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Erin Burnett Outfront

Top Doc On WH Goal For Each State To Test At Least Two Percent Of Its Residents; Trump Refuses To Take Responsibility For Spike In Calls To Poison Control Centers After His Disinfectant Comment; Trump Defends Azar: "A Lot Of People Didn't Get That Right"; Texas Gov Will Allow Some Businesses To Reopen Friday; WHO: Not Enough Research Yet To Determine Immunity; Doctors: Virus Is Causing Sudden Strokes In Some Young Adults. Aired 8-9p ET

Aired April 27, 2020 - 20:00   ET

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

[20:00:00]

ERIN BURNETT, CNN HOST: The President trying to paint the United States as a global leader on coronavirus testing, but according to a White House official, the goal is to help each state reach the ability to test at least two percent of it's residents over a month.

I just spoke to the director of the Harvard Global Health Institute, Dr. Ashish Jha, he said at that rate it would take four years to test every American. He says "at minimum, the administration needs to be doing at least double what it is doing now per day". The administration is now trying to shift the focus to testing after last Thursday's briefing where the President suggested injecting disinfectants into the body as a possible treatment.

Tonight the President was asked about the spike in people using disinfectants since he said.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I know you said they were sarcastic but do you think-

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I can't imagine why -- I can't imagine why, yes.

UNIDENTIFIED MALE: Do you take any responsibility --

TRUMP: No, I don't.

REPORTER: -- if someone were to die?

TRUMP: No, I can't imagine -- I can't imagine that.

(END VIDEO CLIP)

BURNETT: Well, he doesn't take responsibility, he can't imagine why Maryland, Tennessee, Illinois, Michigan all reporting an increase in poison control calls. Let's just remind everybody exactly what he said at that briefing.

(BEGIN VIDEO CLIP)

TRUMP: And then I see the disinfectant knocks it out in a minute -- one minute. And is there a way we can do something like that by injection inside or almost a cleaning?

(END VIDEO CLIP)

BURNETT: That dangerous and bizarre claim caused aides to try and convince the President to just back off the daily briefings. Just don't do them. But the President tonight was back at the podium. Jim Acosta's out front live in front of the White House. So, Jim, what are you learning about -

JIM ACOSTA, CNN CHIEF WHITE HOUSE CORRESPONDENT: Yes.

BURNETT: -- you know, I mean, the President right, he was saying these are not worth my time, I'm not doing these briefings and then he was back. So, what's behind this on-again, off-again situation?

ACOSTA: Erin, perhaps he just can't quit us, that may be one explanation. But I suspect that the explanation that makes the most sense is that the White House wanted to get this testing message across that they were trying to get a handle on testing for the coronavirus across the country. But even during this press conference, Erin, you heard the President at one point say "testing is not going to be a problem at all" as they were laying out this testing blueprint for the country.

But Erin, back on March the 6th, the President said "anybody that wants a test can get a test" -- those were his words. The administration never met that test, they fell millions of tests behind where they expected to be and even in this blueprint for testing for the coronavirus that they laid out this evening in the rose garden at one point in the documents given out to us by the White House, it describes the Federal government as being quote "the supplier of last resort" when it comes to testing materials.

And so, there is some -- a burden shifting going on the administration wants the burden to be shifted over to the states. But if you look at what a recent Harvard study just concluded in just the last couple of days Erin, it shows that more than half of the states across the country have to step up their testing in order to be able to safely relax their stay at home orders.

Yes, you heard the President take some questions tonight, he was asked as you mentioned, just a few moments ago about that bizarre suggestion that American's could inject themselves with disinfectants to fight off the coronavirus and he said he didn't take any responsibility. But really, Erin he didn't answer many of the questions that were asked in the rose garden -- he was taking questions, he just wasn't answering them.

But in terms of the press conference that we saw take place in the rose garden today, first the White House was saying they weren't going to have -- they were going to have a press conference, then they changed this morning to say they weren't going to have a press conference and then finally they said that they would have a press conference. It's sort of a haphazard communications strategy over here which is kind of baffling given that you saw this important message that they wanted to get across this evening.

But I think perhaps the best explanation as to why the President held this news conference was summed up by a Trump advisor I spoke with earlier today who said he just can't give up this captive audience that he has every evening between 5 and 7 o'clock. He knows people are going to be tuning in and as we've seen many, many times, Erin, he has tweeted about these ratings, he is well aware people are watching, Erin.

BURNETT: Yes. He certainly has tweeted about that many times. All right, Jim, thank you.

ACOSTA: Yes.

BURNETT: I want to bring in David Gergen, Dr. Leana Wen, an emergency room physician and the former Baltimore city health commissioner and John King. All right. Thanks to all, so, David, let me start with you. The President tweeting --

DAVID GERGEN, CNN SENIOR POLITICAL ANALYST: Sure.

