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"yale school medicine" Discussed on All In with Chris Hayes
"Earlier today. The president was on a teleconference with the nation's governors telling them when it comes to ventilators quote. Try Getting it yourselves. He then took a shot at New York governor. Andrew Cuomo the guy who's just announced a plan with New Jersey and Connecticut to begin. Take control this thing. The president tweeted. He has more to do to which correspondent quote. I've do more no. You had to do something you are supposed to be the president throat this crisis which has been building now for months the response. The president has ranged from absentee to negligent to actively harmful at almost every turn president trump either publicly downplayed the risk or failed to act proactively such that. We are now very very far behind on Friday. The president is able to pull a stunt with thirty minutes until the markets closed rally the stocks. Today he came out again finally finally appearing to grasp and communicate the seriousness and duration of the pandemic market has been there for a while however they've seen what's coming today. The Dow closed down three thousand points the biggest single day point loss of all time the second largest percent loss. It is very hard for all of us to get our heads around this moment. Because there's no obvious precedent for what we are currently facing and will continue to face for weeks and months. I mean I say this is the father of kids. We're not in school for at least the next six weeks or so. The closest parallels we have at hander disaster preparedness and recovery. We saw New Orleans and the Gulf coast after Hurricane Katrina War war mobilization were to to an extent. We have not seen in over half a century but the one advantage that we have here. We think on that scale that scale of the challenge is we have something to collectively combat society helpless mobilized towards that aim. And if we get it right. We will not be dealing with the level of sheer physical destruction. Our grandparents had do during the war or the people of New Orleans had to deal with after the hurricane. If we can get this right we can rebuild very quickly but we have to get it right joining me now from on how we accomplish that Greg Gonzalvo his assistant professor at the Yale School Medicine and Dr Gary Procup Vice Chair of Pathology Laboratory medicine at the Cleveland Clinic. Dr Gonzales says let me start with you on this. Where do you see us right now? Are you encouraged by the dramatic steps? We've seen the last seventy two hours in terms of shutting things down to try to maximize social distance and slow the spread of the virus. Look we have no choice? We have to institute social distancing measures. Some of which the President Dan his team outlined today. But there's no virtue in late adoption. We lost three months in trying to combat this new virus by delays and equivocations and disavowals about the importance of this epidemic. And so we're doing what we should do right now. But there's a big question about it. It was too little too late. Dr procup from the testing and surveillance standpoint. Where do you see us right now? In terms of our ability to get is on the virus and have a sense of its actual scale and the ramping up of testing which has been increasing daily. But he's still not there yet. That's exactly right Chris. We are ramping up. If we had been allowed to test earlier we would be where we needed to be. And knowing which patients have this virus in which do not so they could go into self quarantine. But we're we are catching up and ramping up. But tell me more about what that means. I mean I know there's been. Some regulatory hurdles have been done away with for the FDA. There's both private labs their common platforms being used. It strikes me though is still hard. Even in the epicenter of outbreaks to get easy and reliable point of care testing. Is that fair? That's absolutely fair so I will say once. The regulatory burdens were lowered van laboratories that were really highly skilled laboratories. Were able to bring up this test. I will say though. There are delays from most of the commercial manufacturers for the instruments there are delays in reagents. So many of these things are hamstringing many of the common laboratories and we're nowhere near point of CARE Testing Greg Lie. We're now in a situation. We're undertaking mass essentially forced quarantine. Right I mean the thing you've seen in San Francisco what we've seen in Italy and in France and in Spain and Greece. I saw this tweet. Today was fascinating and I wanted to get your on it in terms of how testing inter-plays with the policy. We need this is blue bottle. Blue bottle is closing stores but staying open in Japan and South Korea where the virus has also spread because they have quote extensive testing and medical support. Clearly in place. There is a cost. We're paying in not being able to know where the virus is we cannot. We cannot precisely targeted our efforts for prevention or to mobilize resources for care in the coming healthcare surge because we don't know where Infections are and what extent they exist across the country and so we're doing brute force measures right now because we don't have any testing capacity to give us a clear picture of what's going on across the United States. You'RE A deputy biologist you've dealt with other infectious diseases and outbreaks. Before a bunch of health experts issued a letter. I think about two weeks ago about best practices how to how to attack this. How are we doing on that We're doing slightly better but we are still failing on most of the points. We outlined the letter for instance as you started a restaurant in