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CNN NEWSROOM

Interview with Mayors of Philadelphia and Boston; Rural Hospitals Face Financial Difficulties; Live Coverage of New York Governor Andrew Cuomo Press Conference. Aired 10:30-11a ET

Aired April 21, 2020 - 10:30   ET

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


(COMMERCIAL BREAK)

[10:31:35]

JIM SCIUTTO, CNN ANCHOR: Well, we've talked about mail-in voting, how about a mail-in coronavirus test? The FDA has now authorized the first ever mail-in coronavirus test.

POPPY HARLOW, CNN ANCHOR: Our senior medical correspondent Elizabeth Cohen joins us now. It's interesting, how does it work?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: You know, it's interesting, you could mail in your ballot and your coronavirus test on the same day, I guess, you could just really make use of the mail that day.

The way that it works is that you get this test, and it includes sort of a Q-tip kind of swab. And you use that to swab your nose, and then you mail the test back in. And LabCorp, which is going to be market this test, has said that once they get specimens, it takes them usually about two to four days to process it. We'll see if that holds up for this at-home test as well.

But, you know, this is -- if this could be scaled, if we could do this large-scale, this could make such a big difference. Because I personally have spoken to several patients who are saying, you know, what, I think I have coronavirus but I don't feel well enough to go to the doctor or I don't, you know, want to go there and risk getting somebody else sick.

I've talked to a couple patients who have decided to stay at home and kind of wait it out. I'm not saying that's the way to go, but it would be nice if they could just get these results at home.

HARLOW: Elizabeth, thank you very much. Appreciate it. It's going to be interesting to see how that all works out.

While some parts of the country are at their peak or past it, other cities like Boston and Philadelphia --

SCIUTTO: Yes.

HARLOW: -- are still seeing a surge in cases. SCIUTTO: Vice President Mike Pence says the administration is now

working to move resources to those cities. Joining us now, the mayors of those cities: Boston Mayor Marty Walsh, Philadelphia Mayor Jim Kenney. Thanks to both of you. We know you've got a lot on your plate.

Mayor Walsh, maybe I could start with you. I guess the big question for public officials around the country is, what do you need to see first before relaxing some of these restrictions? Because I know you're hearing it both from the health experts, but also people who aren't making any money, they're concerned about their job, they're concerned about their business. How do you make that decision?

MAYOR MARTY WALSH (D), BOSTON, MASSACHUSETTS: I think what we need to see is more data, to see our testing, to see what the testing is saying. In Boston, we have about 5,700 positive cases of coronavirus; in the Commonwealth of Massachusetts, we're at about 39,000. So we're nearly at 40,000, we're number three in the country as far as positive cases of coronavirus.

And to really make informed decisions, you need informed data. And that data right now just simply isn't enough, and the sampling isn't wide enough to be able to make real accurate decisions on how do we restart our economy, what population should not be starting to work when we open the economy, and making those important decisions so we don't get people sick and we're not in this same situation three or four months from now.

HARLOW: Mayor Kenney, to you, the governor of Pennsylvania has actually pushed back the target date to start reopening until May 8th. But the plan, at least now, is that after that, it will be sort of region by region across your state. I wonder what you think of that, because people don't just stay in their city generally, right?

MAYOR JIM KENNEY (D), PHILADELPHIA, PENNSYLVANIA: Right.

HARLOW: So if you have things so different across the state, will that be effective?

KENNEY: Well, it's be -- certainly a factor in the decisions we make. I mean --

HARLOW: Yes.

KENNEY: -- Pennsylvania is primarily a rural state. We have pockets of population in the southeast and in Western Pennsylvania, and smaller pockets up in the northwest and northeast. But in the middle of the state and across the northern tier, there's very few -- little population and very little activity of the virus, although it is there in every county.

[10:35:07]

We're at about 10,000 cases, we're closing in on 10,000 and we've lost 300 souls to the disease. And even though it seems as if we're plateauing, which I believe we might be, I don't want to send a message out to the public that somehow the crisis is over, go back to -- you know, go back to your old activities.

