Transcripts For MSNBCW The Rachel Maddow Show 20200418

Numbers had maybe hit their peak, and would start to consistently drop, thats obviously what everybody was hoping. But since then, the numbers have been back up over 2,000 deaths each day. Or tuesday this week, wednesday, thursday, and now, for today as well. Its just astonishing to be having that Many Americans killed every day now. More than 2,000 americans every day. But just look at how fast this thing has exploded. If you go back seven weeks ago, to the last friday in february, that friday, february 28th, four americans had been killed by coronavirus. A week later, march 6th, it was 26 americans who had been killed. The week after that, march 13th, it was 55 americans dead. The week after that, march 20th, 247 americans dead. One week after that, we went from 247 to 1,574. And the month of april has just been astonishing since then. In that one week, between friday, march 27th and friday, april 3rd, we went from about 1,500 americans dead, to more than 7,000. Last friday, april 10, that number had more than doubled, and now, since last friday, we are having more than 2,000 americans die every day. Weve got more than 32,000 americans dead overall now, and that has all happened, weve killed 32,000 americans in less than eight weeks. New york continues to have the worst toll. Even as we are seeing all these good signs, statistical signs in new york, the number of new infections each day, the slowing and its rise, the number of people hospitalized is falling, the number of people in icu beds is falling, but still, the death toll is skyhigh in new york, every day, and it is staying there. Today, new York Governor Andrew Cuomo announced yet again, more than 600 deaths in new york, in the past 24 hours. 606 deaths yesterday. And 630 today. And those numbers, it has been above 600, 700, for all of the last week. And of that 630 number today, the number of new yorkers who have died in the last 24 hours, again today, Governor Cuomo took care to specify how many of those deaths in new york in the past 24 hours were in Nursing Homes. It was 40 of those 630 deaths. Were going to check in later this hour, with one of the front line intensive care doctors who has been serving in a bulls eye new york city hospital, saint barnabus, dr. Ernest patty, we spoke to last week, you might remember about, the condition in his incredibly hardhit icu in saint barnabus. We will check back in with him live tonight, right at the end of his shift, to talk about what it is like in the icus now, as new york is seeing, in the data, a possible light at the end of the tunnel, but the tunnel is still so black and so long and so cold, with more than 600 new yorkers dying every day. And it is interesting, we watched italy, so closely, from here, as a precursor, we were worried that italy was going to be a precursor, as to what we would go through in this country, those warnings were exactly right in terms of us following italy, and then them handing us the baton of having the worst outbreak on earth. Because we saw italy go before us, we were also heartened when we saw italy start to turn their curve, start to bend their curve, we started to see their infection, new infections, their new hospitalizations, their icu utilization numbers, starting to go down. But even as italy turned the corner on those number, as new york is now, italys death toll still holds steady at an incredibly high rate, even now. I mean they are a couple of weeks ahead of us. But italy is still, even today, up over 500 deaths per day. And it is not coming down. I mean just like new york looks like its turning the corner, on some very important metrics, but new york deaths are staying high, high, high every day. Over 600, over 700. And that, the plateau of very high death numbers every day, thats very worrying, in terms of thinking about the overall number of americans who are going to lose their lives here by the end of this epidemic. We are seven weeks into it, we are over 30,000 americans dead. And the worsthit places are still turning in unimaginable daily numbers. New york as i said, over 600 deaths minimum every day. New jersey had 323 deaths in the past 24 hours. Thats their worst yet. New jersey has had more than 1400 deaths in the past four days. I mean those numbers, you start to combine those numbers, day after day, and state next to state, and it is just, we are losing a lot of people, and we are going to lose a lot of people. But this is the challenge that we have as americans now, who in our lifetimes are going through this, and who will have to answer for what we did in this trying time. We will have to answer for what we did as americans, to minimize the number of lives lost. Save as many people as possible. And toward that ends, theres two things, i think, that will be worth keeping in mind tonight, this friday night, and as we head into another weekend. The first is something that weve been talking about in this show a lot over the last, the past week or so, but i have some new news to share about it tonight, that i think you will find interesting, and different from the way we have been talking about it in recent days, and thats the issue of Nursing Homes and longterm care facilities, which, as you know, has been, has robbed me of my ability to sleep the past week or so. Its because those are the places where the most american lives are at risk from the pandemic, where the most vulnerable patients are at most risk of infection, and at most risk of not getting the care they need to keep them alive. Now, i want to tell you tonight, that we are starting to see some Important Movement on the issue of Nursing Homes and longterm care facilities. Its