Im not going to waste my time on a virtual debate. Thats not what debating is about, sit behind a computer and debate, it is ridiculous, and they cut you off whenever they want. They called up two minutes ago and it was announced and theyre trying to protect biden. Trying to protect biden from the president of the United States who best we know is still infected with the coronavirus. Were going to watch how this one plays out. We know this, we count your votes in 26 days. Another count we do every day. Today it is more than troublesome. Half the 50 states now are trending the wrong direction when it comes to the coronavirus. Only two states, alabama and hawaii, right now are reporting fewer new covid infections this week compared to last week. Lets get straight to the white house for big developments in the campaign. White house correspondent Kaitlan Collins is standing by. The president essentially a little bit of a tantrum, insisting he could do rallies, could have showed up in miami next thursday. Because of that, the president saying no to the Debate Commission changes. Now the whole debate schedule is in jeopardy. It is. And the Biden Campaign wants it push pushed back. The Campaign Manager was saying the president would oppose to multiple negative tests before the debate scheduled for next thursday, though theres no reason why we believe bill stepien would know that. Thats not something we heard from the president s doctor yet. And we know that it can take some time. Thats only two weeks from when the president was diagnosed with coronavirus. And we should note that statement came from a Campaign Manager who is also positive for coronavirus, part of the outbreak weve seen happening in the president s inner circle. John, there are two main reasons the president doesnt want to do this. One, he doesnt want to be muted by moderators, it would be easier if it was done virtually. Thats something the president referenced this morning in the interview. Also, john, by doing this virtually, it would be impossible for any viewer to ignore the pandemic thats going on. And they tried to distract from it in the last debate. It is not something the Trump Campaign wants to talk about because they know how poorly their reviews and handling of it has been. But it would be front and center if joe biden and donald trump are appearing virtually and would remind people of the fact that the president did have coronavirus. So the question is whether or not the president changes his mind. Of course, we have seen him do that within a manner of hours or minutes before. This is an argument some Campaign Aides may try to make to the president , they want him to have a big audience. They want him to have a second showing from the first debate, which they did not think went well. Whether or not theyre successful in that, whether they agree to push it back is something that still remains to be seen. We should remind viewers, the commission on president ial debates didnt consult either campaign before making the decision, it was an executive decision by the organizers. Then they informed them a few moments before they announced it. Clearly the president is not pleased with them. The president is not pleased, he is also losing the race at the moment. A lot of republicans are not happy because he has done something that puts one of his opportunities to change the dynamic now off the table. Grateful for the live reporting at the white house. To the point she was making, the president says he feels great. He is ready to get back on the campaign trail, but sadly we know the president lies constantly, lies constantly. And we know very little about details of his coronavirus case or his treatment. The white house doctor does release vague, upbeat statements most days, but the doctor hasnt answered questions since monday because the president prefers to do the talking. I would love to do a rally tonight. I wanted to do one last night but i think i am better to a point i feel better than i did, jokingly said 20 years ago, i feel perfect. Theres nothing wrong. I dont think i am contagious at all. First of all, if im at a rally, i stand by myself far from everybody, whether i was or not. I still wouldnt go to a rally if i was contagious. Bring in chief medical correspondent dr. Sanjay gupta. You listened to the president. I hope he is not contagious, i hope he is doing better, but we have no way to know that because we dont get detailed information from the white house, especially the medical team. I hate to say it but i am going to keep saying it, the president has a history of not telling the truth. Yeah. I mean, we are dealing with a situation where a lot of incomplete information here, and some of it just a little bit ridiculous in terms of what the doctors have provided, especially with was he on oxygen in the beginning. They really went out of their way to be evasive about certain things which does call into question many of the other things. Theres so much we still dont know about whats going on with his health. It is interesting. The president would be considered a vulnerable patient because of his age and preexisting conditions. Then whats more important is a that he had trouble with the disease, odds are very much in his favor in terms of recovery, but he did have trouble. He needed oxygen, supplemental oxygen. Thats a significant concern. Shows his lungs had a hard time keeping up. He has been on various medications. We dont know if he is still on the medications or not. We have an idea that