We have to make sure we keep on pumping out the social distancing. People need to wear masks out, there's no doubt about that. And the governor had ordered that all masks be worn in all essential businesses.

It's just going to be a pretty long slog. I don't know what's going to happen through the summer. Hopefully we won't have another resurgence, but we have to be disciplined, we have to be mature about this and then we have to turn to the federal government for the help that we're going to need to rebuild our cities and states.

SCIUTTO: So, Mayor Walsh, social distancing is designed, really, not to prevent everybody from getting the virus -- because sadly, many more people will get it -- but flattening the curve so that they don't overwhelm hospitals, doctors, facilities, et cetera. Has the social distancing accomplished that for the city of Boston in terms of allowing the space you need to treat the people who are infected, particularly the most serious cases?

WALSH: I mean, I'm making an assumption here that it has helped. We don't know to what level it's helped unless we have the real information and more testing. We're seeing a spike in our homeless population, about 32 percent of our homeless folks are coming back positive. We have people in our nursing facilities and older folks that are coming back at a high level.

Those numbers don't give us an accurate account of the overall population in Boston. And I think what the mayor said is absolutely right. I think that, you know, we need to continue to be very vigilant on wearing masks and doing the physical, social distancing and making sure that people are staying at home as long as possible.

All of that stuff is going to help us, but I think it's really hard to give you an accurate -- even the curve. I mean, when we talk about the curve and the surge, I mean, the models have changed in the last week, two or three different times. So it's very complicated when measuring how good we're doing with the data that we have, because we don't have complete, accurate data.

Your segment before this talked about doing at-home mail-in testing. I mean, I don't know if that's a reality, I don't know what the -- what the rate is to that as far as the accuracy of that. But we really have to start focusing on national testing across the board.

You know, in Massachusetts, we have rural areas as well as Pennsylvania. Maybe not as many, (INAUDIBLE) high out there. But we still have populations of people in urban areas in the Commonwealth of Massachusetts. And we're seeing those numbers testing at a higher rate because people are --

SCIUTTO: Yes, yes.

WALSH: -- living on top of each other.

HARLOW: Mayor Kenney, you were nodding your head a bit there, too. I mean, are you seeing that -- 32 percent positive rate among homeless -- the homeless population is staggering. Are you seeing something similar?

KENNEY: Yes. I don't know the exact percentage, but I'm shaking my head because everything Marty's saying, we're experiencing the same thing here. I mean, it's like a mirror image of each other, although we're a little -- slightly bigger city.

It really -- it's the rapid testing, it's the tracing, and it's the quarantine that we really need the federal government to help us with. Because -- and Mayor Walsh is right. If we don't have the data, we don't know what we're up against. And this --

HARLOW: Can I just ask --

KENNEY: -- this virus -- yes, go ahead?

HARLOW: Just on that point, can I ask you quickly -- because the mayor of Detroit has had so much success with those Abbott lab rapid 15-minute tests, can you get those? How do you get those? Do you have to buy them, do you go to the federal government? How does that work?

KENNEY: I know that our health commissioner, Dr. Farley, is in contact with all the health commissioners around the country. I'm not sure where they come from, but certainly I'm sure he knows. And if we can get -- we can get the same thing with PPE. I mean, we've been struggling to equip our hospitals and nursing homes with the appropriate PPE because there was no national effort to do it.

HARLOW: Yes. Oh, we wish you guys luck.

SCIUTTO: Goodness. Yes, we do.

WALSH: Just real quick, I -- we're in the same -- as Jim said, we are in the same boat when it comes to testing. We're looking at, can we purchase these tests ourselves. We have about 700,000 people in the city of Boston, I'd love to get my hands on 500,000 tests.

We have the infrastructure right now set up to do these tests through our health centers and hospitals. The issue is, can we get these tests that are -- that we can make sure we see what the data reflects.

HARLOW: Yes.

SCIUTTO: I mean, it's amazing that that's still an open question, right?

KENNEY: We should not -- we should not be --

SCIUTTO: Can you get the tests?