not from the federal government of course. Which is where we really immediate it to be. But we are at least seeing what i think is some Important Movement from some states. Now, i went out of my way to mention a moment ago that new York Governor Andrew Cuomo has started briefing every day, not just on the death toll, in new york state, but he specifically started breaking out the number of those deaths in the past 24 hours, that came from Nursing Homes. And that is good. That is really good that he is doing that because as much rightful attention that there has been to the hospitals and the Health Workers at hospitals fighting for the lives of americans suffering with coronavirus, the Nursing Homes and the longterm care facilities are the other place in our country where huge numbers of coronavirus patients will be and are being found, and ought to be tested and treated and either saved or not. Making that visible, as one of the front lines alongside hospitals, is good, because thats the way we need to think about those facilities, in terms of what places need resources, what places need our support, what places need additional staff. So today, new york state, as of this week, new yorks governor is breaking out the deaths in Nursing Homes alongside the deaths in hospitals. Very good. Today, new york state also started releasing individual data about individual Nursing Homes that have had more than five deaths on their residents from coronavirus. I dont know if you saw this today but im sort of surprised it didnt get more attention than it did. It is a long and sobering list of new york Nursing Homes that have had more than five deaths among their residents but you know what, there is no information th information, no reason this information should be secret. Just as hospitals and workplaces shouldnt be keeping this information secret, this stuff cant be secret in an epidemic, letting people know that youve got cases, that youve got an outbreak, that youve got deaths among your workplace population or your resident population, that information has to be known, its the only way that you can get help, that people know to try to get your resources, to try to limit the additional body count. I dont mean to be that blunt about it but thats why this information needs to be made public even if under normal circumstances you wouldnt expect facilities like this to publicize when people died in their facility, we now need to know. These places where dozens of americans are dying, we need to know where they are. First of all, because its right, that we know, right . But also, because the staff there, will need bolstering, will need help, will need ppe, the remaining living weres in these places where lots of other residents have died, they need us to see them, they need us to be able to see the danger theyre in. Because they need to be given help. We cant help trouble spots that we g , we dont know about, but now we know a lot about them in new york state because new york state has started publishing individual facility data and cobble hill brooklyn, this center has had 55 residents die, in the two facilities in the blank, the one on the left has had 45 and the one on the right had 35 of its residents die. In the manhattan nursing am home on the left, 31 residents died, and the Staten Island home on the right, they have lost 44 souls. Heres four facilities in queens, new figures released by new york state saying that 148 americans have died in these four facilities. And i have to tell you, that may be an undercount, in just one of these facilities, in queens, the one on the far left of your screen there the Sapphire Center for rehabilitation and nursing, that is listed in new yorks data today as having 26 of the residents die but an article that appeared in the New York Times today usaid says that the director of that facility, the Sapphire Center, told his local state representative, that the death toll there is actually higher than that, it is not 26, its 29, the times also spoke to two workers of that facility, who spoke with the times on the condition of anonymity, because they didnt want to lose their jobs, those workers told the jobs that they believe the real death toll in that one facility in queens is more like 60 residents who have died. Which just knocks you back on your heels to think that. But again, new york state reported 26 deaths from that facility today. Two workers there telling the New York Times they believe it is more like 60. And it is its own problem. Not just something to lament, literally something to fix, it is something that needs to be fixed, that we dont know the real count at that facility, or in other facilities around the country. We need to know, we need to know, because those places need help, and they need targeted resources. If youre associated with one of those facilities and you dont want people to know how bad your problem is, this is not the time to be defensive or to be worried about your liability, this is the time to stop the body count, by being public about your troubles, so you can get help. The times today, redid its own national count of nursing home deaths as well. The times concluded that more than 7,000 americans have died from coronavirus in Nursing Homes so far. But the times acknowledges, as does everybody, who has tries to do these counts, it is probably a huge undercut because some state, some county, some facilities arent reporting their deaths which is astonishing, but it needs to be fixed, we need to have real data, real number, because americans just cant be allowed to have large numbers in secret, unlamented, were a freaking first world country, we dont allow thousands of people elderly or not to die with