriesphones for your mobile phone. Like this device to increase volume on your cell phone. phone ringing get details on this state program call or visit welcome back to our special coverage of coronavirus. The state department is expected to announce its most serious travel warning yet. A global level 4 do not travel advisory. That recommends that americans not travel abroad. And with fewer people taking trips, the travel industry is taking a deep hit. Delta is cutting 70 of its flights. United cutting flights by 60 . Jetblue slashing 40 of its flights. Marriott is beginning to furlough tens of thousands of employees. All told, the u. S. Travel association is expecting 4. 6 million travelrelated jobs will be lost because of the pandemic. Joining us now, the travel editor of the website afar. Com. A level 4 travel advisory. Were already hearing reports of americans who have had their flights canceled. They are wondering how theyll get home. Whats the best advice for people, whether they are on business, whether they live there and want to get back to the states or whether theyre on vacation. What do they do now . The hardest thing about when anyone of these bans or travel restrictions goes into place is that the airlines get flooded with calls. What we found is one of the biggest trouble points at a moment like this is that they cant get through to get the help that they need to figure out if and when they can get on a flight home. And airlines have recognized this as a challenge. They are flooded with calls. So one thing ive recommended to people that are abroad that are trying to get through, try at odd hours. Try different methods of getting through. Online chat, if the phone isnt working. Emails. That is one of the hardest parts about this. What is a level 4 travel advisory actually mean . Does it mean that you, if you are if you make the decision to stay in one of these countries that the state department is saying were not going to come save you, youre going to be removed by force . What does that advisory actually mean . Typically with any of the advisories that weve seen and the travel restrictions weve seen, people can come home. Can come back to their country of origin. So citizens can come back. Weve seen that even in the case of in countries where there have been large outbreaks that u. S. Citizens can come home. Im not sure if this goes against that but weve seen that u. S. Citizens are allowed to come home. One of the things the president husband asked about is whether or not the government my have to get involved and theyll be looking at that. They dont want to leave americans stranded abroad. However, first Case Scenario is you find your way back into the country. There are some other issues here. What should i do about upcoming travel, and i dont know, i get this question all the time, spring, summer, destination weddings. What are you telling people about their plans and travel insurance . So basically for plans up until the end of april, you can with any major airline, you can change that trip with no fee. So theyve all amended their policies that you can cancel that booking, bank the money, not get a refund but bank the money and rebook at a later date. Usually up to a year out. Up through the end of april youre good to go to change that flight. After april, it gets a little bit iffy because they havent yet amended the policy to include anything beyond april. Thats u. S. Carriers. Some International Carriers have gone into the end of may. Check your airline. Air france and British Airways have policies that extend to the end of may for changing without a fee. What im telling people for flights beyond april that theyve already booked, to just give it another week or two and wait to see if the airlines are going to extend those policies a little bit more because if you change it now, you wont get you wont have that ability to not have the change fee or to bank that money for a future flight. So id give it another week or two and see if they extend that into may or beyond. Dr. Torres, if i could get a quick answer to you from this. If its being suggested that people avoid crowds of 50, 25 or 10, no one can stay six feet apart and there are at least 150 or more people on the plane. What do you do about being on a plane, dr. Torres . Do you just not fly . Not much you can do about being on a plane when you get your assigned seat. If you have conditions that put you at higher risk, elderly, other conditions, Health Conditions that put you at higher risk, definitely think twice about traveling. International traveling, shouldnt be doing it. Domestically, check where youre going. On planes we have the zones. So if you are within a couple rows of somebody who is sick, that will be an issue. Further away, not as big of a problem. Dr. Torres and michelle ba baran, thank you both. Doctors are making more house calls without leaving the house. Well explore telemedicine. Stay close. Nooooooo not another commercial when you bundle your home, auto and Life Insurance with allstate you could save 25 . In fact, the more you bundle the more you can save. Put the other game on if its important to you allstate can protect it. Home auto and Life Insurance you could save 25 . If its important to you allstate can protect it. What . Bundle and save with allstate. Click or call for a quote today. Saving for avas college. Financial security. Being able to retire. On our terms. No matter what your goals are, our trusted advisors can help you reach them. Ameriprise financial. Our trusted advisors can help you reach them. Its more than just fast. It keeps all your devices running smoothly. With builtin security that protects your kids. No matter what theyre up to. It protects your info. And gives you 24 7 peace of mind. That if its