BURNETT: -- this weekend that these briefings were quote "not worth his time and effort". That of course, didn't last, he was back out today. We do know some of his allies though have been urging him to cut back, right. Nobody -- they just don't see things like that disinfectant doing anything good for him.

GERGEN: They're right.

BURNETT: What do you make of what we saw this evening?

GERGEN: Listen, I think it's a form of addiction -- addictions are hard to give up. But beyond that, I do think that Acosta was right, and that is they wanted to get the message out about their testing plans. They finally have a plan, the Governor has been looking for that. But the testing plan as you (inaudible) has been so inadequate that I think it's winding up to be a negative as well. Dr. Jah from Harvard, well-respected, has pointed out, listen, if they're bragging because the moved from 150,000 tests to 200,000 tests a week.

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What we need -- a minimum is 500,000, and that's the bottom of the spectrum. That's the minimum, minimum, minimum we can get. I think overall, it's just astonishing how they keep bragging about what they're doing when the president -- when the country has just suffered one of the worst months in American history.

As you report, almost 56,000 died, more than that this past month, more than we lost in Vietnam. That's what we're heading. We have another 26 million Americans who are unemployed. That's nothing to be bragging about. That's something to be sort of trying to unify the country, which again, he's not doing.

BURNETT: Dr. Wen, I want to just, you know -- is the point that David says, you know, sort of astonishing -- what is your make -- your take on this testing? You know, Dr. Jah was just saying that, you know, OK, you went from 150 to 200. That's directionally good. That's good. But it's not a good absolute number.

He's saying you need to be at 500 and he's like, "And a lot of people are saying I'm extremely conservative, and I acknowledge that I am extremely conservative with 500, 500 is probably too low." But they are bragging about 200.

DR. LEANA WEN, FORMER BALTIMORE CITY HEALTH COMMISSIONER: Yes. We've been behind on testing this entire time, and that's the reason actually why we had to close everything down because we don't know exactly where all these cases are in the country. So, we had to use this blunt instrument which is what social distancing is. Now, the time that we can remove that blunt instrument and go back to tracing each individual case is if we could be sure of our numbers. And we're nowhere near that.

And we're still nowhere near that with the administration's new plan. So, I am really worried. I mean, I'm worried that they're still not acknowledging why widespread testing is needed and what levels that we need to be. They are also not acknowledging the role of the federal government. I mean, it just doesn't make sense for there not to be a national coordinated effort at this point.

And I hope that the administration is going to spend more time going forward on -- not on justifying why more tests aren't needed, but instead on what they're going to be doing to help states, and particularly those on the front lines, patients and doctors, to get these results.

BURNETT: All right. And they're saying they're the supplier of last resort -- that that's the role they want to be: last resort, not first go-to.

So, John King, you know, the president out there talking about testing -- also, you know, it came up sort of the person who used to be there who is not there anymore when it comes to the briefings, would be the health and human services secretary Alex Azar. Right? Early on, you know, he was sort of the main player. Early, he was in charge of the task force for a brief while -- downplayed the impact of the virus at least publicly, similar to what the president did.

The president was asked about Azar today. Here's what he said.

(BEGIN VIDEO CLIP)

TRUMP: I think it's a very unfair question because you have many great professionals, some of them you have great respect for. And you have many people in the other party. You mention Alex Azar. But you have many people in the other party that have said the same thing and with even more confidence. So, a lot of people didn't get that right.

I was very fortunate, whether it was through luck or whatever, that we closed the border. We put a ban on China.

(END VIDEO CLIP)

BURNETT: Obviously, 40,000 people came through after that ban. But, you know, what's your reaction to that, John?

JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT: Well, he's right. Other politicians in both parties did underestimate this at the beginning. And their constituents have every right to ask them questions about this and hold them accountable. They have every right. He is the president of the United States. He has access to more intelligence, more experts, more global intelligence than any person on planet Earth.

Secretary Azar did underestimate. The president did put that travel ban on China. As you noted, it had some loopholes. But the president also said in late January to CNBC, "No, this will not be a pandemic." He said after that, "We're at 15 cases, we'll soon be down to zero."

I could go on for an hour for all the things that February -- the president said in late January and early February that proved he was either underestimating or refusing to take seriously or at least refusing to publicly acknowledge that in his re-election year there might be a big, global and national crisis. And, so the president, you know, yes, he did the China ban. And he wasted February otherwise.

One other quick point about the testing thing, Erin: these briefings are kind of surreal. Did you hear anything today in the presentation that you haven't heard from Dr. Wen for the last month, that you haven't heard every time you've talked to a mayor, every time you've talked to a governor? They have been screaming for this help.

Then the White House comes out today with this briefing, and if it's the only thing you watch -- if you hadn't watched anything else or listened for the last month, you'd say, "Oh, wow, look at that, a plan." It tracks everything the governors, the mayors, the public health officials have been screaming for, for months.

The issue is there's often a difference between the show of the White House and then the tell. The tell is what those mayors, what Dr. Wen, what the other experts tell us after the fact. Let's hope this time a week from now we're saying, "Hey, wow, the governors are saying this time it works, this time, they're getting us the supplies, we have a problem, they're answering."