no record of it. And without giving all of us at least a chance to get help to them. And so we need to know. Multiple states, the federal government has been absolutely useless on this score but multiple states are trying to change it. Ohio republican governor mark dewine this week signed an executive order to mandate reporting, public reporting by facilities in his state. Good. Same thing from democratic Michigan Governor Gretchen Whitmer who we spoke with last night on this show, that executive order in michigan, good. New york, as we showed you is now breaking out the death toll in aggregate from Nursing Homes and publishing information, as of today, on individual facilities and the numbers that have died there, as painful as it is to see that information, it is absolutely necessary. And i want to tell you tonight that other states are stepping up, in other ways. Yes, the federal government is still failing to do anything in this part of the kreis sit crisis at all. But the states in the absence of any federal leadership are now innovating. And as new states, by necessity, innovate, some of them will start to develop new best practices for how to deal with this pandemic in the most vulnerable places in the country. And as that happens, every state in the country should start to emulate those best practices. And so well try to track them as they develop. In massachusetts, for example, where half the states deaths have been in Nursing Homes so far, the state has now told every nursing home and assisted living facility in the commonwealth of massachusetts that the state will come in and do testing for free for all residents and all staff. Regardless of symptoms. Thats a good start. I mean those tests need to be repeated frequently. It cant just be a onetime thing. But the state, taking responsibility, for getting testing to every facility in the state. For all residents. For all staff. That is a good start. In some facilities, theyre using the National Guard to go in and do the testing in massachusetts Nursing Homes because the state says well get everybody tested in every facility. Good. Its a good start. Its just a start. Its a good start. In the state of oklahoma, today word that will get somebody in heaven some day if they are not empty words. The state Health Department announcing within the past 24 hours in oklahoma that getting testing and ppe, personal protective equipment, into Nursing Homes, is now the top priority of the Oklahoma State Health Department. Ive been waiting for a state Health Department to say that. In oklahoma, they have formed a state longterm health fast task force. Okay, call it whatever you want. Theyve got somebody working on the problem. There are 11 regions and each has an epidemiologist and nurses and Long Term Care skull ants and each team will be responsible for testing in the facility in their part of the state and the oklahoma newspaper today reports that those teams will work on how to isolate residents who have it, they will beef up Infection Control protocols in Nursing Homes and they will quote work with facilities, on their personal protective equipment needs. Now, working with them on those needs is not the same thing as committing to get those facilities what they need. But at least theyre pointing in the right direction, right . At least theyre point can at the part of the problem where the most americans will lose their lives if we dont change course and start helping. Now, i will say the state of oklahoma is also doing some really dumb things at the same time. The states governor now says he wants to restart elective surgeries next week for some reason. The oklahoma hospital association, the oklahoma medical association, the oklahoma nurses association, are all screaming bloody murder about what a terrible idea that is, particularly because oklahoma has a dire shortage of ppe, and that matters both for its hospital staff and also for its nursing home staff. So you dont want to be burning ppe on surgeries you, by definition, dont have to do. The tulsa world quotes the person in charge of the states ppe supply says oklahoma has roughly 10 of the masks they believe they need right now so choosing to go back to reopening elective surgeries to use a ton of them is insane. Oklahoma is making some terrible decisions, too, or at least the governor is trying to make some terrible decisions but people can do good things and bad things at the same time. And the state deciding to zero in on Nursing Homes as the stated explicit top priority of the Health Department in that state, yes, yes, other states, honestly, should be doing that, too, if you are trying to save the most lives and if you are looking at the numbers of who is at the most risk, and who is dying at the quickest clip. So thats your update today in terms of Nursing Homes. Watch the states as they try to figure this out. And then hopefully watch the states learn from each other, as the federal government abdicates the lives of these tens of thousands of americans with that are at risk in these facilities. As the states start to pick it up, other states should feel pressure to do what the wellrun states are doing, reporting that information, making it public, making exceptions to your previous rule, to make that information public, and then committ committing to get help to those places. Use the National Guard if you need to. Use National Guard medics if you need to. If you called up your medical reserve corps and asked recently retired Health Care People to come back into the field one of the places you could be using them is uplift Nursing Homes and longterm care facilities to staff them up, to shore them up, to help them develop better Infection Control