New York Times Reports, Hidden Outbreaks Were Spreading In U.S Cities Far Earlier Than Americans Knew
JIM SCIUTTO, CNN NEWSROOM: And Seattle by March 1st.</s>POPPY HARLOW, CNN NEWSROOM: And it's remarkable. Also today, new details about the first known death in the United States linked to coronavirus. A 57-year-old woman from Santa Clara County in California was healthy, they thought. She had no underlying conditions and, quote, died suddenly. That happened on February 6th. It is alarming, and this new information is prompting more states to begin retracing their own timelines. But states are also moving toward reopening at the same time. Georgia moving closer to opening businesses. We're learning that the president's task force had to convince the president to change his view on the governor's plans there in Georgia. Let's get to that in a moment. But, first, let's get to this study, Elizabeth. What does this tell us and how did they get to these numbers?</s>ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Let's go right to the numbers and see what we have here. So The New York Times is reporting this is a model out of Northeastern University. So it's not looking at past infection per se, it's modeling what past infection would have been given certain circumstances. So if you look on the far left, on March 1st, the CDC was saying 23 cases. That's a very small number. And they were all at this point, pretty much all, linked to travel, people who had been in Wuhan. But in Boston, Seattle, according to this model, there were actually 2,300 cases, in Chicago 3,300, and San Francisco 9,300, and in New York 10,700. So, again, I want to emphasize this is modeling. This is saying, based on a whole bunch of data, this is what we think it would have been. But even if it's a fraction of what these modelers think, and these are very respected modelers out of Northeastern University in Boston, even if it's a fraction of what they think, it seems clear there were many more cases than the CDC was aware of.</s>SCIUTTO: Other focus, of course, is --</s>COHEN: And this --</s>SCIUTTO: Sorry. I was just going to say, the other focus, of course, is on what treatments work and do not. There's been a lot of focus on a drug the president himself has pitched, hydroxychloroquine. A study from the Veteran Affairs granted a small one, showed it was not working, might actually be damaging. There's another large study in New York. Do we know where that stands and when we're going to hear results from that?</s>COHEN: Right. So, Jim, this one is a bit of a mystery. We were expecting to hear preliminary results several days ago, and we didn't. We don't know where this stands. It involves the governor. It involves all sorts of people. Let's see take a look at what's happening with this large study out of New York.</s>COHEN: Coronavirus patients desperate for a cure, awaiting the results of studies on several drugs so they'll know which could work, including this one, hydroxychloroquine, one of the biggest studies so far at the University at Albany in New York. But there's a mystery about that study. Hydroxychloroquine has been heavily politicized. President Trump is the cheerleader for it.</s>DONALD TRUMP, U.S. PRESIDENT: We're having some very good things happening with it. It will be wonderful. It will be so beautiful. It will be a gift from heaven if it works.</s>COHEN: But doctors say it needs to be studied first. On April 12th, New York Governor Andrew Cuomo gave a date to expect preliminary results from the Albany study, which is being sponsored by the state.</s>GOV. ANDREW CUOMO (D-NY): I think we'll get actual reports on April 20th.</s>UNIDENTIFIED FEMALE: Yes, we'll get some preliminary results back on April 20th.</s>COHEN: But April 20th came and no results. The next day, Cuomo was asked about it again after he visited the White House.</s>REPORTER: Do you have any indication of what the state results have been? You said that they were going to be sent to Washington yesterday.</s>CUOMO: I have no -- I do not know. I do not know.</s>COHEN: The researcher says he'll be releasing final results as early as the end of next week and the hopes of helping COVID patients as soon as possible.</s>DAVID HOLTGRAVE, UNIVERSITY AT ALBANY, STATE UNIVERSITY OF NEW YORK: So we're hoping that by next week, we will have reached the final phase of this study. I think this study is really important and it's important that we quickly get to the final phase as fast as we can.</s>COHEN: So far, the most recent studies have not looked good for hydroxychloroquine, the largest thus far at the Veterans Health Administration. 368 coronavirus patients, those who took hydroxychloroquine, had more than twice the death rate as those who did not. In a French study of 181 patients, hydroxychloroquine didn't work and some patients taking it developed heart problems. Neither of those studies has been peer reviewed or published in a medical journal yet. One small study also had 20 study subjects and showed the patients had a lower viral load after taking hydroxychloroquine. But that study's methods have been questioned and the journal that published it is reviewing it again. For coronavirus patients and their families, more waiting to see which drug might make the difference between life and death.