Transcripts For MSNBCW The Rachel Maddow Show 20200419

Was hoping. But since then, the numbers have been back up over 2,000 deaths each day for tuesday this week, wednesday, thursday, and now for today as well. It is 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. By 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 is slowing in its rise. The number of people hospitalized is falling. The number of people in icu beds is falling. But still the death toll is sky high 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, 630 today. Those numbers, its been above 600, 700 for all 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 frontline intensive care doctors who has been serving in a bullseye new york city hospital, st. Barnabas. Dr. Ernest patti we spoke to last week, you might remember, about the condition in his incredibly hardhit icu at st. Barnabas. Were going to check back in with dr. Patti tonight live 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. You know, its 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 were 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 new infections, their new hospitalizations, their icu utilization numbers starting to go down. But even as italy turned the corner on those numbers 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 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, and we are over 30,000 americans dead. And the worst hit 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 1,400 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 its 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 end, 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 on this show a lot over 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 weve been talking about it in recent days, and thats the issue of Nursing Homes and longterm care facilities, which as you know has robbed me of my ability to sleep for 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 need 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 as there has been to the hospitals and to 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 being tested, treated, and either saved or not, right . 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 as of this week, new yorks governor is breaking out the number of 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 among their residents from coronavirus. I dont know if you saw this today. 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 . Theres no reason this information should be secret. I mean just as individual states, counties, cities, hospitals, 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 you 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 it 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 residents 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 dont know about. But now we know about a lot of them in new york because new york state has started publishing individualized facility data. So we know, for example, today in cobble hill, brooklyn, this facility has had 55 of its residents die. In these two facilities in the bronx, the one on the left has had 45 of its residents die. The one on the right has had 35 of its residents die. In this manhattan nursing home on the left, 31 residents have died. In this Staten Island home on the right, they have lost 44 souls. Heres four facilities in queens. New figures released by new york state today say that 148 americans have died in these four facilities. 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, thats listed in new york states data today as having 26 of its residents die. But an article that appeared in the New York Times today 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. Its not 26. Its 29. The times also spoke to two workers at that facility who spoke with the times on the condition of anonymity because they didnt want to lose their jobs. Those workers told the times they believe the real death toll just at 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 its more like 60. And it is its own problem, not just something to lament, but literally something to fix. It is something that needs to be fixed that we dont know the real count at that facility or at 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 be worried about your liability. This is the time to stop the body count by being public about your trouble 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 of coronavirus in Nursing Homes so far. But the times acknowledges, as does everybody who has tried to do these counts, usa today has done a count, a. P. Has done a count. That thats probably a huge undercount because some states, some counties, some facilities just arent reporting their deaths, which is astonishing, but it needs to be fixed. We need to have real data, real numbers because americans just cant be allowed to die in large numbers in secret, unknown, and therefore unlamented. I mean were a fricking first world country last i checked. 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 is still absolutely useless on this score. But Ohio Republican Governor Mike Dewine this week signed an executive order to mandate public reporting by facilities in his state. Good. Same thing from democratic michigan governor gretchen whitmer, we would spoke with last night on this show. That executive order in michigan, good. New york as we just showed you is 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, its 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 crisis at all. But 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 try to emulate those best practices and so well try to track them as they develop it. 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, they are 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 words that will get somebody into heaven someday if they are not empty words and they signify a real change. 