KENNEY: We should not be in competition with each other, that's the problem. We've been in competition with every state and city in the country on PPE, and now on testing. This is what the federal government should be doing, to help guide us through this. HARLOW: We wish you guys luck. My goodness. Just -- it's just a huge,

huge thing to tackle. We wish you luck, getting those fast tests. Thank you both.

KENNEY: Thank you.

WALSH: Thanks.

[10:39:58]

SCIUTTO: Well, some rural hospitals were teetering on the edge of collapse before the coronavirus pandemic. And this crisis has made the situation even worse for them.

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HARLOW: The coronavirus pandemic is having a catastrophic effect on hospitals in rural America. Many, battling this medical crisis while also facing financial ruin.

SCIUTTO: Yes. It raises the question, can they survive? CNN's Leyla Santiago, she is live.

Leyla, these hospitals, they're not getting the attention that bigger medical centers of course, where this outbreak has been focused -- Boston, New York, Seattle -- are getting, so how are they managing?

[10:45:07]

LEYLA SANTIAGO, CNN CORRESPONDENT: Right. Well, you know, I spoke to one rural hospital here in Virginia that called the coronavirus "crippling," and that rural hospital hadn't even had a COVID-19 case yet. Our team spoke to five different rural hospitals across the country, each of them echoing that same sentiment. And this, as COVID- 19 cases are on the rise in rural areas.

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SANTIAGO (voice-over): Among the rolling hills and the open fields --

DANIELLE (PH) BEHR (PH) CORONAVIRUS PATIENT: A laid-back community. To me, it's one of the best places to live.

SANTIAGO (voice-over): -- rural America has largely been able to avoid the worst of coronaviruses, no packed ICUs or morgues filling up. But there are people with COVID-19. Eighty percent of rural counties across the country have now reported cases. And though it is nowhere near the spike seen in metropolitan areas, for doctors like Dr. Donovan Beckett in West Virginia --

[10:45:01]

DONOVAN BECKETT, PHYSICIAN, WILLIAMSON MEMORIAL HOSPITAL: It's been devastating. I mean, it -- having COVID on top of an already struggling health care system has been quite burdensome. SANTIAGO (voice-over): The presence of a pandemic is just one more

financial burden on struggling rural hospitals, already trying to stay afloat. Nineteen rural hospitals closed last year, victims of cuts to Medicare and Medicaid funding and reduced populations.

RANDY TOBLER, CEO AND PHYSICIAN, SCOTLAND COUNTY HOSPITAL: It's just a perfect storm for Armageddon --

SANTIAGO (voice-over): Dr. Randy Tobler is an OB-GYN, and the CEO of Scotland County Hospital in Missouri, which serves about 5,000 people. When elective procedures came to a halt in response to the coronavirus, their revenues dropped by more than half.

TOBLER: When we were already in a tremendously fragile financial situation, it has really put a tremendous burden on our ability to meet payroll --

SANTIAGO (voice-over): Last month, the hospital furloughed some staff and reduced pay across the board, desperate to avoid running out of money and having to close, which would be devastating to the community.

TOBLER: Yes, these are the vulnerable populations. They're older and they're sicker, and they're therefore more vulnerable to the coronavirus menace.

D. BEHR (PH): It is critical for our area to keep the hospital here --

SANTIAGO (voice-over): Tobler's patients, Danielle (ph) and Jake (ph) Behr (ph), are both recovering from COVID-19 and said having a hospital with familiar faces closer to home made all the difference.

D. BEHR (PH): We are about an hour from any other health care facility. And there are times when people need emergency care, and we need it now.

SANTIAGO (voice-over): Back in Mingo County, West Virginia, Williamson Memorial Hospital will likely shut down any day.

BECKETT: And we've obviously had to do away with having elective procedures done on an already struggling volume level, so that creates a perfect storm and it makes it difficult.

SANTIAGO (voice-over): After filing for bankruptcy late last year, the hospital was hoping a future partnership could save it. Then came COVID-19.

BECKETT: It was the last straw, and the current owners decided that they would go ahead and pursue closing the hospital.

