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CNN Live Event/Special
New Model Projects 72,000+ U.S. Deaths by Early August; At least 31 States Will Partially Reopen Within Days; Trump Orders Meat Processing Plants to Stay Open; Fauci: COVID-19 Vaccine "Doable" by January if Things Fall Into Place; Fauci: FDA Moving "Really Quickly" to Approve Drug Remdesivir to Treat Coronavirus; British PM: "I Think We Did the Right Measures at the Right Time"; Sweden Does Not Require Social Distancing as Death Toll Climbs; South Korea Passes New Milestone. Aired 8-9p ET
Aired April 30, 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]
ANDERSON COOPER, CNN HOST: Hello, welcome, I'm Anderson Cooper in New York.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Hey, Anderson. I'm Dr. Sanjay Gupta. This is the CNN GLOBAL TOWN HALL: CORONAVIRUS FACTS AND FEARS seen around the world on CNN International, CNN Espanol, and also streamed on cnn.com. Tonight, a key member of the White House task force on coronavirus, Dr. Anthony Fauci, will be joining us to answer your questions as well as the latest on treatments and the push by dozens of states to begin reopening their economies.
Also, Bill Gates -- he's going to be here to discuss what the United States and the world at large is going to need to do to accomplish when it comes to testing and the deployment of a possible vaccine.
COOPER: This is our ninth Global Town Hall. No one Town Hall is more significant than the other. Tonight is unique, though. The federal guidelines that recommend social distancing and brought a virtual end to public life for most expired tonight.
What that means for our physical and mental health and whether now is the appropriate moment to let them end, at least from the federal perspective -- that's going to be a major theme during tonight's program. Of course, now, it's up to governors to decide in their own states how much to loosen them or if to loosen them.
GUPTA: Yes. And at the bottom of our screen you're going to see our social media scroll. We want to hear from you. So, tweet us your questions with the hashtag #CNNTownHall. You can also leave a comment on the CNN Facebook page. Also, a lot of you have sent in video questions all around the place. We're going to get to as many of those as we can.
COOPER: Yes. We're also going to have reports, of course, from across the country and around the world on how those at home and abroad are still fighting this virus. But first, where we are as the nation in our fight against the virus and the problems that we still have to confront.
(BEGIN VIDEOTAPE)
COOPER (voice-over): The U.S. has now had more than a million positive cases of the coronavirus. More than 62,000 people have died. New modeling shows this pandemic will continue. The new projected death toll in the U.S. is estimated to be 72,000 people. That's up from 67,000 projected only one week ago.
At least 31 states will be partially reopened by the end of the week. Public health officials warn the governors in those states to be careful.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: You can't just leap over things and get into a situation where you're really tempting a rebound.
COOPER (voice-over): Food supply is also a concern as thousands of meat plant workers around the country have been infected with the virus. To protect the plants and the food supply chain, the president signed an executive order forcing plants to stay open. The workers wonder how they will stay safe.
There are encouraging steps in the fight against this virus. Companies in the U.S. and the U.K. say they may have a vaccine ready for partial emergency use in the fall. And White House coronavirus task force member Dr. Anthony Fauci says a vaccine for the general public may be available in January.
FAUCI: We want to go quickly, but we want to make sure it's safe and it's effective. I think that is doable.
COOPER (voice-over): In the meantime, researchers believe the antiviral drug remdesivir could be an effective treatment for coronavirus patients. In New York, which remains the epicenter in the U.S., the USNS Comfort has discharged its last patient and has left New York City's harbor.
The field hospital at the Javits Center is also winding down. But with more than 1,000 deaths reported a day nationwide, this virus is by no means contained.
GOV. ANDREW CUOMO (D-NY): Every day, I think maybe today is the day the nightmare will be over, but it's not.
(END VIDEOTAPE)
COOPER: Sanjay, I want to start off just by asking you -- I think it's the question we've asked pretty much at the start of all of these Town Halls --
GUPTA: Yes.
COOPER: -- what do we know, you know, this week that we didn't know last week? What is still a mystery that we need to know? And also, what about New York Governor Andrew Cuomo -- GUPTA: Yes.
COOPER: -- saying there, I mean, how will we know when this nightmare is ending?
GUPTA: Well, that is the question I think everyone wants to know, everyone's asking. And I think we're still a ways away from knowing the answer to that. We know that we've seen signs of improvement around the country, Anderson. We've seen numbers start to plateau in several places. We haven't seen this 14-day downward trend, though, that we need to see in order for people to feel more confident in reopening the country.
We know that if we want to be confident in doing that, it's going to come down to test, trace and treat. Just like we've talked about. We know our testing is not necessarily where it needs to be. We know that it's going to take hundreds of thousands of people to adequately trace. We don't have that many.
But there have been signs of optimism, Anderson, as you mentioned, with regard to treatment. This antiviral drug remdesivir -- I first heard about this back in 2014. You may remember it was trialed unsuccessfully at that time for Ebola. But it's now giving us some hope, showing that it can have impact on this novel coronavirus by shortening recovery time.
It's not a knock-out. It's not a home run -- whatever sports metaphor you want to insert. It's not a cure, but it's a start and it's an important one. The thing, Anderson, I think I've really been struck by this week is that after speaking to so many people both inside and outside the medical profession, there seems to be this cognitive dissonance.
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Some people are really talking about this as if it's close to being over or already over. But others are saying we're still very much in the beginning and we absolutely cannot get complacent. So, we don't know when it's going to end for sure, but we know we're not there yet, Anderson.