</s>COHEN: We're going to be staying on this, Poppy and Jim, until we learn the results of this large study out of the University at Albany. Poppy, Jim?</s>SCIUTTO: That's right, you've got to go with the date. Elizabeth Cohen, thanks very much. Joining us now to talk about this, CNN's Dr. Sanjay Gupta and Dr. Arabia Mollette from Brookdale University Hospital Medical Center in New York. Good morning to both of you. Sanjay, if I could begin with you. I mean, this Northeastern study is fascinating. What would it mean on a couple fronts if this is accurate? One, would it mean far more of us have been exposed to this than we realize, but also, two, does it change our narrative as to where this came from, principally?</s>DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: I think it definitely means the former point. There is probably a lot of people out there who have been exposed to this, that this was spreading within the community far earlier than we thought. I think for most public health people who have been following this since the beginning, I don't think at any point they thought they were absolutely catching the first patients who had been actually contracting this infection. They thought they were representative of a tip of a larger iceberg, they just didn't know how large this iceberg is. And, frankly, we still don't know. These numbers coming out of Northeastern are pretty staggering. They seem high. As you know, there were a couple studies that came out of California that suggested maybe there's 50 to 80 times more patients out there who have been infected than we realize. The truth is probably somewhere in between. But, yes, this is -- we thought that the first patient was diagnosed January 21st. The first patient now, or at least what we think of may be the first patient, actually died of this February 6th. If you look at the lag time between the time someone is exposed, the time someone developed symptoms, hospitalization, it could be three or four weeks. So if a person died on February 6, that means it was already likely spreading in the community in early January. So I think that part we know for sure. It still seems the origins of this still seem like they likely came from animals, it likely was something that originated in that area of China. But, you know, there is a humility, Jim, to your point. We're learning as we go along, and I think we have to continue that humility right now.</s>HARLOW: Dr. Mollette, just to remind our viewers how they first met you, we have some video, I think, when we first met you in this remarkable piece that our Miguel Marquez did inside your -- yes, it happens to the best of us -- inside your E.R. And this was March 29th. So, really, as we were peaking here, getting there in New York, and as you write beautifully in your daily news opinion piece this week, you serve some of the most underserved and underresourced people in New York City. Do you think you were seeing some of these cases much, much earlier than previously thought?</s>DR. ARABIA MOLLETTE, E.R. PHYSICIAN: I'm glad you asked that question. We just had a conversation, my staff and I, we had a conversation about this yesterday, and one of the things that many of us were saying amongst each other was that we noticed that the volume at the emergency department back in February started to increase, and we noticed that many people were coming in really, really sick. And at first, we were thinking like, okay, is this the flu? Of course, we were swabbing people for the flu. I know I swabbed the same patient for the flu three or four times perhaps thinking in my mind, did I misswab the person or this was a false negative, and therefore, people -- we were admitting people but we couldn't figure out for the life of us why they were so sick. And many them were coming in hypoxic or very high fevers, used to be a shortness of breath. But, again, we just didn't know at that time. And then many of my -- or some of my coworkers also fell ill, but no one had an idea of what was taking place or what happened. And so now, we've been having this conversation and we figured that perhaps it was due to the coronavirus.</s>HARLOW: Wow.</s>SCIUTTO: Yes. Humility, as you say, Sanjay, right? We all need humility because so much information is coming in. I wonder that if you're surprised, when you look at some of these early antibody tests -- and, again, it's early, there's not a lot of data because it's not widely available. But when you see 2 or 3 percent of people that have those antibodies, does that surprise you then if we're learning that more were exposed? I mean, does that teach us anything about whether your body can produce something to protect itself against this?