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 Facility task force, okay . Call it whatever you want. Theyve got somebody working on the problem. They broke the state into 11 regions. Each region has reportedly been assigned an epidemiologist, a dedicated nursing team, and longterm care consultants. Those teams will each be responsible in each of their 11 regions for getting testing at each facility in their part of the state. The oklahoma newspaper reports today that those teams will also 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 they are pointing 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 today quotes the person in charge of the states ppe supply saying that 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 that are at risk in these facilities. As the states start to pick it up, other states should feel pressure to start doing what the wellrun states are doing, reporting that information, making it public, making exceptions to your previous rules to make that information public and then committing to get help to those places. Use the National Guard if you need to. Use National Guard medics if you if you called up your medical corps and asked recently retired people to come into the field, one place you could be using this is to uplift longterm care facilities, to staff them up, to shore them up, to help them develop better Infection Control facilities and the other things theyre going to need to surge the mejd care theyre able to provide to their residents. Do it. All right. So watch that. The other place to keep your eyes on now, and watch this over the weekend 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 work in 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 places. And weve got a cluster of three states where that is happening right now that you should keep an eye on. One of them, south dakota. One of the Fastest Growing 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 in place a stayathome order just for his city. The south dakota situation here with the largest known cluster in the country, its just like watching a slow motion train wreck. Nearly 800 known cases at that one plant. It was 250 at the start of the week. We are told reliably that they still have not tested everyone who works at that plant. Theres no stayathome order. The local paper, the argus leader, is running a running tally every day now of all the new workplaces in and around sioux falls that have decided to shut themselves down or have otherwise reported that they too have coronavirus cases among their workers. Thats because everybodys 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 rapidly increasing caseloads in the country. The entire state of south dakota has a grand total of 2,300 hospital beds. The governor, though, is unperturbed. We do have a hot spot in sioux falls. I think everybody is well aware of that, and people are talking about that. I also want to give you a little bit of perspective on this situation. I know that the National News is talking about the fact that this is a hot spot in the nation. You know, 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. Yes, 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 about what appears to be a new burgeoning outbreak at a Meat Processing plant in waterloo, iowa. Several Meat Processing plants in iowa have already closed. The one in waterloo, though, is open. The local mayor in waterloo has asked for the plant to be closed. Workers at the plant say they were only even told to cover their faces at work as of tuesday of this week. The governor is repeatedly now acknowledging what looks like an outbreak at that plant there, but the plant for now is staying open. Worryingly, the governor keeps saying publicly at her 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 worldherald 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 bead on a few other ventilators they might be able to scare up from 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 for just a couple of weeks so they could 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. Governor ricketts 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 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 nebraskans. But Governor Pete 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 little noticed, lowprofile Nursing Homes and care facilities and rest homes that are in every city and every suburb and every little town in the country that are used to getting no 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. How about no no uh uh, no way come on, no no nnnnono only discover has no annual fee on any card. From fires and hurricanes in 90 years at farmers we thought wed seen it all. Nnnnono to animal antics we could laugh about later. But we havent seen this. So, farmers is reducing auto premiums by 25 , extending payment due dates, and expanding coverage for the delivery drivers who are carrying us through. And then well do the next thing, and the thing after that, until this is another thing weve seen and done. 450degree oven, to box, to you, know that from our its our policy that your pizza is never touched once it comes out of the oven. And were taking extra steps, like no contact delivery, to ensure it. Now more than ever, we need the good stuff in life. Togetherness, patience, laughter, love. Milk. Love whats real. Its a voice on the other end of the phone. A note to say youre on our mind. A willingness to come to you. The world and how we interact with each other is changing. But that will never change who we are at lexus. Now, more than ever, you and your needs come first. Find out what Service Options are available in your area at lexus. Com people first four minutes ahead of schedule, flight 9738 from china couldnt get to illinois fast enough. Loaded with millions of masks and gloves for illinois First Responders, were told security was heightened out of an abundance of caution, some saying there was concern the feds may 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 fedex 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 stealth mode so the federal government couldnt swoop in and try to seize those supplies. The reason to worry about 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 singleday death toll so far. Today, it reported the highest single day race in new cases. Governor j. B. Pritzker announced what illinois parents and families have 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 suspending inperson learning in schools for the remainder of the 20192020 school year. That announcement today affects 2 Million School kids across illinois. In illinois, theyve got a big epidemic. Theyve got very worrying outbreaks in Nursing Homes and other worrying outbreaks behind bars. Now like other midwestern states, illinois has multiple cases at an important Meat Packaging plant. 