But that simply hasn't been the case in the past.

BURNETT: And Dr. Wen, over the weekend, Dr. Birx said on "meet the press," quote, "We have to realize that we have to have a breakthrough innovation in testing."

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And, you know -- again, Dr Jah was -- was talking about that and saying -- well, he sort of interpreted that as she's hoping on innovation because she's basically realized that this administration isn't capable of doing what is needed on testing. Do you think that -- that -- that really was that sort of an admission from Dr Birx?

WEN: I don't know what her true intention was but it sounded like it was justifying why we're not producing enough of the tests that we do have. I mean, we do have the ability to produce existing tests, these -- this antigen tests that she's talking about, it might be a breakthrough but look, there are tests that we need to be doing right now. People need to know if I have symptoms of COVID-19, do I have this disease or not?

Currently, we're not able to give every patient who wants to know that answer and we're not able to test asymptomatic people. We know that asymptomatic transmission is a big issue but we're not able to test people and find out what is the true rate of COVID-19 in the communities where they live. Those are existing tests. We don't need to wait for a breakthrough in order to manufacture more of these tests. We just have to have the political will and the determination for the national government, from our Federal Government, in order to do that.

BURNETT: And -- and you know, and I guess, to your point, even, you know, in New Jersey, one of the main testing centers, it still says, "No symptoms, no test". Certainly, the State of New Jersey doesn't want that there in that situation because we don't have the number of tests to provide asymptomatic random testing.

So John King, is this what we're going to -- we're going to continue to see from the President? And by the way, I should note, not only was the briefing on and then off and then on, but he didn't do it in the briefing room, he did it in the -- in the more formal rose garden, right where he wanted to give a chance for those CEO's again to, you know, to sort of tout -- tout them and their relationships with him.

KING: Right, we have seen the tension inside the briefing room. He often has tension, whether it's with Dr Birx, even more so with Dr Fauci, where they say one thing, the President disagrees or the President says something and they have to disagree. Look, the President has a very healthy ego to put it mildly. David has worked with several presidents. That's part of the trade, every president has a big ego, every -- every politician has a big ego. But for this president, he -- what -- how did he -- what did he do today?

He changed the script so that a parade of CEO's could walk up to the microphone and tell him how great he is. So that is the most important thing to the President of the United States in a middle of pandemic, as David just noted, we are at Vietnam level numbers in terms of the deaths. 50,000 plus just this month.

This is the month the President of the United States in late February said it would go away when it got warmer, it would be gone, in theory. And the most important thing to him today was to prove to the press, "Yeah, I'll still come out even though I said it'd be a waste of time but first, I'm going to have a parade of people come up and tell me how great I am."

BURNETT: Right, thank you all very --

GERGEN: Could you imagine --

BURNETT: Yes, thank you all very much. And next, the Governor of Texas saying he will allow the State to begin reopening this week and the number of Coronavirus cases, of course, is still on the rise in Texas. So is that move going to be the right thing or too fast? We're going to talk to a Dallas County official who says it is too fast.

Plus the World Health Organization warning antibodies don't necessarily mean complete immunity. So what do they mean? What is the value of -- of knowing you've had it? And President Trump says he says he knows the status of Kim Jong-Un's health. He said it today. So what is it?

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(COMMERCIAL BREAK)

BURNETT: New tonight, the Governor of Texas saying he will allow retails stores, malls, restaurants and movie theatres to open, but at 25 percent of capacity. This does come as the number of cases is still rising in Texas.

Ed Lavandera is out front in Dallas tonight, and Ed, health officials have warned of the risks of relaxing social distancing too soon. Some Texas medical experts, of course, say that the testing is not where it needs to be. But Governor Abbott thinks that this is the right time. What's the rationale he's put out?

ED LAVANDERA, CNN CORRESPONDENT: Well, look, the fact of the matter is the Governor is under a great deal of political pressure across the state to re-open the economy and you get a sense in hearing from a lot of state leaders that they expect some perhaps -- or are prepared for some up tick in the number of coronavirus cases here in this state.

We're standing in the middle of a parking lot of a popular movie theatre here in North-East Dallas, completely empty. And the governor says that places like this -- movie theatres, restaurants, malls and other retail stores will be allowed to re-open on Friday after the stay at home order is lifted on Thursday, but only at a 25 percent capacity. The Governor also says what is not included in this next phase of opening is hair salons, barbershops, gyms, that sort of thing -- and those won't be allowed perhaps to be re-opened until mid-May.

But as you mentioned, Erin, still a great deal of concern about the testing and the quality of testing that is being done here in Texas. State officials say that by early May, they expect to be doing 25 to 26 thousand coronavirus tests per day, but there's a lot of question as to whether or not that is enough at this point to really get this virus and to prevent another spike in cases breaking out here in this state.