connected, its protected. Even that that petcamera thingy. [ whines ] can your internet do that . Xfinity xfi can because its. Simple, easy, awesome. [ barking ] welcome back to our special coverage of the coronavirus pandemic where were answering your questions about coronavirus in an attempt to prevent overcrowding in hospitals and the continued spread of the virus, the Trump Administration announced medicare would be expanding access to telemedicine. It allows patients to interact with doctors without leaving their home. Joining us now, jen due bough skus. Dr. Natalie azar is back with us also. Lets get a simple definition out of the way. Whats telemedicine . How does it work . Yeah. Well, telemedicine is quite simple. Its receiving a doctor visit over the phone, skype, face time. Whats the difference between using a specific telemedicine system and just saying, hey, doc, lets face time . I think there are other aspects of telemedicine that make it different, including protecting your Health Information privacy, right . Yes. Thats absolutely correct. So there are Telemedicine Services that are not insurance, and there is something thats available to purchase. Teledak, thats one of the services, offer a hipaa come plooipt platform and thats why theyre okay to use. What weve seen in the past is that doctors have not had those platforms. Just making a phone call over the phone is not compliant. And what trump did with this restriction change was hes allowing doctors to talk to patients over the phone even though thats not technically hipaa compliant. Is it helpful, im assuming it is, just to be able to see the patient, to have that facetoface conversation . I think there are a lot of folks who frankly, they like to see their doctor. They want to know. And is it helpful for the doctor as well . Yeah, thats a great question. And i think one of the things thats patients are going to be asking, do i have the same quality of visit . What we want to do is maker sure that were really thoughtful before we have that telemedicine visit. We go ahead and think about what are all the symptoms . Is there anything else i need to know . Do you have a cough, runny nose, aches and pains . Think through the symptoms first before having that visit. And then the second thing you want to do is think about what questions do i have . And be prepared when, you know, what are iside effects, symptoms, what are some of the other things that i need to be aware of . Ask every single question that you have. And then the other thing is that telemedicine is different in that youre not in the doctors office. You want to be prepared if the doctor does order a prescription, that you have your farmees add dress on hand to give to the doctor and they can send a prescription to the farm pharmacy. Two things, you mentioned that study out of the university of minnesota. Go to twitter at unmmedschool. Youll find the information there. Quick question, perhaps a limitation of telemedicine. One of our viewers mentioned they worked in telemedicine taking the calls from patients that wanted to schedule. The problem im hearing over and over people in an area doing drive dri driveup testing have no way of getting the test. That might not close one of the key gaps, just getting tested. Yeah. I know. And i see those as kind of two separate things. I mean, the purpose of telemedicine is to really limit the really to socially distance, even doctors from their patients. But i think more on the patientside as a Patient Advocacy move, a lot of our patients are older and have those underlying medical conditions we talk about, are immuneo compromised and travel into an urban area to see their doctor maybe just to get a blood test. Can they have a conversation over the phone instead using telemedicine and perhaps do labs locally so they dont have to do that travel . You know, if its a wonderful thing, we are we launched ours today. Were all getting trained on it. One thing thats important at least in my institution is that both the provider and the patients have to agree to it. The patient also has to go there a little bit of training to understand how it works. Its something that we needed to do urgently to continue to be able to provide care. Dr. Natalie azar and jan due bough skis, thank you both. Thank you for watching this hour of msnbc live. We are back here tomorrow, one 00 eastern. Keep your stories and questions coming. Email us. Please include your name and your city. We know you already set your dvr but join lester holt for a special tonight on coronavirus, on msnbc, nbc and our Free Streaming Network nbc news now. If you havent set your dvr yet, do it while we take this break. And then the news continues with katy tour on msnbc. Katy tour onc this is big. Double dozen big its captain ds new double dozen shrimp. Yeah, you heard that right. Two dozen golden, crispy shrimp piled high on one plate time to double down when the captain is callin. Captain ds. Neutrogena® rapid wrinkle repair®. Weve got the retinol that gives you results in one week. Not just any retinol. Accelerated retinol sa. For not only smoother skin in one day, but youngerlooking skin in just one week. And thats clinically proven. Results that fast or your money back. Unless youre attached to your wrinkles. One week is all it takes. Neutrogena®. aurelia i was just frustrated i almost gave up. Company. One week is all it takes. 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In the east. Time and resources are wearing thin. Here is whats happening right now. Italy has surpassed china as the country with the most coronavirus deaths. The state department is expected to raise the Global Travel adds vooizry to level 4 advising americans not to travel. Domestically more than 10,000 americans have tested positive