COOPER: Yes, as we reported just a moment ago, at least 31 states are going to be partially re-opened by the end of this week. Here they are, politically speaking they're a mix and from most parts of the country, for many states that means retail and restaurants can partially re-open, as can hair and nail salons, elective surgeries will now be allowed in places.
In Texas, Governor Greg Abbott's order to begin re-opening supersedes any local orders. Joining us now to talk about this from the epicenter of the pandemic is Erica Hill, here in New York. So, the Federal guidelines expiring tonight, as I said, it's really been Governors and mayors who set specific standards and moving forward that's going to continue to be the case. What are you learning about what will actually change? ERICA HILL, CNN NATIONAL CORRESPONDENT: You know, it really depends as you pointed out Anderson, it depends on where you are and it also depends on the state. As you said in Texas, the Governor said his order supersedes everything.
In Florida, the Governor announced phase one would begin on Monday -- that will allow for some retail and restaurants to open with restrictions, 25 percent capacity being one of them, adequate spacing as well. You still can't visit nursing homes, schools remain closed, but what's interesting about Florida is that three of the hardest hit county's -- Miami-Dade, Broward and Palm Beach are excluded from the Governor's plan there.
So, they are not part of that phase one re-opening, other areas of the state though, we know are opening beaches. (Destin) for example on the Gulf Coast, they are ready to welcome tourists back, the mayor there saying he's concerned about the economy and they need to get their beaches open. But it really depends on the state of California still under a stay at home order.
Although, a plan to phase a re-opening was announced this week, they are likely weeks away the Governor said from low risk businesses opening, but today he also closed the beaches in Orange County because he said there were too many people out there last weekend.
GUPTA: You know, Erica, I was just talking about this sort of cognitive dissonance people talking about re-opening and at the same time we're seeing big numbers of infections in some places. So, take New Jersey for example, what's happening there?
HILL: Yes, New Jersey has the second highest number of cases in the country, just behind New York, up over 118 thousand today and the Governor -- Phil Murphy, who met with the President today said the state has been in his words "crushed" by this virus. As we know, he did say they're starting to see a little bit of improvement when it comes to how those cases are coming in.
But listen, there are still a high number of deaths in that state, there's so much more testing that needs to happen. That said, he did also talk about a phased re-opening and some things that they will see open in certain areas this weekend are parks and golf courses.
COOPER: Obviously, there are also concerns -- continued concerns about the food supply chain, today the President issued an executive order requiring meat packing plants to remain open.
How tough is that going to be for companies -- first of all a lot of companies have sick workers and you know, the working conditions in a lot of these plants, it's shoulder to shoulder, it's very hard work and it's tough for it to maintain social distancing.
HILL: You're right. The main concerns that CNN is hearing from workers in these processing plants across the country is that it's very difficult to social distance, they're right next to each other, they spend long hours a day in close proximity to their colleagues. And they're also concerned about having adequate PPE to protect themselves and that the plants will be deep cleaned.
The mayor -- one mayor in South Dakota said he was worried the plant in his town -- the Smithsfield plant is so old he's not sure how they'll keep up, so that's certainly something that's going to be a focus heading forward.
COOPER: Erica, thank you very much. Joining me now with more on the treatment and vaccines is CNN's senior medical correspondent, Elizabeth Cohen. So, Elizabeth, just in terms of vaccine with so many different companies working towards the same goal, what's a realistic timeline?
Because now all of a sudden some of the timelines they're talking about seem really, really quick and how many of these vaccines would actually work?
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: These are all excellent questions and we're still trying to figure some of this out, but let me tell you Anderson what we do know. So, there are actually dozens of companies that have told the World Health Organization that they're working on vaccines. Only seven of them that we know of are actually in human clinical trials, and that started a while ago.
If we take a look at the list, the NIH trial -- the National Institute of Health one, that started on March 6 and then you could see followed by CanSino, which is a Chinese company and then followed by several other companies. The most recent ones that started were Pfizer and University of Oxford in England on April 23. Now, we've been talking a year, a year and a half somewhere in that timeframe and today Dr. Tony Fauci was asked "What do you think? Could we have a vaccine by the end of the year?"
And he said "Look, I started saying a year, a year and a half back in January, so, yes, the end of this year would be 12-months from when I first started saying it". So, he thinks that it is possible that this could work by the end of the year but Anderson, there are so many "if's" here.
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The clinical trials have to go very quickly, the FDA has to move quickly, there's a lot of things that need to happen to get a vaccine on the market in the US by the end of this calendar year.
GUPTA: Yeah, it is -- it is interesting. He does seem to have struck a more optimistic tone this past week, Dr Fauci. We'll talk to him about that in a minute. Elizabeth, I know you also -- you know, we've been talking a lot about Remdesivir because it did show some impact this week in -- in these trials. You -- you've been doing a lot of reporting about Hydroxychloroquine as well. I just wonder, is there any update on that? Have there -- has there ever been any data that you've looked at that's been released on that?
COHEN: On Remdesivir -- yes, absolutely. This week, there was a -- data that was released by Dr Fauci. This is preliminary data. We have not seen it published in a medical journal and that's an important point to make but what he said was, "Look, we studied this data in order to see how long it was taking people to recover." So let's take a -- a step back and think about what Remdesivir is. If you haven't heard much about it until recently, there's a reason for it.