facilities around the other things that theyre going to need to surge the medical care that theyre able to provide to their residents. Do it. All right. So watch that. The other place to keep your eyes on right now, and watch this over the weekend, as this is going to develop because im worried about this. A cluster of states in the middle of the country that have no stayathome orders in place, but where there are now big burgeoning epidemics, a number of which seem to be springing from large Meat Processing facilities, where lots and lots of people are working very, very close quarters, and where circumstances have been such that it seems like weve got many burgeoning outbreaks in many of these facilities. I mean big clusters, big outbreaks are bad anywhere, they are particularly bad in states that are light on hospital beds, while simultaneously being blessed with governors who dont want to do anything statewide to stop what are now fastgrowing epidemics in those place, and weve got a cluster of three states where that is happening right now that shoe keep an eye on. One of them, south dakota. One of the fastestgrowing case counts in the country right now. Theyve got this huge cluster of cases at a sioux falls Meat Processing plant. That cluster alone has now ballooned to 777 known cases. There arent even a Million People in south dakota. Theyve got 777 known cases in that one cluster. Theres no stayathome order in south dakota. After total rejection of his requests for a stayathome order from the governor, the mayor of sioux falls as of today has now dropped his own effort to try to put it in place, a stayathome order, just for his city. I mean the south dakota situation here, with the largest known clust ner the country, its just lion like watching a slow motion train wreck. Nearly 800 known cases at that one plant. 250 at the start of the week. We are told reliably they still have not tested everyone who works at that plant. Theres no stayathome order. The local paper, the argueus leader is running a running tally every day now of all of the new workplaces in and around sioux falls that have decided to shut themselves down or have otherwise reported that they too now have coronavirus cases among their workers. Well, thats because everybody is still going to work, because theres no stayathome order in south dakota, because the governor thinks its fine. South dakota has one of the most rapidlyincreasing case loads in the country. The entire state of south dakota has a grand total of 2300 hospital beds. The governor though is unperturbed. We do have a hot spot in sioux falls, i think everybodys well aware of that, and people are talking about that. I also want to give you a little bit of perspective on the situation. I know that the National News is talking about the fact that this is a hot spot in the nation. Thats fine, however they want to classify it, well take it, weve given our businesses an opportunity to be innovative, theyve had the opportunity to still deliver services to their customers. We just have a really businessfriendly environment. It is very friendly. South dakota borders both nebraska and iowa, both of whom also have republican governors, who have not put in place stayathome orders. The Iowa Governor kim reynolds has spent the last couple of days talking about what appears to be a new burgeoning outbreak at a Meat Processing plant in water lie waterloo iowa. Several have already closed but the one in waterloo is open and the mayor of waterloo has asked for it to be closed given the workers at the plant and work verse been told to only cover their faces at work as of tuesday this week. The governor is repeatedly now acknowledging what looks like an outbreak at the plant there but the plant for now is staying open. Worryingly the governor keeps saying at press conferences this week that she believes the usda is probably doing something to keep workers safe at that plant. Nobody knows what she is talking about with that, as the usda appears to be doing no such thing. But she thinks thats happening, and so they are blundering on in iowa, again, no stayathome order in iowa. In nebraska, this was the front page of the omaha world herald today, lamenting that the outbreak in grand island nebraska, which is the states Third Largest city, grand island, nebraska, has a per capita case rate on par with hardhit states like louisiana and michigan. Michigan which now has the third highest death rate in the country. Theyve only got one hospital in grand island. Theyve got hundreds of cases in that community. 11 patients at that one hospital were on ventilators already, as of yesterday. But the state Health Director keeps saying that everything will be fine there. Theyre reporting that theyve got a beat on a few other ventilators they might be able to scare up from a few other places maybe for that one hospital. The local Health Director and the mayor of grand island, again this is the local Health Director, not the state Health Director who says everything is fine, the local Health Director and the mayor of grand island, nebraska, have asked the governor, please, for a stayathome order, shelter at home order, please, maybe even for just a couple of weeks so they can try to get their hands around this fastgrowing outbreak there. Governor ricketts in nebraska has told grand island no, they cant do that, because everythings fine. The governor of nebraska said today, quote, our plan is working. I dont know what the plan is exactly, but it apparently involves opening up the giant Nebraska Crossing mall, as of next week, theyre planning on reopening a big outlet mall next week, while they dont deal with this huge outbreak in the middle of the state thats