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. J. B. Pritzker is governor of the great state of illinois. Sir, i know that you are 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 are about what you know is coming in terms of apex patient loads and what youre expecting in terms of case numbers 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 we were actually second in the nation to do so. So we were in a very good position from the start in terms of bending 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 stay at home in place. And we believe that based upon hospitalization numbers, based 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. Its 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 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 in 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 caseload that theyre dealing with . Well, let me start by saying that weve been on top of our Nursing Homes from very early on. 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, make sthur 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 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. But 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 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 j. B. Pritzker of the great state of illinois. Sir, youve got a lot on your plate with this. Stay in touch with us. Let us know if theres things going on in illinois that the country needs to know, if you want to talk about it here, well have you back anytime, sir. Thank you. Thanks, rachel. All right. Much more ahead here. Stay with us. 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Use caution driving or operating machinery. Tell your doctor if youve had Mental Health problems. The most common side effect is nausea. Talk to your doctor about chantix. The most common side effect is nausea. This virus is testing all of us. And its testing the people on the front lines of this fight most of all. So abbott is getting new tests into their hands, delivering the critical results they need. And until this fight is over, we. Will. Never. Quit. Because they never quit. Hey, dr. Sampson davis, emergency medicine physician. Our volume, i thought was going down but realized we were on divert, which means that we were filled to capacity in the hospital and not accepting any patients at this time. But we went off of divert today and had a spike 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 im seeing now again, were seeing the older population of people. Some nursing home patients now as well. So if you have family members or friends in a nursing home, you want to check on them as well to make sure that theyre okay. The message to the 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. So you do not want to spread it. Its just so imperative at this time right now that we stay the course and do not gather in order to prevent reexpansion of this virus. Again, you know, people are dying. This is real. This is happening, and we will get there. We will get 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 weeks. I did not pronounce a single patient dead today as opposed to the last few weeks where its been multiple people per shift. I still had 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, so. One emergency medicine physician in new jersey saying he thought the volume was going down but then he realized they were on divert status, so their patients were going to other hospitals. Once they took themselves off divert status, the volume came right back up. The new york physician saying that while things are still bad, there are some 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 infections, new hospitalizations, icu bed usage all down. Thats good. But still the death tolls coming out of the new york state every day are 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 in one of the hardest hit hospitals in new york, dr. Ernest patti at st. Barnabas hospital in the bronx. Here he was a week ago tonight. Well, the battle continues. The end of another shift. We still have a large number of people intubated down here. I believe theres 13 intubated and about five or six on cpap. As you heard him there, dr. Patti sort of fighting to be heard over the background noise in the icu, in the e. R. , not your gardenvariety hospital background noise, right . 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. Barnabas. 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. Come on, no no nnnnono only discover has no annual fee on any card. Subut when we realized she wasn hebattling sensitive skin, nnnnono we switched to new tide plus downy free. Its gentle on her skin, and dermatologist recommended. New tide pods plus downy free. Safe for sensitive skin with eczema and psoriasis. Who knows where that button is . I dont have silent. Everyone does right up here. It happens to all of us. We buy a new home, and we turn into our parents. What i do is help new homeowners overcome this. What is that, an adjustable spanner . Good choice, steve. Okay, dont forget youre not assisting him. You hired him. If you have nowhere to sit, you have too many. Who else reads books about submarines . My dad. Yeah. Oh, those are progressive cant protect you from becoming your parents, but we can protect your home and auto when you bundle with us. Look at that. This is hals heart. Its been broken. And put back together. This is also hals heart. And his relief, knowing hes covered by blue cross blue shield. And this is our promise, with over 80 years of healthcare expertise to be here for you now. And always. This is medicare from blue cross blue shield. This is the benefit of blue. This is medicare from blue cross blue shield. We do things differently and aother money managers, dont understand why. Because our way works great for us but not for your clients. Thats why were a fiduciary, obligated to put clients first. So, what do you provide . Cookie cutter portfolios . Nope. We tailor portfolios to our clients needs. But you do sell investments that earn you high commissions, right . We dont have those. So, whats in it for you . Our fees are structured so we do better when our clients do better. At Fisher Investments were clearly different. Working on the front lines, and heres one small way that you can help them in return. Complete your 2020 census today. 