It was developed for Ebola years ago and it didn't actually work very well for Ebola and it's never been on the market for anything. So it's not currently in hospital or pharmacies. This is a drug that people get intravenously and when they gave it to very sick patients hospitalized with COVID-19, what they found was that it cut down on the amount of time that it took for recovery.
When they took a placebo, it was 15 days and when they got Remdesivir, it was 11 days and, you know, four days doesn't sound like much. Four days fewer in the hospital is -- is certainly a good thing. Also, what Dr Fauci kept pointing out is that it's a proof of concept. If Remdesivir is doing something, we can look at the way it works, we can look at the enzyme that it acts on and try to make other drugs that could hopefully work in the same way.
COOPER: Mm, Elizabeth Cohen, thanks so much. Now to London where British Prime Minister, Boris Johnson, newly recovered Coronavirus told his people today that they are past the peak of the disease. Joining us now from London is CNN's Christiane Amanpour. So Christiane, Johnson defended the government's response which, it's been under a lot of criticism certainly, laid out a plan to try to reopen the country. What -- what -- explain what he said.
CHRISTIANE AMANPOUR, CNN CHIEF INTERNATIONAL CORRESPONDENT: Well, he basically said we're past the beak and then the chief medical officer said we're nowhere near the end of this pandemic. We have had a situation here where there have been numbers of deaths reported, then all of a sudden jacked up this week because guess what, they forgot to add the incredible numbers of deaths in care homes. So now, the numbers of deaths here are amongst the highest in Europe, much more than 26,000 and it's -- it's very, very difficult for people here to -- to get a grip on this.
Plus, you know, they've been promised 100,000 tests per day. This hasn't happened, they've been promised since the beginning of April that this would happen at the end of the April. We're now at the end of the April, it hasn't happened, although they claim that they're ramping it up. But this is, you know, really, really tough and although Boris Johnson says, yeah, we're going to have a -- you know, a plan to reopen, he also says, "I refuse to risk a second wave and a second infection". So he hasn't given any clarity.
And you know, we're behind you in the -- or rather, ahead of you in the United States and there's still no clear route towards opening up so it's -- it's kind of interesting hearing that so many places in the US are considering opening it up. And just one other thing in Europe, on the vaccines, I spoke to the President of the European Commission today.
On Monday, they're launching a massive global G20 effort to raise $8 billion to find and work on vaccines and the rest and the US government has not agreed to take part. The Gates Foundation will and also Gavi, the Vaccine Alliance will but not the US Government. So they're -- they're missing US leadership in this regard.
GUPTA: And Christiane, I -- I want to ask this, Sweden. I think it's fascinating, a lot of people may know what's happening over there. They're essentially not doing lockdowns and -- and now people, including President Trump, are using that as an example to defend lockdowns for example here in the United States but what is the latest out of Sweden?
AMANPOUR: So here's the thing with Sweden, it's really an outlier. And look, those who are frustrated at lockdowns, even here in -- in the United Kingdom, will say, "Hang on. Look at Sweden, they seem to be doing okay."
Well, it looks like they're in fact not. Their death rate is the highest amongst their neighbors in that part of -- of Scandinavia, of that part of -- of Europe there. They've got something like 2,500 deaths compared with 400 or so for -- for Denmark. 200 or so for Norway which did do very early lockdowns and a very, very early financial relief for workers to encourage them to lockdown. So Sweden in fact is not out of the woods and -- and they say 50 percent of their deaths are amongst their elderly in the elderly care homes and then they say "Well, now we may have some kind of a herd immunity if there's a second wave."
[20:15:00]
Wasn't our intention, they say but maybe. So, you can see a little bit of the ethical dilemma, you can see a little bit of the practical differences and the results of different attitudes and approaches to all of this.
COOPER: Also South Korea, I understand there's some positive news from there.
AMANPOUR: Yes. Well, there is actually and it's important because where it erupted in Asia is now where it's really under control according to the governments there in China and in South Korea. So, South Korea said today for the first time no new domestic cases since it reported their first infection back in January -- that's important.
They've had about four cases they say, but these were from travelers and they were not domestic cases. So, what is it that created the success in South Korea, it hasn't changed since day one. It was testing, isolating, tracing and they keep saying "Look, we started to build up tests, even before we had a lot of cases. We really did, as soon as we understood what was happening in China, as soon as the WHO said test, test, test. Even before that, we were ramping up tests." So, I think that for them has worked plus the isolating and the tracing.
COOPER: Christiane Amanpour, thanks very much Christiane.
GUPTA: Thank you.
COOPER: Appreciate it. Sanjay, we're going to take a quick break, when we return we'll talk to Dr. Anthony Fauci from the White House coronavirus task force to answer your questions.
(COMMERCIAL BREAK)
[20:20:00]
COOPER: We continue the CNN GLOBAL TOWN HALL: CORONAVIRUS FACTS AND FEAR with answers to your questions about the pandemic. At the bottom of your screen there -- our social media scroll showing some questions people are asking. Joining Sanjay and me is Dr. Anthony Fauci from the White House Coronavirus Task Force.
Dr. Fauci, great to see you again. We want to get to viewer questions in a moment. But first, when you look at these two diverging realities where on one hand, cases are going up, deaths are rising, and on the other hand, we're on the eve of the federal social distancing guidelines expiring and at least 31 states partially reopening in different ways, what is your message overall tonight to people who may be confused by these --
FAUCI: Yes.