already pretty well fullup, filled up the one hospital in that community. The Nebraska Hospital Association is up in arms about them planning to reopen this gigantic mall, saying doing that would quote pose a serious threat to the health of all nebraskaens, but governor ricketts is not listening to the Nebraska Hospital Association, hes got no plans to stop the opening of that big shopping center. Open it all back up. The real truth of whats going on in americas coronavirus outbreak is not something that you are going to find by listening to whatever is said into the podium at the White House Daily briefings. The real truth of whats going on in americas coronavirus epidemic isnt just on the coasts, and in the places that we know are the hardest hit already, like new york and new jersey. The real truth of whats happening in our country, where weve got 30,000 americans dead already, the real truth of it is right in the middle of our heartland now, too, some of the biggest worries weve got right now are right in the center of the country. And theyre also in those littlenoticed, lowprofile, Nursing Homes and care facilities, and rest homes, that are in every city, in every suburb, and every little town in the country, that are used to get nothing attention. Well, its all of our business now. Because thats where the most americans need the most help. Heads up. Eyes open. This is going to be a trying time. Heck, theyd come all the way out here just for a blurry photo of me. Oh, thats a good one. Wait, whats that . Thats just the lowbattery warning. Oh, alright. Now its all, check out my rv, and, lets go fourwheeling. Maybe theres a little part of me that wanted to be seen. Well, progressive helps people save when they bundle their home with their outdoor vehicles. So theyve got other things to do now, bigfoot. Wait, whatd you just call me . Bigfoot . My name is daryl. Subway is still serving the subs delicious subs made fresh and easy to get for takeout or delivery. And now, with our family takeout special, get a free footlong when you buy two. Instead of using aloe, or baby wipes, or powders, try the cooling, soothing relief or preparation h, because your derriere deserves expert care. Preparation h. Get comfortable with it. When you think of a bank, you think of people in a place. But when you have the chase mobile app, your bank can be virtually any place. So, when you get a check. You can deposit it from here. And you can see your transactions and check your balance from here. You can save for an emergency from here. 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Loaded with millions of marches and gloves, for illinois first responders, were told security was heightened out of an abundance of caution, some saying that there was concern the feds might somehow intercept this precious cargo. The state calling it a herculean task. The flight which began in shanghai, costing illinois taxpayers 888,000, according to these state receipts, saw its final leg take off from anchorage, alaska, a second flight with similar cargo, scheduled for next week. Dubbed by some as secret flights, to keep washington from muddying the pricey delivery. At 3 21 p. M. Local time a chartered fed ex flight landed at Ohare International airport in chicago yesterday carrying two dozen pallets of masks and gloves, ppe, bought by the state of illinois, brought to illinois, basically in stelgts mode stealth mode, so the federal government couldnt swoop in and try to seize the supplies, the reason theyre worried about is that is because the federal government has been doing that with shipments to other states. Illinois managed to land that plane full of supplies less than an hour after announcing the states highest single day death toll so far. Today illinois reported the highest single day rise in new confirmed cases. Governor jb pritzker announced what illinois parents and families have honestly been expecting to hear about the rest of their lost school year. Ive said time and time again, my decisions are hard ones but they will follow the science, and the science says our students cant go back to their normal routine. Therefore, i am suffereding in Person Learning in schools, for the remainder of the 20192020 school year. That announcement today affects two Million School kids across illinois, and illinois, theyve got a big epidemic. Theyve got hospitals struggling with surging patient loads and worrying outbreaks in Nursing Homes an other worrying outbreaks behind bars and like other midwestern states illinois has cases in an important Meat Packaging plant and Illinois State Officials Say the peak there is yet to come. Joining us now for the interview is a man who has a lot to do at the moment, jb pritzker, governor of the great state of illinois, i know youre incredibly busy right now, thank you for making time to talk with us. Thanks for having me on, rachel. Let me ask you how concerned you are about what you know is coming, in terms of apex patient loads and what youre expecting in terms of case number, and the resources that your state has to handle them. Youve obviously had to go to pretty extreme lengths to try to make sure that those pallets full of equipment landed safely and actually got to the right place in illinois, what are you most worried about in terms of scaling up to meet the challenge . Well, id remind you that we put our stayathome order in place, were actually second in the nation, to do so, and so we were in a very good position from the start in terms of bend can the curve, and weve seen a bending of the curve, so originally, you know, we had estimates of thousands and thousands of deaths, that would come to illinois, if we didnt put the stayathome order in