bars or closing across many cities and states across the United States. Where are these people going to find their livelihoods over the next two months there needs to be an immediate a provision of some sort of economic relief to many people who are? GonNA LOSE THEIR JOBS. Have NO SICK PAY. Who HAVE NO VACATION PAY? Do not have the option of working from home over the next six to eight months. Mitt Romney today said we should give every American thousand dollars a month for the next few months that distort and both parties should agree to it and get it going now. Dr procup. I talked to a bunch of doctors over the weekend. Some here in New York City Emergency Room. Doctors were very concerned. In fact one today told me that today you could see it in the Er that it was. It was really palpable today. How much coordination is happening? We have a very fragmented. Healthcare System in America unlike a place like Italy between hospitals between doctors and between regions or anyone who is coordinating folks like yourself and others to sort of be together planning so that places can prepare. That don't have a huge outbreak. Now for what's coming I would say there's non great coordination overall it takes individual groups to coordinate. I will say within our city within Cleveland. The leaders of the medical institutions have gotten together and talked how they can coordinate for example. You know we. We've coordinated the drive through swabbing area with university hospitals so it takes individuals to take the initiative to coordinate. There's not great coordination above that. But there really should be all right. Greg Gonzales Dr procup. Thank you both for sharing tease for important. I WanNA bring it now. Connecticut Governor Ned Lamont today announced his State is Coordinating Corona virus response efforts with New York and New Jersey Governor. Tell me how you and those other governors came to make the decision issue the announcement today about Jim's and bars and restaurants and like Chris. You summarized it very well In your introduction. You can't wait for the feds to take the lead so is a small state of Connecticut. Doesn't work for me just to do Restaurants and bars alone so do it in coordination with Andrew. Cuomo New York and Murphy. Down in New Jersey makes a lot of sense. I was on the phone with Rhode Island today. So we're taking the lead where the feds have fallen off. We've got lead but I'm GonNa tell you what really brings it home was luck last night The bars are pretty crowded in this city and people were taking this to heart now. They're closed people. Know this is real. It's notable I think I've looked at some metric today about traffic and things like that. Clearly this this is having effect. What are you doing at the state level? What are your Public Health? Experts telling you about how to understand what's coming your way. I was on the phone with all the hospital system today. And we've got to do a lot more now. We're GONNA have a hit on our ICU. Intensive Care Unit so we have no idea what's coming and that's going to mean more people. More nurses more beds more equipment more ventilators. We're not getting much help from the feds. That has the president said Go. Get Your own ventilators. But you don't get that at Amazon Dot Com. We're working this hard to do what we can to prepare for. That wave is just a week or two away are there. Are there simple. Clear things In terms of say Medicaid reimbursement the federal government could be doing could be stepping in to aid your efforts right now that you're not getting well you've described the testing in some detail right now. I've got to do a better job of convincing folks. If they're ill they're not feeling right. They may have some early case of the flu. Stay home take care of you in terms of getting paid. Take Care of you in terms of health care but you gotta have the get up and go to stay home. Stay home going to the office going to work going to school. That's a dangerous place to be these days. If you're not feel right I get that message. We've been communicating avenue. Reviewers that that basically at this point we need to keep ers clear for the most at risk but as you think about your ICU's reaching a capacity potentially as the pandemic grows like what do you need. What resources do you need? And where can you get them in? Can you get them from federal government? Are there easy things a federal government can do for you? Well I can tell you. Danbury hospital is already at capacity and they have two hundred. Nurses are on furlough because they were in contact. If I could test those nurses I could potentially get them back into the game suitor. You've got you've got two hundred nurses sitting on the sidelines right now. Who can't get back to work because they can't be tested to confirm whether or not they have the virus exactly we got a surge in us. Demand is going up and I'm losing nurses by the day we'll have to furlough themselves for a period of time. That's a priority for testing for me. Where are testing capacities going up? But it's going up very incrementally and that's dangerous on the economic front. You heard what Greg said. Obviously this is enormous social disruption enormous economic disruption and hardship. What can the state do? And what are things that only the federal government can do? What are you planning? We are working with our small businesses right now. We have a lot of folks in the service sector you know. They're stored their business their restaurant there. Are that stopped. And what can we do to help them get through? How can we provide You know unemployment compensation to their folks are covered for a period of time. I'm providing small business loans right now to help them cover this bridge..