COOPER: -- you know, sort of different realities?
FAUCI: You know, Anderson, the message is to take a look at the clearly articulated guidelines for opening America again. And if you take a look at them, even though the so-called 30-day mitigation period has ended, the first component of opening America again is what we call a gateway, which means that you need to have to go down over a 14-day period, incremental or decremental, decreases, in the number of cases that you have before you can even think about going to Phase 1.
And then you stay a certain time in Phase 1. And then there's another checkpoint before you go to Phase 2. And another checkpoint before you go to Phase 3. So, there really is -- if you follow the guidelines, there's a continuity that's safe, that's prudent, and that's careful. So, the concern that I have is that there are some states, some cities or what have you, who are looking at that and kind of leapfrogging over the first checkpoint.
And, I mean, obviously, you could get away with that, but you're making a really significant risk that if you do that and you don't have in place the absolute clear-cut capability of identifying, isolating and doing the contact tracing, when people do start blipping -- because there's no doubt in my mind that when you pull back mitigation, you're going to start seeing cases crop up here and there.
And if you're not able to handle them, you're going to see another peak, a spike. And then you almost have to turn the clock back to go back to mitigation. So, that's the reason why I keep trying to articulate to the public and to the leaders, take a look at the guidelines. They don't tell you because you've reached the end of the 30-day mitigation period that all of a sudden you switch a light on and you go for it.
That's not the way to do it. Each state, each city, each region is going to be a little different. And there may be some situations where people can go into that pretty quickly because they've already passed the first gateway. But others should not do it if they're still on the way up and they haven't plateaued. So, that's really my concern.
GUPTA: And it doesn't appear -- at least when we look at the data that any one sort of meet -- any state meets these criteria fully at this point. So, I mean, it sounds like none of these states should be reopening. But is this going to be sort of incremental infections, do you think, or do places like where I live here in Georgia, do you think you could potentially see exponential growth, again -- a few cases and then suddenly really taking off again?
FAUCI: Well, you don't know for sure, but I don't think that you will see something as explosive as we saw in New York because of the special characteristics of that city, which made them vulnerable -- or even in New Orleans which had a very sharp peak and then came down very nicely.
What I think you'll see is these spikes like in certain areas, nursing homes, plants where workers congregate, prisons and places like that. So, when you look at the chart, that's where you'll see it. The thing you'll really get into trouble -- if it spills over into the general community the way it did in New York City because if you can't stop that from happening, then I think you're really going to see the sharp peak that is going to be very disturbing when that happens. Because it's really going to take a while to get it back down.
But I must say that, you know, the discretion is given to the governors. They know their states. The mayors know their cities. So, you want to give them a little wiggle room. But my recommendation is, you know, don't wiggle too much. Try as best as you can to abide by the guidelines that were very well thought-out and very well delineated.
Some of them are doing that, but others are taking a bit of a chance. I hope they can actually handle any rebound that they see.
COOPER: Can you talk about the development -- sort of the race to develop a coronavirus vaccine. I mean, it seems like it's -- there's a lot of people all around the world, a lot of different companies, governments working on this. Are they work -- do they work together? Is this kind of a battle, a rush to try to be the first one to get it out there?
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FAUCI: No. You know, I don't think, Anderson, that's it's a rush to get it out there to beat somebody else. I mean, everybody wants to get a vaccine for their country for the safety of their country and if possible, make it available to the world.
I mean, I can only speak for what we're doing, we have a core group of a number of candidates that we at the NIH and FDA and other agencies within the government -- the DOD, including the Department of Defence are working together now to try and get a situation where we can get something that's done, that's safe, that's effective, that's quick and that you can scale up, because each of those are really important. I mean, just say that I have a vaccine throw it into people, what people don't appreciate because they're so intent to getting a vaccine quickly is that they could be deleterious negative effects of enhancement of infection.
So, you've got to make sure you don't get slowed down by that, but you're aware there are safety issues. And then what we're going to do is we're going to -- we're in phase one now which means we're looking predominantly at immediate safety and some immuniniginicity namely, does it induce the kind of response you want it to. We're going to go quickly as we get into the summer into a phase two, three. We're going to go right into it, looking at safety and looking at immuniginicity.
Now if there are cases that are around either here in the United States, which likely there will be some or some of our international sites, because we have clinical sites that we put together years and years ago for HIV and for influenza and for other things. If we get in there and there are a number of infections, you can get an efficacy signal right away, which means you may know right ahead of time whether or not you have something that works.
But importantly, what's being done now that's different than with most situations are that before we even know a vaccine works, we're going to have make the investment in hundreds of millions of dollars to start developing a vaccine so that we ultimately prove it works, you don't have to wait five or six months to scale up to get enough doses to give to a meaningful number of people. That's a risky financial circumstance, but it's certainly, certainly is worth the risk given what's at stake.
GUPTA: Dr. Fauci, you seem to have struck a bit of a more optimistic tone about vaccines, I know that you said a year and a year from this past January would be next January, but still I felt like you were trying to give some good news at that point, you actually thought it would take even longer.
Now, do you really think that January is realistic? I mean, with everything that we know right now?
FAUCI: Well, Anderson, I think -- Sanjay, I'm sorry. Everything falls into place right, it will happen. But there are a number of situations there that could go wrong, like it may all of a sudden have a safety signal. Oops, we have a problem.