place. An we believe that based on hospitalization numbers, based on upon even the new cases, even with the high of new cases today, that were reaching an apex. Its going to be a couple of weeks. But we have been preparing for some time now. So in addition to expanding hospital beds, at existing hospitals, i also contracted to build out mccormick place, our Convention Center in chicago, so that we would have plenty of space, 3,000 beds, in fact, for any overflow that might occur at our hospitals. Youve been pretty outspoken about your frustrations with the federal response and with what feels like the sort of random approach from the federal government toward individual states, in terms of what the federal government is willing to help with. Is that relationship getting any more rational over time . Are you seeing improvement at all from the federal government in terms of what theyre offering the states and what theyre willing to help with . Well, weve gotten a lot of terrific help from the army corps of engineers and the army, and fema and hhs on the ground, theyve really been very good to us, but the irrationality has come out of the white house, it is when they make promises from the white house directly to me and then dont deliver. Originally, they promised tens of thousands of tests. We never got those. Then they promised hundreds of thousands of ppe. We never got what we asked for. In fact, i got, i asked for 300,000 n95 masks, directly to the president , and his staff, and they said well deliver that, in fact, they said, in trump time. And then a few days later, 300,000 surgical masks arrived, as you know, those are very different things. So weve been very disappointed over time, about the promises, and the failure to deliver on those promises by the white house. Having said that, you should see what the army corps of engineers has done at mccormick place, and three other hospitals across the state, that weve been building out, to make sure that we have surge capacity. They really are heroes. They Work Together with our Union Laborers across the state. And im just so pleased and proud. And i am hopeful, very hopeful that well be able to manage the surge. Governor, let me ask you about Nursing Homes in your state. We are watching the federal government essentially abdicate any responsibility for overseeing or helping Nursing Homes but we are starting to see states innovate, just in the past week, weve seen the states of michigan and ohio put in place executive orders from their governors, among other things, requiring Nursing Homes to make public account of their cases, and or their death counts, in some cases other states are going further in terms of guaranteeing that all residents and staff at every nursing home can get tested at state expense. What are you doing in illinois . What are you doing specifically on the issue of illinois Nursing Homes publishing information about the case load that theyre dealing with . Well, let me start by saying that weve been on top of our Nursing Homes from very early on. Naefg, before our stay at, in fact, before our stayathome order was in place i was on the phone with governor inslee in washington, i was on the phone with Governor Cuomo in new york both of which have had terrible times with their Nursing Homes, to learn what went wrong and what should we be doing to get it right, and so from early on, we created a strike team, each nursing home where something has flared up, weve thrown that strike team on top of it, made sure that they have the proper ppe, that they know how to use the ppe, that they separate out the covidpositive patients from those who are negative, and make sure generally that weve clamped down on, with a quarantine. Now, we also closed down to visitors, very early on, and weve been taking temperatures, and generally checking the medical condition of all of the staff at those Nursing Homes, again from the middle of march. So those are the things that we did back then. Now, what were making sure we do, because im a big believer in transparency, i dont need an executive order to put this information up, in fact, over the weekend, were going to put every single nursing home and every single case, whether its staff or a nursing home resident, online, everybody will be able to take a look at it, but weve already known that data, and weve been looking at it internally to make sure that we take care of those staff and those patients. Youre going to put that, as of this weekend, youre going to start making that data public . Thats correct. Every nursing home in the state of illinois, and again, we know who they are, we know who the private owners are, and weve made sure that we have all of the right information, because weve been actually collecting that for some time, and looking at it ourselves, but now, we want to make sure that the public can see it, too. Im glad to hear it, sir. Governor jb pritzker of the great state of illinois, sir, youve got a lot on your plate with us this stay in touch us with, let us know if there are things going on in illinois that the country needs to know, and you want to talk about it here, we will have you back any time, sir. Thank you. Thanks, rachel. Much more ahead. Stay with us. St like your finge, your lips have a unique print and unique needs your lips are like no others, and need a lip routine thats just right for you chapstick has you covered chapstick. Put your lips first. Alice loves the scent of gain so much, she wished there was a way to make it last longer. Say hello to your fairy godmother alice. And longlasting gain scent beads. Part of the irresistible scent collection from gain yoat natures way, that startsn with quality ingredients. Like our sambucus