And what is also interesting, Erin, is that a neighboring Louisiana, the Governor there, this afternoon also extended their stay at home order until mid-May, Erin.

BURNETT: All right. Ed, thank you very much. I want to go to Dallas County judge Clay Jenkins. And Judge, you voted, I know to extend Dallas County's stay at home order until May 15, you had 100 new cases just this morning, 31 hundred in total, 84 deaths.

You obviously think that the Governor is moving to fast by doing this more than two-weeks ahead of where you thought would be appropriate.

CLAY JENKINS, DALLAS COUNTY JUDGE: Well, yes, it's faster than I would like. And I think what I've done is I've taken that document that we didn't get a preview of and I've given that to the public health authority and he is meeting tonight with the heads of epidemiology and infectious disease or our local hospital systems and I'm waiting to hear them report back.

I think though what we know is that when you look at other science based plans, movie theatres are not one of the first things that's opened. And so, I think it's going to be incumbent on the residents here to use good smart decision making and just because something can be open, doesn't mean it should be open and just because something is open, doesn't mean you should go there.

BURNETT: So how does this work? I mean, obviously the governor has the ultimate authority in the state, right. So, you may not agree but it supersedes. So, they can open if they want.

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Twenty-five percent capacity. How does that even get enforced? I mean, how do you have that -- I mean, I guess in a movie theater, that would be easier to enforce than in a shopping mall frankly. I mean, how do you even do a 25 percent, and how do you enforce it?

JENKINS: Well, so, the governor says 25 percent, but then the ways that people go about achieving that in his open Texas book are completely voluntary and up to the business. We'll look at ways, we'll work with local businesses here and we'll look for rules that we can come up with so that the workers and the people that go to these places, if they go there, will be more safe.

But I think the question people have to ask themselves first is, given that most public health officials and scientists in the United States say it's not safe to go to a movie and places of substantial spread like we have here in Dallas and down in Houston, do you really need to go to a movie right now?

BURNETT: So, why do you think Governor Abbott did this right now? I mean, because I just want to make it clear, the White House model for -- that they keep citing for when things would reopen, the White House model itself says Texas should not relax social distancing until June 8th. So, they're not -- it's not as if, you know, the -- Governor Abbott is going with the White House model. Why do you think he is doing this now?

JENKINS: Well, I don't want to speculate on what's going through his mind. I'll tell you that what I'm doing, and what I hope others will do, is base it completely on the science. You know, we're not experts in science, we elected officials. We have to rely on the public health, infectious disease and

epidemiology experts that tell us what is the best way to keep you safe. Because job one is keeping you safe. And that's the best way we'll be able to open our economy and keep it open is to keep you safe.

BURNETT: So, what do you say to people in Dallas who are, you know, debating what to do? I mean, because, you know, there are some people, no matter where they are in this country -- but certainly this is how people -- some people are going to feel on Friday.

They're going to feel like the thing to do to help build their communities is to try to support those businesses that are reopening, right? But they don't want to do that if they're going to get sick or get anyone else sick. But there is going to be, you know, immense pressure from a patriotic point of view to try to support those businesses.

JENKINS: Well, the political decisions may change. But what you need to do is focus on the science and listen to what the public health experts say. And if the public health experts tell you something's not safe to do it, even if it's legal to do it and even if there's a business that will allow you to do it, don't do that.

And we have to realize that when we make these decisions, it has an impact on the rest of the community. So, the idea that those of us who want to stay home can and those of you who want to crowd into a restaurant can do that or a movie theater can do that.

The problem is that we all live very close to one another, and the decisions of one may have a very bad impact on another. And so, I think it's as I talked about early on, it's Operation Protect Nana and Grandpa. We've got to keep making those good decisions.

BURNETT: All right, thank you very much, Judge Jenkins. I appreciate your time.

JENKINS: Thank you, Erin.

BURNETT: On OutFront next, New York's governor is saying that almost a quarter of the people in New York City have the antibodies for Coronavirus. So, could that be right? I'm going to speak to the experts who have been studying this virus from the beginning.

And young Coronavirus patients with mild conditions suddenly suffering severe strokes. I'm going to speak to one expert studying this alarming reality. Why is it happening?

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(COMMERCIAL BREAK)

BURNETTOST: Tonight, the World Health Organization warning that antibodies don't necessarily mean immunity when it comes to Coronavirus. Officials from the WHO saying there is simply -- there just is not enough research yet to determine what the relationship between -- antibodies and immunity will be.

OUTFRONT now, two of this country's leading voices on epidemiology, Dr John Ioannidis, epidemiologist at Stanford University and Marc Lipsitch, epidemiologist at Harvard. And I appreciate both of your time, it's good to have you both back. So Dr Ioannidis, you know, you've been focused very closely on antibodies.

You've been involved in a study on them and I'll get to that in a few moments but do you fundamentally believe that the presence of antibodies does mean some level of immunity?