</s>GUPTA: Yes. No, I think this is very interesting. I had a good conversation with the people who are running these antibody studies using the MLB as a backdrop. They're testing the executives, players, people who work in the arenas, everybody, trying to get a diverse sort of look at this. And you are seeing a pretty significant number of people who have some antibodies. But there is caveats here. And I think these are important caveats, not to just throw cold water on it. But first of all, there is a question about the tests themselves in terms of how good they are, how accurate they are, the blood spot test versus actually getting your blood drawn. There are only four tests that have been approved for emergency use authorization. There are some 90 tests out there. I mean, this is confusing for people out there. Everybody wants to get their hands on one of these tests right now, but you've got to be careful, because the last thing you want is to get an inaccurate result, a false positive, and think, hey, I'm good to go, I've got the antibodies, that may not be the case. And the second point is exactly that. Once you have these antibodies, what you're really asking, I think a lot of people are, is do I have immunity and how long and how strong is that immunity? And right now, we still can't answer the question. And I think there is still value in getting these tests once they come out and are validated, but we have to make sure that we're asking the right questions and we're getting the right answers. It may not tell you for certain right now that you are immune to this. So we still have to all practice these same behaviors for a while.</s>HARLOW: For sure, that's a great point. Dr. Mollette, before we go, you are seeing a crisis on top of a crisis, right? And you write about that, the economic crisis for so many of the patients that you treat that may be getting sick, but also the fallout from not having their jobs or having to go work on the frontlines, whether it's in food or transportation, et cetera, and potentially getting sick. But you still say and plead with people to stay home. That on top of what this is costing, I think Kaiser's estimate was upwards of $41 billion, the cost for the uninsured in this country with COVID-19.</s>MOLLETTE: This is hard. This epidemic has revealed the ugliness of our healthcare system. It revealed the ugliness of our socioeconomic system, it also revealed the social inequalities as well especially against the communities that are underserved. I served and I worked -- I work and represent these communities, particularly the black and brown communities, or African-American and Latino communities. And it's painful and disturbing to take care of people who are so worried about paying their bills and putting food on their table. And I oftentimes had to put myself in their shoes. As a matter of act, I've been in their shoes before, and many of my relatives as well. And so even though that is the case, the numbers are increasing. Even though I think yesterday that Cuomo reported that we have 500 deaths, one death is enough. Two deaths are enough. And for me, it's very traumatizing. And this whole experience since the end of February for us, because this is when the volume actually increased in the first week of February -- the first two weeks of February, it exploded. This had been a very traumatizing experience for many of us. You don't understand how many times we take breaks and we cry. Yesterday, one of my nurses broke down in the lounge and just cried because we are -- we've lost someone, an employee that worked in our emergency department, one of our nurses had also lost her husband to the coronavirus, I lost a relative, as well a family friend, I lost a neighbor, I lost several coworkers. And I know I'm sounding shaky, but --</s>HARLOW: I'm so sorry.</s>MOLLETTE: I'm sorry.</s>HARLOW: I'm so sorry. No, it's -- we know when all of us, Jim and Sanjay and us, were all watching your piece with Miguel, we were just all so moved by the work you're doing and the message you're sending, and we didn't even know all the loss you've endured. So thank you.</s>MOLLETTE: Losing patients. And when they look into your eyes and they give that last breath, what makes you think I'm going to be okay after this, or any healthcare workers that are on frontline? Their eyes pierce your soul. And it's different. It hits very different. So I'm really hoping that we find a treatment, a cure, a vaccination, and because after the social distancing measures are lifted, we're going to see an increase until we find a cure for this disease. I'm just asking for prayers for my healthcare workers and everybody that's been infected by this. So, sorry for getting a little emotional.</s>HARLOW: Don't be sorry.</s>SCIUTTO: Don't be sorry.</s>HARLOW: Yes, that we can give you is those prayers. We'll do that and thank you for what you do every single day, Dr. Arabia Mollette, and to, Sanjay, for what you do every day. We'll be right back.