made from elderberries grown and picked at their prime. Choose the way to quality immune support, choose natures way sambucus. Subway is still serving the subs delicious subs made fresh and easy to get for takeout or delivery. And now, with our family takeout special, get a free footlong when you buy two. Confident financial plans, calming financial plans, complete financial plans. Theyre all possible with a cfp® professional. Find yours at letsmakeaplan. Org. Hey, dr. Sampson, emergency medicine physician our volume i thought was going down but realized we were on divert which means we were filled to capacity at the hospital and not accepting any patients at this time. But i went off of divert today, and the volume was spiked again. We had about 20 patients today, all very, very, very, very sick, multiple code blues called. Lost one patient here in the Emergency Department today that passed away, and most of the people that were seeing now again, were seeing an older population of people, some nursing home patients now as well, so if you have family members or friends in the nursing home, you want to check on them as well to make sure theyre okay and the message to young people is to make sure that you keep the physical social distancing going. Its very important, because you can be carriers of this virus. And do you not want to spread it. It is so imperative at this time right now, that we stay the course, and do not gather, in order to prevent, prevent reexpansion of this virus. Again, people are dying. This is real. This is happening. And we will get there, we will guest past this moment, we just have to stay the course. I do have an update which is that today was meaningfully different than shifts in the last couple of weeks. Dy not pronounce a single patient dead today. As opposed to the last few weeks, where its been multiple people per shift. I still have many patients today come in very ill and while not through deaths door, definitely knocking on, it so were still having those conversations with patients, and with families, about end of life wishes, round the clock, so while no one died today, this is still very much a threat, and still very much with us, and part of our society, but positive news. One emergency medicine physician in new jersey, saying he thought the volume was going down, but then he realized he was on divert status, so their patients were going to other hospital, once they took themselves off divert status, the vom came right back up. And the new york physicians saying while things are still bad, there are good signs. New york continues to lap all other states in terms of the toll of this virus. But there have been signs of improvement. New infection, new hospitalization, icu bed usage, all down. Thats good. But still, the death toll is coming out of new york state every day, huge, more than 600 deaths in the last 24 hours alone, and that has been true every day this week. Last week, we heard from an emergency room physician, one of the hardest hit hospitals in new york, dr. Ernest patti, at st. Barnabus hospital in the bronx. Here he was a week ago tonight. The battle continues. The end of another shift. We still have a large number of people intubated down here. I believe there are 13 intubated. And about five or six on cpap. As you heard him there, dr. Paatti sort of fighting to be heard over the background noise in the icu, in the e. R. , not your garden variety hospital background noise, thats the sound of multiple patients being mechanically kept alive. Thats the sound of more than a dozen ventilators being used. Well, today, we heard from dr. Patti again, with an update on the situation for him at st. Barnabus. Today is friday, april 17th, the first thing you notice is the noise level is much less than last friday. Significantly decreased. I have to say the hospital is still full and still running at max capacity, but the Emergency Department is definitely a little less congested. Lets hope it stays this way. Ill report at the end of the shift. Stay safe. Stay healthy. Stay strong. Dr. Patti recorded that today, just before he started his shift, as you heard there, he promised to update us when his shift was over. His shift has just ended and hes going to join us live next. Its totally normal to have constipation with belly pain, straining, and bloating, again and again. No way. More exercise. More water. And more fiber is the only way to manage it. Is it . Maybe you think. Its occasional constipation. Maybe its not. It could be a chronic medical condition called ibsc, and time to say yesss to linzess. Linzess works differently than laxatives. It helps relieve belly pain and lets you have more frequent and complete bowel movements. Do not give linzess to children less than six and it should not be given to children six to less than 18, it may harm them. Do not take linzess if you have a bowel blockage. Get immediate help if you develop unusual or severe stomach pain, especially with bloody or black stools. The most common side effect is diarrhea, sometimes severe. If its severe, stop taking linzess and call your doctor right away. Other side effects include gas, stomach area pain, and swelling. Change your thinking to ibsc. If your constipation and belly pain keeps coming back, tell your doctor and say yesss to linzess. Subway is still serving the subs delicious subs made fresh tell your doctor and easy to get for takeout or delivery. And now, with our family takeout special, get a free footlong when you buy two. Joinings now because he said yes to coming back and ive been happy about it all day is dr. Er ne earnest patty. Dr. Patty, i appreciate you coming back a week after we last spoke. Thank you so much. My