DR. JOHN IOANNIDIS, PROFESSOR OF MEDICINE, OF HEALTH RESEARCH AND POLICY (EPIDEMIOLOGY), STANFORD UNIVERSITY: Hi, Erin. I think that there's some level of immunity, yes. Perfect, certain immunity? No. Antibodies are like a surrogate marker.

They can tell you that most likely you have been exposed to this virus and there's a very good chance that you have immunity but many people probably have been exposed and may not have detectable antibodies and others may not have been developing antibodies for -- for other reasons and vice versa.

So it's a surrogate marker. It's good to use it to get a sense of how common the infection is in a given community, in a given location. I think it's early in the day to say that it can be used for individual decision-making and I would not say that we should use it as a passport of immunity for single individuals based on what we know so far.

BURNETT: Meaning you -- you get, you know, the antibodies, so you're good to go. You can go to the movie theatre because you've got nothing to worry about. You know, Marc, from your perspective, what is the greatest value of antibody testing right now?

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DR. MARC LIPSITCH, PROFESSOR OF EPIDEMIOLOGY, HARVARD UNIVERSITY: Well, I think as John said, the value is to figure out in a population how many people have been exposed and, also, eventually to begin to understand this relationship between antibodies and immunity. If we don't -- if we can't test people, we can't figure that relationship out. So, the trick will be to design the proper studies to figure out both of those.

BURNETT: So, Dr. Ioannidis, "The New York Times" is now reporting on a study of antibody tests. And they said 14 tests that they looked at -- only three had reliable results, and even the best had some flaws. I mean, how do you get around this?

You know, this has always been a difficult thing to understand because we're told if a test is 99% reliable, but given in a population where only 1% of the people have been exposed, you have a 50% chance of getting a wrong result.

OK, well, then, people say, "Well, why can't you test that blood sample against the population where a whole lot more people have been exposed?" You know, it's sort of hard to understand why these things seem to be so fundamentally unreliable. Why are they?

IOANNIDIS: Well, antibodies are a test, and any test needs to be very thoroughly validated. Some of these tests may be pretty good. Some might be excellent and some may be horrible. So, you cannot generalize from one test having pretty good performance in avoiding false positives and false negatives that other tests will do the same.

Each of these tests, I think, needs to be very thoroughly validated to know its exact performance and reduce the uncertainty about that performance.

BURNETT: So, Mark, what I'm trying to, you know, understand -- there are still so many that have said, "Well, look, this is the key to the economy." The point that Dr. Ioannidis raised, right -- this issue of a passport -- there's a lot of people from the economic point of view that want to say, "OK, well, if you've been exposed to it, that's your passport.

And maybe we don't know if you're going to be immune for your life or for two or three years, but they're betting on a vaccine or a treatment and it's good enough, you can go on out there." But if these aren't going to be that reliable and we don't know what they're really telling us, then it would seem that they are not a replacement for widespread testing of whether people actually have the virus. Is that true?

LIPSITCH: They're not a replacement, they're a complement. And what they do is -- especially as the number of people exposed like in New York City or in other hot spots, like Chelsea, Massachusetts -- as the number gets larger then at the population level, they give a more and more accurate answer even if the test is not perfect.

But for individuals, as Dr. Ioannidis said, it's not -- we don't have the data right now to make individual-level decisions. And we need to test to get better and we also need to do a careful set of studies -- what are sometimes called seroprotection studies -- that will ask the question of whether antibody immunity is a predictor of not getting infected.

And those are very hard studies to do because the risk of finding false relationships is high for all sorts of reasons. But they can be done.

BURNETT: So, Dr. Ioannidis, you know, there was a -- the Sweden public health department, they were estimating that for every person who tested positive for the actual virus, 99 others have had it and that would put them at a third of the people in Stockholm have actually been exposed.

You did a study on coronavirus infection in Santa Clara. You believe that the numbers, or study shows the numbers may be 50 to 80 percent higher in terms of the number of people who actually have been exposed in the official count in that county. And in New York, Governor Andrew Cuomo is now saying 25 percent of people have had it in New York City.

Do these numbers seem right to you? Do you think we're looking at a world where in major metropolitan areas, whether it be Stockholm or New York, that you're looking at 30 percent? And I ask this in the context of, we are told that herd immunity could start as low as 50 percent.

IOANNIDIS: I think that these are different pieces of the puzzle and they're coming in at a fast pace and this is great news. They seem to be pretty consistent with each other. And, of course, the ascertainment problem is different depending on how much testing has been done in each area. So, you know, Santa Clara probably has had less testing compared to New York, so, probably we have a larger iceberg that was not visible compared to New York.

But even New York has a very large iceberg that is being revealed now. It's hard to say what is the exact percentage that you need to get herd immunity. You know, Mark has done fabulous work trying to elucidate this problem. And, you know, the percentages may vary.

I think that we need to track that theory carefully and we need to see how different locations perform, how these numbers change over time as the epidemic wave -- at least the first epidemic wave is maturing.