It may be that actually it doesn't work, it doesn't protect people. I mean, you know, we've been involved, I've been involved in vaccine work for decades. Not every vaccine that we went after worked, so that's an assumption that it's going to be safe, that it's going to be effective and that we're going to be able to do it quickly. I think each of those are not only feasible, but maybe likely. That's what I mean when I say by January, we'll do it. But I can't guarantee it.
GUPTA: Sure.
FAUCI: So, what might happen is people months from now will say "Well, you said we were going to have a vaccine in January, I didn't say that. I said we're going to shoot to be able to have one if we're successful at each and every one of these places.
And believe me, there's nobody in the world no matter what they say from what country that's going to guarantee that they're going to have a safe and effective vaccine at any given time frame. They may be cautiously optimistic about it, but nobody's going to guarantee that if they're being honest with you.
COOPER: I've got some viewer questions, let's get to them. Len Cava, in Florida sent in this video.
(BEGIN VIDEO CLIP)
LEN CAVA, RETIRED FORMER CORPORATE EXECUTIVE AND BUSINESS OWNER: How is contact tracing realistically possible? As an example, assuming an employee of a grocery store tests positive, which means they may have had the virus for up to 14 days with no symptoms, during that time they would have been in contact with hundreds if not thousands of people while at work -- and that's just at work. Can you explain the procedure to contact trace that person? It seems like an impossible task.
(END VIDEO CLIP)
FAUCI: Yes. No, it's a good question, a great question, but it's not an impossible task, because if you look at many of what the CDC has in their great information store on their website.
[20:30:00]
There are different levels of risk. So if I walk into a store and someone is the -- is the clerk there and that person is got an asymptomatic infection and I go in and I'm there, I hand them a box of potato chips and I give them a couple of dollars, I get the change back and I'm with them for two or three minutes. That's a really low risk.
If you're there in the store with them, within a few feet of them for a considerable period of time, you're at medium risk. If you're at high risk, you're buddy-buddy, you're with them all day. So you don't have to -- do every single person that comes in there and test every single person. It depends on the level of the risk. If you have enough tests, in a perfect world, then you would be testing more people but when you're in a situation where you want to be realistic, you don't have to test every single person.
GUPTA: Got -- we've got another question here, Dr Fauci. This one was submitted on CNN.com. And it reads that, "COVID can cause severe strokes in young and middle-aged people." And the question is, "For the duration of the outbreak, should people take a low dose aspirin to potentially offset the risk of stroke? Then, after the outbreak ends, stop taking the aspirin to stop the risk of side effects?" What do you think of that? Is that short term, you know, sort of prophylaxis?
FAUCI: Yes. Well, there's -- there's a reasonable approach to that and then a caveat. So getting back to what you just said, that we are seeing a disturbing appearance of strokes even in relatively young people. So we know that aspirin, even a single baby aspirin a day does inhibit platelet aggregation which means it can prevent what are called microthrombus or small little clots in the blood vessel.
So reasonably speaking, if you're going to take something, taking an aspirin if in fact you have early involvement with the possibility that you're infected, I don't want to be on the record for saying, I would recommend that, but that's not an unreasonable thing for somebody to do but when you do that, you've got to realize that there are potentially toxic consequences. Aspirin can cause bleeding, particularly if you're somebody who's older in which now we know when you take prophylactic aspirin, the level of bleeding is a risk, particularly in older people. So depending upon what you want to do with yourself, you measure and balance the risk benefit. But the idea of doing that is not a crazy idea.
COOPER: Dr Fauci, as always, we appreciate not only your time - -
GUPTA: Thank you.
COOPER: -- but more importantly, your -- all your efforts. Thank you.
FAUCI: Great to be with you guys, thanks. Always good to be with you.
COOPER: Take care. More of our global town hall and your questions coming up. Also, the estimates of deaths caused by the virus are going up. I'll -- we'll talk to the director of the research institute in charge of the projections for the reasons and later, Bill Gates joined us for an extended discussion, a very in-depth discussion about his thoughts and concerns as the country begins to reopen.
[20:33:00]
(COMMERCIAL BREAK)
COOPER: Welcome back to our CNN global town hall, the latest coronavirus modeling is showing an increase in the estimated deaths nation wide to just over 72 thousand by early August. Those numbers, which of course are only projections are from the institute of health metrics and valuation at the University of Washington -- they've been cited by the White House coronavirus task force.
Dr. Chris Murray is the director of the institute and joins us now. Dr. Murray, thanks for being with us, your newest model increases the predicted number of deaths by thousands. What specifically has made the number take up?
DR CHRISTOPHER MURRAY, DIRECTOR, INSTITUTE OF HEALTH METRICS AND EVALUATION, UNIVERSITY OF WASHINGTON: Well, the number has gone up because we've seen these protracted peaks in some places. It took a while for New York, for example, to come off the peak of this, now fortunately it's on it's way down.
We've seen that phenomenon in a number of places, we've seen states adding presumptive deaths to their death counts -- not all states are doing that. So, we're in this sort of funny zone where we've got the confirmed deaths and then some states adding in quite a large number of presumptive deaths where people couldn't get tested before they passed away.
And so, we're seeing quite a lot of fluctuation in the numbers that's contributing and remember that our -- the increased numbers there are still assuming what's not going to happen -- namely that people would've kept to social distancing through the end of May.
We're working hard to factor in how that's going to bump up the numbers as we expect to see some longer and resurgent epidemics in some states.
COOPER: Yes, there's no doubt as people lessen the social distancing the deaths will go up.