pleasure, rachel. Thank you for having me back on. I appreciate it. Weve been watching some of the met tricks kind of turn in the right direction in new york, but you said today at the start of your shirt that st. Barnabis is still full at capacity. Are things different this week compared to last week . I definitely felt that way during the week, rachel. When i came in for my shifts in the middle of the week, we were on divert status for a bit and seem to be decompressing the Emergency Department. You spoke to one of my colleagues yesterday or your msnbc did, forgive me and he had mentioned that the ic us still running at max capacity. It is. But ive noticed today that the volume coming in has slightly decreased. I didnt pronounce anybody today, which was wonderful, and i didnt have to put we didnt have to put very many people on ventilators today. It was actually a day where we felt maybe we were plateauing out a bit, and were very optimistic. We still have are getting sick patients in because i had a number of sick folks but not to the extent that i reported to you last friday. Im so glad to hear you say it, although, i reck nieognize situation is still incredibly taxing. By the time they get to you in the e. R. , i know people are in trouble. They dont end up there by accident. But with this incredible volume of patients that you and your colleagues have seen, do you feel like youve learned anything in terms of how to maximize patient outcomes, how to of timmize who will happen to the patients over time . We have learned a number of things. We learned, you know, there was a lot of information being sent back askand forth from institut to institution. Trying to, you know, give colleagues a hence or helpful way to approach the patients. A lot of it revolved around ppe and creative ways to use it and, you know, and reuse it. Others, though, death with the way in which we actually treated these folks, as far as how much oxygen to put them on, what goals to set our oxygen levels at and those things have been helpful. Weve learned about giving fluids through iv, how much, how little and how to approach the process as folks come in. Its a steep learning curve for us. We learned a tremendous amount. What we do know is, though, that the folks who come in that have lots of comoore brbid diditiec preexisting conditions like obesity, diabetediabetes, they be more challenging because they present more problems in addition to having the covid19 infections. Yes, were learning a lot. Every day im learning something. Im a lifelong student, rachel. Well, your position on the learning curve is going to be a position of incredible power and is going to be an incredible asset to medicine. I feel like you and your colleagues seeing the number of patients that youve seen, seeing the volume that youve seen when other places in the country, i was just talking with the governor of illinois a moment ago, when other cities have patient apexes, i feel like you and your colleagues will have so much to offer in terms of best practices. Does the system of medicine and emergency medicine work where you can share this with your colleagues around the country . Definitely. All of us, i know many of my colleagues that i work with, remember, i told you its a team sport, emergency medicine and the team doesnt just necessarily live within the four walls of your hospital. The teams lie in the greater good for the united states. I mean, we all are in communication with our different medical societies and groups and circle of friends and we definitely share the information. Its been a really, really amazing experience. You know, i do have to tell you, though, we did get a bit of bad news and when i was talking to some of my senior members of the hospital, as well, we actually did lose so far four Staff Members at our hospital in addition to the doctor we mentioned last week. Its been a battle for us where weve done a lot of, you know, leaning on a lot on each other, leaning on each other because many of us knew all of these Staff Members quite well. Like i said, were a big family at st. Barnabis or as i affecti affectionally refer to it as the barn. Dr. Patti, sorry for your loss and thankful for your sacrifice. Thank you for your time tonight, sir. Its my pleasure. Everyone should please remember to practice social distancing, check in on all your relatives and loved ones and really, really practice good hygiene, its super important. One day ill tell you a funny story growing up with my kids. I noticed hygiene was decreasing years ago and now were paying the price. I will have you back to tell that story. Thank you, dr. Patti. Appreciate it. Well be right back. Thank you. Discomfort back there . Instead of using aloe, or baby wipes, or powders, try the cooling, soothing relief or preparation h, because your derriere deserves expert care. Preparation h. Get comfortable with it. When you think of a bank, you think of people in a place. But when you have the chase mobile app, your bank can be virtually any place. So, when you get a check. You can deposit it from here. And you can see your transactions and check your balance from here. You can save for an emergency from here. Or pay bills from here. So when someone asks you, wheres your bank . You can tell them heres my bank. Or heres my bank. Or, heres my bank. Because if you download and use the chase mobile app, your bank is virtually any place. Visit chase. Com mobile. Thats going to do it for us tonight. Time for the last word with ali filling in for lawrence tonight. Good evening, rachel. Have a great weekend. See you monday. Just ahead is the president trying to quote incite division in the midst of a growing pandemic. Thats what democrats believe