BURNETT: So, Mark, what is your view on this? Do you think -- first of all, do you think these numbers are reasonable? That you look at New York like Governor Cuomo says, and you could be at 25 percent? And if you do you think it's reasonable, is it fair to say herd immunity could start at 50 percent? So, therefore as you relax social distancing, you know, you're halfway there in terms of your exposure.

[20:35:00]

I mean, there's a way to look at this as a positive. But does that actually -- does that logic add up to you at all?

LIPSITCH: Every person who's been infected and has anti-bodies and has not had a bad outcome is a positive. So, in that sense, yes. I think there are a few things to consider, one is probably herd immunity threshold the point at which the virus can't spread is probably a little bit higher than 50 percent, maybe 60 or 70.

We don't know yet. But the other issue is it's really important to go from these sort of convenient sample studies which is what everybody's doing at this point -- for good reason, it's the easiest thing to do, where you look at someone in street corners or on you know, at a drive through place. And move beyond that to random, real random sampling.

For example, the New York City ones were done in supermarkets and a person in a supermarket is probably more likely to be exposed to coronavirus than somebody who's sitting at home sheltering in place. So, we need to be very cautious about the sampling and that will give us better answers.

BURNETT: That's a very fair point. Doctor, before we go, I just want to ask you, you obviously had early on said it was possible that this coronavirus would end up with a death rate at the end that was less than that of the flu. You know, in part because more people had it than we knew about. But as more data has come in and as we see 56 thousand people dying in

the past month and in major metro areas, that out-pacing cancer or heart disease. Do you still think that it is possible that the death rate could be less than that of the flu?

IOANNIDIS: So, my guess at the early stage based on practically very unreliable data, was that it could be anywhere from 0.05 percent up to 1 percent. That was my most plausible guess that I had suggested, the data suggests that we will get numbers within that range.

You know, from the lower bound to the upper bound, the infection fatality rate is not like, a constant -- like, the gravitational constant of g. it will be different if you have a population that has excellent health care, the hospitals do not crash, you have young population, very few people who are disadvantaged and very sick and elderly, you protect your nursing homes and you don't get (inaudible) infection.

Conversely, if you go to New York, if you go to Queens, you know, hospitals got overwhelmed, you had lots of (inaudible) infection, New York had lots of nursing homes that really were massacres of lots of deaths happening there. You're likely to have a much higher infection fatality rate.

So, it's not a constant value, it's up to us to navigate the waters and try to make it as low as possible. If we just have very young people infected it would be less than the flu, if we have you know, (inaudible) infection in elderly homes, it can be a disaster.

BURNETT: All right. Thank you both very much.

LIPSITCH: But also --

BURNETT: I appreciate both of you taking the time --

IOANNIDIS: Thank you.

BURNETT: -- again. And next, 60 percent of job losses in February and March in this country were women. Why the shut down is hitting women hardest. Plus President Trump says he knows about Kim Jong-un's health status, but he won't say what it is.

[20:38:00]

(COMMERCIAL BREAK)

BURNETT: Tonight, growing concern among doctors over the increase of strokes among young and middle-aged patients with Coronavirus. So what exactly is the connection? "OUTFRONT" now: Dr Pascal Jabbour, the Chief of Neurovascular Surgery for Jefferson Health at Thomas Jefferson University in Philadelphia, helping to lead a study into all of this.

And doctor, I appreciate your time tonight. You've co-authored a paper that details 12 specific cases where COVID-positive patients suffered stokes and 40 percent of those patients were under the age of 50. Can you tell us detail as to what made these cases stand out to you and so unusual to you and your colleagues?

DR. PASCAL JABBOUR, CHIEF OF NEUROVASCULAR SURGERY FOR JEFFERSON HEALTH, THOMAS JEFFERSON UNIVERSITY: Yes, hi, Erin. So when the pandemic started, we noticed that there was a high incidents of COVID in patients presenting with stroke. And we noticed also that there were a lot of young patients with no risk factors.

So as you said, 40 percent of the patients were less than 50 years old and overall, 50 percent of all the patients in the study did not have any risk factors for stroke. We also noticed that the pattern of the clots were different and there were sometimes multiple vessels involved and the clots were in -- on both sides, arterial and venous sides.

BURNETT: So -- so when you say that they didn't have underlining conditions leading towards strokes, when you look at the younger patients, right, because these are the very same people, right, that were told -- have -- have very minimal less -- risk for Coronavirus -- did any of them have underlining health conditions that may have been a factor aside from Coronavirus?

JABBOUR: No, those young patients did not have any other risk factors, no risk factors for stroke. And 50 percent of the patients presented didn't know that they had the -- the Coronavirus. So stroke was the first symptom of Coronavirus in those patients.

BURNETT: Wow. So -- so what you're saying is that they may have -- have felt -- I mean, would -- would you go so far as -- to say that they were asymptomatic or did they have some sort of symptom where they ended up in -- asymptomatic until the point they had something indicating a -- a brain clot?