MURRAY: That's certainly what we're expecting to see, we're trying to figure out, because our model's driven in a large part by changes in mobility, so we've traced the changes of the social distancing mandates into changes in mobility and how that translates into fewer deaths, less cases, less transmission.
And now coming out of that where we're seeing already some increases in mobility in some of the cell phone data, the question is how quickly will people change their behaviour and how quickly will they go back to having more contact, more contact means more transmission and sadly eventually more death.
GUPTA: So, just to be clear this increase in numbers then does not account for these re-openings? Because we know that they're coming and some have already come, but you say that numbers have gone up to spite that. So, they're definitely going to go up even more, you're predicting?
MURRAY: The numbers are up despite that, we are really hard at work trying to translate these changes in the mandates into what that's going to mean. And the reason that's harder than you might think is we know mobility's a driver of transmission, but at the same time we're seeing states ramping up their testing and if the more you test, the more you find infectious individuals or even asymptomatic individuals and get them to isolate, the more you can tamp down transmission.
So these two opposing effects and the goods news is the US has doubled testing in the last week, not equally in all states, but we've got to try and figure out how the balance of those two forces will play out, but certainly our numbers are going to go up once we take that all into account.
COOPER: When you look at the data, I mean, are the flatter, longer peaks, is that unique to the United States or has that happened around the world?
[20:40:00]
MURRAY: You know, it's happening in different places in the world. You know, if you can go to two adjacent places in Italy -- you know, Liguria and Lombardia -- and one of them had a pretty up and down sort of pattern -- you know, the down swing was really quick like Madrid was in Spain. And then, you know, an adjacent region has this long- protracted peak and a very slow decline.
And nobody's really come up with a great explanation for who gets the long-protracted peak and who's lucky enough to have the quick decline -- must be related to, at some level to, you know, behavior and social distancing. But we're having a hard time predicting in advance where that's going to happen.
GUPTA: Many of the models I look at, Dr. Murray, don't extend out a few days or a few weeks. Yours goes to August. I'm curious, how did you pick August? And what are your expectations after that?
MURRAY: You know, August just started when we started off this effort and we were talking to the hospitals that we were primarily trying to help plan for the surge. And we said, "So, what time frame do you want some planning numbers for?"
GUPTA: I see.
MURRAY: And the response we got back was, "Four months." That's the way they were thinking about it.
So, we said, "OK, we'll try to -- we'll do forecast out to August." We haven't changed that farther going out because there is so much uncertainty about what will seasonality and temperature do to transmission. And then, on the other hand, we're also being asked by a lot of groups to make forecasts of when there may be a resurgence in the fall.
GUPTA: Right.
MURRAY: So, we'll get there. We'll come up -- we'll extend our forecast window into the fall, but first priority for us is to really capture what's happening now in the country and the relaxation of social distancing and the warmer weather and how that all plays out as well as the rise in testing.
GUPTA: Got it.
COOPER: You know, it's interesting because we've obviously been talking to you throughout this. And, I mean, I remember when the modeling that -- your projections to August were, I think, like, 61,000. And I feel that was, like, several weeks ago. And correct me if I'm wrong because this is just from memory. And then there was better social distancing in southern states in some of your modeling.
MURRAY: Yes.
COOPER: So, when I saw that, you know, the death toll had actually, basically, you know -- was coming close to what you projected for end of August already -- is that just the longer -- that the peaks had been longer? Is that or is it that social distancing hasn't been followed as much as you had anticipated?
MURRAY: You know, our approach to forecasting -- I think we've talked about it before, Anderson -- is really very data driven. It's like weather forecasting. So, we're trying to forecast the path of a hurricane. And so, our models adapt to what we're seeing in the data. They're not sort of like a theoretical stand about what we think the epidemic will be. And so, we've seen a number of swings happening.
So, we started off at about 80,000 deaths with a wide range -- you know, 35 to about 150,000. And then we saw as you mentioned, that mobility metrics suggested that the south was doing a better job than we originally thought. That brought the numbers down.
And then you had this very long-protracted terrible epidemic in New York --
COOPER: Yes.
MURRAY: -- where New York stayed at the peak with you know, thousands of deaths a day at the peak that really racked up the death toll. And we've seen protracted peaks much smaller. But even here in Washington state, we stayed at the peak longer than we expected to see mostly for hospitalizations, a little bit for death.
Put all those together, you're getting these changes and then the new thing that's happening on top of that is this presumptive deaths that were missed -
COOPER: Yes.
MURRAY: -- in nursing homes and elder care facilities. So, people are back-reporting. They're sort of rewriting the history by telling us about deaths that the states missed in the past.
COOPER: Yes.
MURRAY: And, you know, our net forecast for the country is the balance of all this new information feeding in on a daily basis.
COOPER: Well, Dr. Murray, we appreciate your expertise as always. Thanks so much.
MURRAY: Happy to be here. Thank you, Anderson.
COOPER: Quick reminder, at the bottom of your screen you'll see our social media scroll shows some of the questions that you're sending us. You can tweet us your questions with the hashtag #CNNTownHall or leave a comment on the CNN Facebook page.
Back now with Sanjay. And also, I want to bring in a veteran of many of our Town Halls -- Dr. Leana Wen, a visiting professor at the George Washington University School of Public Health, also Baltimore's former Health Commissioner.