SANTIAGO (voice-over): The relief package Congress passed last month provided some temporary relief to rural hospitals with a $100 billion fund for hospitals and other health care providers. It's not enough, Tobler says. TOBLER: We were a vulnerable -- and remain a vulnerable, and are

probably now a more vulnerable rural hospital because there's no foundational change.

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SANTIAGO: And, Jim and Poppy, Dr. Beckett in West Virginia tells us, if there is no federal or state intervention -- when I asked him when they would shut their doors -- he said, April 21st. That's today.

HARLOW: My goodness. Leyla, thank you for --

SCIUTTO: That's too bad.

HARLOW: -- keeping on all of that reporting. It's so important.

[10:49:03]

All right, ahead for us, a story you broke overnight, Jim -- a critically important one. U.S. officials, saying they're keeping an eye on intelligence that says -- indicates that North Korean Leader Kim Jong Un is in, quote, "grave danger" after having surgery. More on that, ahead.

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GOV. ANDREW CUOMO (D-NY): -- City. But just as we're seeing across the country, this virus presents a slightly different problem in different parts of the country. It also presents a different problem in different parts of the state.

Overall, the total hospitalizations are basically flat from where they were yesterday. And as you see, the overall curve is on the way down, and that is good news, certainly.

The net change in hospitalizations is down, not down as much as we would like. Change in intubations is down, and that's always good news because intubations means a person is on a ventilator. Eighty percent of the time, when people are on a ventilator, they don't come off the ventilator in a successful way.

The number of new people in the state who walked int he door yesterday or were diagnosed with COVID is 1,300. That is down, and that's good news, relative to really bad news, which is what was happening up until then, right? We have to remember our calculus of good, our definition of good has changed here. Good is now "not terrible."

[10:55:00]

But on an absolute scale, 1,300 people walk in the door with COVID on a single day in the state of New York, that would not be good news in any other context between -- besides the context we're living in.

This is Erie County -- Buffalo's in Erie County, New York -- and you see the numbers --

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CUOMO: -- right away. Testing, isolation, et cetera. But that's remained fairly constant, and that's also good news.

But the point that different regions of the country have different quote-unquote "curves," the virus does not hit at the same time, at the same rate. So you hear about different states in the country. And when they're going to hit their apex, when they're going to hit their top and when they're going to come down, it's different all across the country.

It's also different across the state. We've been talking about states like they're uniform, homogenous entities. Some are more homogenous than others. When I was in the federal government, I worked in every state. So you have a whole different variety of states. This state, we have very different regions within New York.

When you say "New York," people think New York City. Yes, one of the densest places on the globe. You also have Upstate New York, where, in some counties, you have more cows than people. You know, people don't think of New York that way. So as you see variety across the country, we have variety across the state of New York.

And you have to watch each one of those individual curves, and when does that region hit a high point and where is that. Because depending on that region's curve, is how you have to calculate your strategy. And you're looking at those curves, how long is the ascent up the mountain and then how long are we on that plateau and then how long is the descent from the plateau.

Western New York, I believe, we're on the plateau. All right, now the question is, how long are we on that plateau and is it a plateau or might it still ascend? Downstate New York, it appears that we're on the descent. And the question then becomes, in Downstate New York, well, how quickly do we descend?

The worst news -- and the really ugliest part of my job these days -- is telling New Yorkers this news. In Erie County, we lost seven hospital deaths yesterday, for a total of 125. In the state, we lost 481 people, 452 in hospitals, 29 in nursing homes. Again, nursing homes are a central focus and priority for all of us going through that.

Where are we today? We're operating with two rules. First rule is do no harm; second rule is start to plan the reopening. Planning the reopening is just that, plan the reopening. Understand that calculated, calibrated, nobody's ever done it before. How do you do I, when do you do it. But first rule, do no harm.

We paid a tremendous price to get where we are today, and make the progress that we have made today. We paid a tremendous price to control this beast. We closed down everything, people have worked tirelessly in the health care system, in the first responders and the essential workers. You showed you can control the beast. Do no harm. Don't go backwards, that's the first point. And then plan the reopening. [10:59:58]

On the do no harm, you take a place like Erie County, any region in the country or in a state that is still on the ascent or on the plateau, be --