JABBOUR: Exactly. The majority of them, they weren't symptomatic until they developed the stroke symptom. And what we noticed also that some of the patients are coming late and this is really important because patients are scared of going to the hospitals and that's why we have a small window, a short window to be able to help those patients and to intervene so any patient with any stroke symptoms, they need to call 911 right away or they need to present to the emergency room.

And especially young patients that are confined at home with a diagnosis of COVID, those patients specifically if they have any stroke symptoms they need to call 911.

[20:45:00]

BURNETT: So, you know, we hear this and we hear OK, now you're saying that somebody could appear to be asymptomatic and their first symptom would be a sign of a stroke and a stroke itself, and this can happen in young patients.

You know, this is as we're also finding out possible brain impacts from the virus, obviously we learned about smell and taste, nerve damage, kidney damage -- I mean, does it just shock you that this virus could be causing such wide spread damage within the human body? JABBOUR: Yes, I think there are a lot of things that we don't know yet and at this point we need to keep our eyes open and if we see any trends or anything unusual we need to report it, we need to investigate it. So, we're going to see a lot of things, I think.

BURNETT: What has happened to some of these patients in terms of their ability to recover from these strokes?

JABBOUR: So, those patients unfortunately, 50 percent mortality in those patients with strokes. So, in general the mortality after a stroke intervention is around 10 percent, but in those patients, it was 50 percent. Despite the fact that we were able to retrieve the clot and open the vessel, those patients ended up dying either from multiple organ failure or from the lung injuries they had. And some of them ended up having strokes elsewhere. So, the outcome wasn't very good.

BURNETT: All right. Dr. Jabbor, thank you very much, I appreciate your time. And I hope for this is something people can be aware of just to make sure people are aware of every possible thing that can happen here so, that they can do the best that they can to get medical care as quickly as possible. Thank you, sir.

JABBOUR: Thank you for having.

BURNETT: And also tonight, the President's economic advisor Kevin Hassett says the United States could see unemployment numbers like the ones during The Great Depression, where of course, unemployment peaked at just about 25 percent. And that unemployment so far, is hitting women particularly hard. Women in fact, account for 60 percent of the job losses over the past two months. Kyung Lah is out front.

(BEGIN VIDEOTAPE)

CHARMAINE COOK, POPPED FRESH BUSINESS OWNER: It's like my home away from home.

KYUNG LAH, CNN INTERNATIONAL CORRESPONDENT (voice-over): But this is Charmaine Cooks small business. Seven days a week, from dawn until late into the night.

COOK: You know, I put so much into it. We were on the verge of something really great.

LAH (voice-over): Cook, single mom, owner of Popped Fresh was catering award shows and movie premieres just weeks ago.

LAH (on camera): How long can you keep going?

COOK: Really, not much longer. It's so disheartening because I thought this was going to be something I had for a long time. Starting all over again will be tough. You know, that's a lot of people to compete for jobs with.

LAH (voice-over): 26.5 million now out of work. Especially hard hit, women. 60 percent of job losses in February and March were women, exceeding men in nearly every sector of the economy. Coronavirus gutting retail and leisure, hospitality where women make up the bulk of those job losses and women own just under half of all American small businesses -- where the initial blow of the virus shut down has been felt the most.

LATRICIA WILDER, VIBE RIDE DETROIT: I mean, it's life or death for us.

LAH (voice-over): Latricia Wilder left the comfort of a lucrative career in corporate sales in Detroit radio to follow her passion -- fitness. Opening a heart pumping studio called Vibe Ride Detroit, barely open two years, she applied but hasn't been approved yet for the small business loan from the Federal government.

WILDER: Does that work for you?

LAH (voice-over): The married mother of a young child now watches the numbers in her state get worse. This week a quarter of Michigan's workforce has now filed for unemployment.

WILDER: It's just a day to day, hour to hour thing. I've had so many highs and lows, but I refuse to be a victim in this. I have to believe that we will survive this. Do I know how? Not today.

UNIDENTIFIED MALE: Target post.

SUMMER DAVIS, OWNER, LOS ANGELES URBAN ADVENTURES: Nice.

LAH (voice-over): Not knowing is what's common amongst so many business owners and this crisis says Summer Davis, mother of two.

DAVIS: I think I might just be in shock, because we literally have no income.

LAH (voice-over): Davis owns a Los Angeles and international touring company.

DAVIS: Look to the back.

LAH (voice-over): Demand has evaporated as travel ground to a halt.

DAVIS: I even thought should I sign up to be a delivery driver? You know, should I work at the grocery store?

LAH (voice-over): She's now joining more than three million Californian's.

DAVIS: This is the unemployment application for sole proprietors.

LAH (voice-over): Filing for unemployment for the first time in her life.

DAVIS: There it goes.

(END VIDEOTAPE)

LAH: So, what might happen to these women owned businesses? Well, if you look at recent history -- in the 2008 financial crisis, women and businesses owned by people of color were more likely to fail than businesses owned by white men.