So, Dr. Wen, with this latest coronavirus modeling showing an increase in the estimated deaths nationwide and as they are going to now incorporate the ending of social distancing, it's likely to go up, does it concern you that so many states are relaxing their orders?
DR. LEANA WEN, VISITING PROFESSOR, GEORGE WASHINGTON UNIVERSITY: Yes, it does. I mean, I'm worried for three reasons. One is that the numbers are going up, as you were saying, Anderson. And also, we don't know the true numbers because of under-testing.
[20:45:00]
GUPTA: Right.
WEN: Second is we have lack of capabilities. We just don't have the public health infrastructure to do the tracing and quarantining that we need. And third, I'm not sure that the American people are ready for another wave of -- not only resurgence of deaths, but also for another wave of shut downs if necessary.
So, I hope that all those who can will continue to shelter in place, stay at home and those who have to go out should take additional precautions like wearing a mask, washing our hands and trying to stay six feet apart, because we can all do our part to continue to protect each other and our loved ones.
COOPER: All right. Let's get some viewer questions. Sanjay, Andrew in New Jersey sent in this question which reads "Why was a vaccine never finished during the original SARS or MERS outbreak?" And then there is a follow-up about -- well, let's answer that one first.
GUPTA: Yes. So, they were started, these vaccines were started and some of the techniques that they used for those vaccines are actually being built upon now. But a couple of things, one is that the other outbreak SARS and MERS, because of some of the strategies we've been talking about we were able to make those epidemics, pandemics sort of really sort of fizzle out.
So, a vaccine wasn't as necessary and you know, vaccines cost money. So, as things started to die down in regards to those other infections I think the vaccine plans that guys like Peter Hotez were working on just sort of went away.
COOPER: And how similar are those diseases to COVID?
GUPTA: Well, so, the coronavirus is the same thing that caused SARS and MERS, a type of coronavirus. So, that part is similar and some of the techniques to use sort of a genetic vaccine, some of that was started -- some of that knowledge was sort of gained back started with SARS back in 2003. So, able to build on it but each vaccine's still going to be different, each pathogens going to be different.
COOPER: Dr. Wen, Alex Miller in Connecticut sent in this video, let's take a look.
(BEGIN VIDEO CLIP)
ALEX MILLER, HIGH SCHOOL STUDENT: Hi, my name is Alex, I'm 16 years old and I tested positive for COVID-19 two weeks ago. And since then, I have had small painful bumps on my tongue. So, I was wondering if you knew of any other cases for this symptom or any remedies for this symptom? Also, I haven't lost my sense of taste, thank you.
(END VIDEO CLIP)
COOPER: Dr. Wen.
WEN: Well, as far as I know there is no association that we know of between the bumps on the tongue and COVID-19 although Alex brings up a good point about the loss of smell and taste that even though COVID-19 is a respiratory virus, it is believed to cause these other types of symptoms.
So, I would say for Alex specifically about the bumps, if they are causing enough pain and discomfort that he's having trouble eating and drinking he should call his doctor and in the meantime I hope that he recovers well.
COOPER: Dr, the CDC actually added new coronavirus symptoms to it's list earlier this week and I want to put them up on the screen just to go over them. It's fever, cough, shortness of breath, chills, repeated shaking with chills, muscle pain, headache, sore throat, loss of taste or smell.
WEN: Yes, so what we knew before about the most typical symptoms for COVID-19 were the fever, the cough and shortness of breath. Now it's important that CDC added six more symptoms, because one of the criteria for testing from a lot of places is having these symptoms.
So, many of these new symptoms are what you would expect for a viral syndrome -- the chills, the shaking, headache, etcetera, that's what you see for viral syndrome. The one that's different is the loss of smell and taste and again, I think that illustrates that COVID-19 is not just effecting the lungs, it's effecting potentially the nervous system, other parts of the body too and we're learning a lot more as the disease goes on.
COOPER: Yes. Sanjay, this next question came in via Twitter with our hash tag CNN Town Hall, it's at the bottom of your screen there reads "As long as you follow social -- hash tag social distancing, is it OK to continue solo outdoor activities like jogging or running? Any other steps to make sure we're safe as we workout?"
GUPTA: Yes. No, I think so, that's the key is whether you're inside or you're outside, you want to maintain that physical distance. That's the key in terms of breaking the transmission, that's what we're trying to do here is break that transmission of spread and hopefully start to make the virus die down like other viruses have.
COOPER: I can make a tutorial video on how to watch Netflix safely or stream other movies cause that's about the only activity I've been doing. But you made a video Sanjay that shows us the best way of running safely outside. Let's take a look.
GUPTA: OK.
(BEGIN VIDEOTAPE)
GUPTA (on camera): Everybody wants to be outside. I want to be outside, people are going stir-crazy inside and it's OK out here for certain. You also want to run and running's OK, the risk of getting the virus while you're running is really, really low, but it's not zero. So, here's a couple of caveats to keep in mind.
[20:50:00]
GUPTA (voice-over): Same rules apply, you want to maintain a physical distance when you're running, just like when you're inside. We hear six feet, according to Lindsay Marr at Virgina Tech, when you run, maybe you make that closer to 10 feet or 12 feet.
Why? You're breathing harder, you may be putting more virus into the air. Avoid people as much as possible, maybe you're going to run at odd times, early morning or late at night. Maybe you're going to run different routes, just to sort of mix it up.