2020 census data helps communities plan funding for hospitals, clinics, and Emergency Services across the country. An accurate count helps Public Health officials know who is at risk, and First Responders identify the resources they need to protect our communities. Complete your census at 2020census. Gov and help shape our future. Joining us now, because he said yes to coming back and i have been happy about it all day is dr. Ernest patty. I really appreciate you coming back a week after we last spoke. Thank you so much. My pleasure. Thank you for having me back on. I appreciate it. We have been watching some of the metrics kind of turn in the right direction in new york writ large. But you said today at the start of your shift that st. Barnabas is still full, still at capacity. Are things different this week compared to last week . Well, i definitely felt that way during the week. When i came in for my shifts during the week, we happened to be on divert status as well for a bit and seemed to be decompressing the Emergency Department you spoke to one of my colleagues yesterday, or msnbc did, forgive me, and he mentioned the icu is running at max capacity. It is, but i noticed today the volume coming in is slightly decrease. I didnt pronounce anybody today, which was wonderful, and we didnt have to put very many people on ventilators today. It was actually a day where we felt we were plateauing out a little bit and were very optimistic. We still are getting sick patients in. Because i still had a number of sick folks, but not to the extent i reported to you last friday. Im so glad to hear you say it, although i recognize the situation is still incredibly taxing. Is anything improving in terms of patient prospects. By the time they get to you in the er do you feel like you learned anything in terms of how to maximize patient outcomes, how to optimize whats going to happen in term of outcomes for the patients othver time . We have learned things. We learned there was a lot of information being sent back and forth from institution to institution, trying to give colleagues hints or helpful ways to approach the patients. A lot of it revolved around ppe and creative ways to use it and reuse it. Others, though, dealt 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 oxygenation levels at and a lot of those things have been helpful. Weve learned about giving fluids, how much to give, how lit toll give and how to approach the process when folks come in. Its definitely been a steep learning curve for us. We have learned a tremendous amount. What we do know is the folks who come in who have lots of comorbidities, meaning other illnesses like copd, cardio pull mononary issues, obesity, those folks tend to be more challenging because they present other problems in addition to having to covid19 infections. So, yes, were learning a lot. Every day im learning something. Im a life long student, rachel. Your position on the learning curve is going to be a position of incredible power and an incredible asset to medicine. You and your colleagues seeing the number of patients you have seen, seeing the volume you have seen i was just talk to the mayor in illinois. When other place haves apexes i feel like you and your colleagues will have much to offer. Will you be able to share this with your colleagues around the country . Definitely. We are all of us many of my colleagues i work with remember i told you its a team sport in medicine. The team sport doesnt necessarily live within the four walls of your hospital. The teams lie in the greater good for the united states. 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. So its been a battle for us where weve done a lot of, you know, leaning on a lot of each other, were 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. Barnabas or as i affection natalie refer to it, the barn. Its been a challenge. Dr. Patty, senior medical physician at st. Barnabas in the bronx. Thavgful for your time. Thanks for having me. Everyone please remember to practice social distancing. Check in on all your relatives and loved ones and practice good hygiene. Its super important. One day ill tell you awe funny story about growing up with my kids. I noticed hygiene was decreasing years ago in the general public. I will have you back to tell that story. Thank you. Appreciate it. Well be right back. Stay with us. Stay with us [ piano playing ] oh. Oh, darn wha let me help. Lift and push and push there. Its up there. Hey joshie. Wrinkles send the wrong message. Help prevent them before they start with downy wrinkleguard. Than Rheumatoid Arthritis or Psoriatic Arthritis. When considering another treatment, ask about xeljanz xr, a oncedaily pill for adults with moderate to severe Rheumatoid Arthritis or active Psoriatic Arthritis for whom methotrexate did not work well enough. It can reduce pain, swelling, and significantly improve physical function. Xeljanz can lower your ability to fight infections like tb; dont start xeljanz if you have an infection. Taking a higher than recommended dose of xeljanz for ra can increase risk of death. Serious, sometimes fatal infections, cancers including lymphoma, and blood clots have happened. As have tears in the stomach or intestines, serious allergic reactions, and changes in lab results. Tell your doctor if youve been somewhere fungal infections are common, or if youve had tb, hepatitis b or c, or are prone to infections. Dont let another morning go by without asking your doctor about xeljanz xr. Thats going to do it for us tonight. Welcome to christmas in rock feller center. Open your shopping bags. Brunk goodies. They say we dont appreciate things in life until theyre gone. Three, two, one. Cheers to 2020 maybe they should really say, we dont appre w