[20:50:00]

But in the recovery, in the immediate years after that 2008 crisis, Erin, they're the ones who led the recovery adding in 1.8 million jobs -- Erin.

BURNETT: All right. Thank you very much, Kyung. On "OutFront" next, President Trump just added to the mystery over Kim Jong-Un and whether he's alive or not or something in between. Plus, Jeanne Moos on how a nation is paying tribute to the men and women on the front line.

(COMMERCIAL BREAK)

[20:55:10]

BURNETT: Breaking news. President Trump revealing tonight he knows about the health of Kim Jong-Un. The North Korean dictator, of course, hasn't been seen in weeks, didn't show up at the crucial, you know, anniversary for his grandfather. And CNN has learned the U.S. is monitoring intelligence that Kim is in grave conditions after his surgery. Here is what Trump said tonight, adding to the speculation.

(BEGIN VIDEO CLIP)

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I hope he's fine. I do know how he's doing, relatively speaking. We will see. You'll probably be hearing it in the not too distant future. He didn't say anything last Saturday.

UNIDENTIFIED FEMALE: Did Kim Jong --

TRUMP: Nobody knows where he is, so he obviously couldn't have said it.

(END VIDEO CLIP)

BURNETT: Kylie Atwood is out front for us now. So, Kylie, the President is doing his part to deepen the mystery and there is a lot of mystery on Kim Jong-Un and whether he is alive and where and -- or in what condition.

KYLIE ATWOOD, CNN NATIONAL SECURITY CORRESPONDENT: Yes, I mean, the bottom line here, Erin, is that President Trump did not actually provide any clarity today when he spoke about the health status of Kim Jong-Un. Now, as we have reported at CNN, the U.S. is monitoring intelligence as of last week that Kim Jong-Un may be in grave danger after undergoing a surgery.

And President Trump said today that he does know the health status of Kim Jong-Un "relatively speaking" and that terminology is actually quite key even though it's not very descriptive because there are many layers of intelligence that to get to the truth here. And the U.S. isn't monitoring some intelligence, but it doesn't necessarily tell the whole picture. We have South Korea saying there's nothing to indicate that Kim Jong-Un is not, indeed, in fine medical condition.

The other thing that President Trump said when he spoke today is that we may find out in the not too distant future about the status of Kim Jong-Un. Now, obviously, he didn't put a timeline on what he meant when he said "the not too distant future", but it does indicate that he does have a reason to believe that we are going to find the answers to these many questions about Kim Jong-Un's health sooner rather than later -- Erin.

BURNETT: All right, Kylie, thank you very much. And now to the front lines and those fighting the Coronavirus fight. Here's Jeanne.

(BEGIN VIDEOTAPE)

JEANNE MOOS, CNN NATIONAL CORRESPONDENT (voice-over): Tributes to health care workers have sprouted like spring flowers from lawn signs to celebrity-led sing-alongs.

TONY BENNETT: Let's sing our song.

MOOS (voice-over): Tony Bennett's statue is even masked these days as San Franciscans paid tribute to front line workers.

(SINGING)

MOOS (voice-over): But there's another location where the tributes are more concentrated, where images are shared of medical workers with angel's wings grouped among other masked superheroes, photoshopped with an added cape. #CourageIsBeautiful bubbled up when dove soap made it its tagline in a video that went viral, showing the marks made by the protective gear medical workers wear. Dove donated some $2 million to the cause and paid to promote the hashtag.

Now relatives of front-line workers are adding their own images, "my daughter", "my beautiful niece", "my cousin", "ICU nurse in Indy praying before shift with no N-95 masks". Tributes ranged from a shared montage of exhausted health care workers to this sand sculpture of a medical worker holding the world in her hands created by a New Jersey couple. John Goudy has won prizes in sand sculpting competitions, but those can't compete with the emotion that went into this one.

New Orleans artist Terrance Osborne didn't know his painting "Front Line" had been shared on #CourageIsBeautiful.

TERRANCE OSBORNE, ARTIST: I'll take it. I mean, that's nice, of course, that's what it's about. So, the piece is a nod to the Rosie The Riveter piece, you know, that piece from World War II.

MOOS (voice-over): Though Rosie didn't face the dangers medical personnel do. The next time you hear --

(SINGING)

MOOS (voice-over): -- leave a piece of it for those who wear their mask in marks even when they take it off. Jeanne Moos, CNN, New York. (END VIDEOTAPE)

BURNETT: And thanks very much to Jeanne and thanks to all of you for joining us. "CUOMO PRIME TIME" starts right now. I don't usually get to hand it off to you, Chris, but I'm so glad you're doing better. Take it away.

CHRIS CUOMO, CNN HOST: What a pleasure, thank you. I've loved watching you here at home. You're doing great job, Erin. I appreciate it. I am Chris Cuomo. Welcome to "PRIME TIME."

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