And let's say you see someone in front of you a few feet. Lindsay says maybe you switch over to the other side of the road at this point because you do want to avoid someone's as she calls it "breath cloud". There's a thing about masks, if you're truly going to be running by yourself, you don't need one.
But if there's a chance that you might be sharing a path or a sidewalk with somebody else, then probably have a mask with you. At a minimum, it's a courtesy to let people know that you're taking this seriously and trying to protect them. Keep in mind, if you have any symptoms whatsoever, you should be staying home.
GUPTA (on camera): So, go ahead and do it, I do it, Dr. Fauci does it, it's good for your physical health, I think it's good for your mental health as well.
(END VIDEOTAPE)
COOPER: So, if you're running near, you know, on a path where there's other people nearby you should you wear a mask?
GUPTA: I think so, yes. I think if you're truly not going to come in contact with other people and still able to maintain a safe distance, which you heard maybe closer to 10 or 12 feet because you're breathing harder, then I think it's OK not to wear a mask. I carry one with me if people are going to be around, I think it's a courtesy as well, I mean people are frightened, Anderson, so I think it shows that you're taking this seriously.
COOPER: Yes. Dr. Wen, this next question came in via Facebook with our hash tag CNN Town Hall, it's there at the bottom of the screen. The question is "Should we change our clothes after returning home from being in public places like the grocery store?"
WEN: With the chance of actually acquiring COVID-19 from your clothes that somebody else may have transmitted virus to those chances are very low.
But I would say that if you are a heath care worker, if you're somebody who is around a lot of virus potentially at work, then it makes sense to come home, change your clothes, leave your shoes outside. You can still do so out of an abundance of caution, but the chance of actually acquiring COVID-19 that way are very low. COOPER: All right. Sanjay, yes, your go.
GUPTA: And I tell you one thing I've been doing, I don't know if you've been doing this Leana, at the hospital, I actually change my clothes there now so, I go and change into scrubs and then change back to try and reduce the chance of bringing it home.
COOPER: Dr. Wen, Carly in Virginia sent in this video, let's take a look.
(BEGIN VIDEO CLIP)
CARLY BUXTON: My son was born two weeks ago during a peak week of this crisis and since then we've been quarantining at home. I expect it will be many months before he's held by anyone outside of the family or before he goes to any public places.
My question is this, does spending the first few months of life in an ultra-sterile environment have any lasting impact on a child's immune system? Thank you.
(END VIDEO CLIP)
COOPER: Dr. Wen.
WEN: Well, Carly, I'm in the same boat as you. First of all, congratulations, but I also have a four week old and no-one else has held the four week old other than my immediate family and we're certainly not planning to go to any public places.
Look, I wouldn't worry about lack of exposure for now, because actually for newborns they have such limited immunity anyway and we wouldn't want to expose the baby to all kinds of other germs anyway.
And this outbreak is going to be over at some point and we will be able to see people again and in the meantime, I would say you can also boost the baby's immunity by breastfeeding if you can, doing a lot of skin-to-skin contact and just enjoying the baby.
COOPER: All right. Sanjay, Eric in New York sent in this video, let's take a look.
(BEGIN VIDEO CLIP)
ERIC VIETZ, BANK BRANCH MANAGER: Is it appropriate to compare the infection fatality rate of COVID-19 to the infection fatality rate of the seasonal flu when we have a flu vaccine? What would the infection fatality rate approximately be for the seasonal flu if we had no vaccine?
(END VIDEO CLIP)
COOPER: Sanjay.
GUPTA: That's a really good question and a good point. I mean, what we say is that the fatality rate for those who get infected with the seasonal flu is around point one percent. Now keep in mind though, keep aside the vaccine for a second, because we all have lived on this planet, we all have some immunity to this seasonal flu because there's some variation of the flu changes a bit every year, but we do develop some immunity.
And because a lot of people have been exposed, we start to develop some herd immunity to the seasonal flu as well, so those things help us. Then you layer on top of that the vaccine, so again -- but the fatality rate to the question, which is a good question is point one percent for those infected, so in this country, if 30 million people become infected with the seasonal flu which is not that atypical that means 30 thousand people roughly would die of that. So that's -- I think that's the way to sort of think about it.
[20:55:00]
COOPER: All right, Sanjay. Dr. Leana Wen, thank you so much as always. Sanjay, stay with us. Up next, Bill Gates shares his thoughts on testing vaccines and how we successfully reopen the country. And we've got a nice announcement to make ahead, also.
(COMMERCIAL BREAK)
COOPER: Welcome, again, to CNN GLOBAL TOWN HALL: CORONAVIRUS FACTS AND FEAR. Johns Hopkins University reports there are now more than 1 million cases in the U.S.
GUPTA: Almost 63,000 dead and all of that as federal guidelines on social distancing expire tonight and at least 31 states will have started to reopen by this weekend.
COOPER: Back here with us once again to talk about this as well as testing, treatments and more, Bill Gates, Co-Chair of the Bill and Melinda Gates Foundation.
Bill, thanks so much for being back with us. It's been a little over a month since you were here, and in that time, you said the U.S. had not hit its peak. So, at this point do you think we have peaked and where do you think we are right now in kind of the ark of the pandemic?
BILL GATES, CO-CHAIR, BILL AND MELINDA GATES FOUNDATION: Well, we certainly hit our first peak, and if we stayed with the social isolation policies then most places in the country would continue to see a decline. Because people are going to go back to more association in some places in the country, it's very likely that there'll be future peaks as well.
[21:00:00]