theres a lot of things we still arent getting clear answers on. He said no fever the last four days, but he is on steroids, and that can suppress a fever. That would not be a valuable sort of indicator there. Again, this cocktail of medications together is something that maybe nobody else has received the way that he has, that particular cocktail. One of the medications is not available under emergency use authorization. So it is a very cloudy sort of picture of whats going on with him. By the way, it doesnt have to be. The doctors could be forthright if they decided to brief the press, they could tell us. Instead, they want to say they briefed the press but not provide all of the details. Right. To that point we get written statements from dr. Conley. He last spoke to reporters and took questions, only a few, on monday before the president was released from walter reed medical center. He has been at the white house monday, tuesday, wednesday night now. Were having this conversation. Heres one from october 6th. Earlier in the week. This morning the president s team of physicians met with him in the residence. Had a restful night at home, today he reports no symptoms. Vital signs, physical exam remain stable. Ambulatory oxygen levels. Doesnt tell you anything. The next day we get similar. This one says he is fever free for more than four days. What it doesnt say, sanjay, please help me as someone thats the expert, doesnt say he is fever free because he takes medication, doesnt say he is better because of medication. It doesnt layout what the president needs or if he is if they believe he is almost completely recovered, he doesnt need medication, why isnt it laid out in the reports. Right. Absolutely. Clearly they want to paint a rosier picture. Yet there are little clues that they leave behind. There are basic unanswered questions, john. If they wanted to be completely forthright, as you and i talked about, theres no obligation for them to do this, why do we come back to the first question, when was the last negative test. In part, it is for Contact Tracing to figure out who else may have been infected because of the president , but also in terms of his own clinical course, how likely is he to be contagious. If you look at the people that have the disease, they have a period of time around day seven or so where its a window of concern because of the bodys inflammatory response. Where is he . Is he at that day yet . Did he already pass it . Does he have pneumonia . It is a respiratory virus. We dont know the answer to that. We know he had lung scans and we know they werent normal to your point, they would have said they were normal otherwise, they werent normal, so what did they show. Again, are you trying to give us a picture of the president s health or are you trying to basically paint this opaque thing thats designed to give this rosy scenario. It sounds like he says hes doing well, which is great, as you point out. But is it because of the meds . Are the steroids masking the illness or is he really recovering from the disease. Seems like a significant question to answer. I get it. Number one, he is losing in the race, wants to get out campaigning to improve chances of come back. Number two, he enjoys traveling the country in the presence of supporters. He is a politician, likes to be with the crowd. You completely understand that. Listen to him this morning. He is playing his own doctor on television, trying to make the case it is okay, let me out of the white house. I dont have heart problems, diabetes, any of the problems you read about. Perhaps a couple of pounds we could lose here or there, but you know, a lot of people are in that category. No, im in good health and, you know, look, what happens is if you really were around the thing, you can catch it. If youre reckless anywhere around this thing, you can catch it. Covid is everywhere. A lot of people havent caught it, they wear a mask and keep their distance. The president and those around him have been reckless. Thats my political statement. To the medical stuff, i dont have heart problems or diabetes, anything jump out as you, because his own doctor wont answer questions, especially from professionals like yourself, the president is left to play doctor on tv. Yeah. Well, first of all, we know he is a vulnerable patient. He himself realizes this is as you get elderly, above age 70, youre going to be more vulnerable. He falls in that age range. He has a common form of Heart Disease revealed by his own studies that he had on his heart. I think most importantly he has already shown through the course of the disease that this disease had some impact on his lungs. He required oxygen. The doctor threw aggressive medications. Dexamethasone, a steroid in the context of covid is typically used if someone has more serious disease because theyre worried about the inflammatory response becoming too robust and causing a problem. So there are all these indicators, regardless of the fact he is vulnerable, which he is, he is already falling into a different risk str. To your point, he is probably still contagious. We dont know where he is on time line of the disease because were still not getting that information. As a general rule, ten days after you first became symptomatic you are contagious, you should be in isolation, all the things we talked about for six or seven months now. For all those reasons, his own health, health of people around him, he should be isolating now. Preferably at the hospital. Obviously he is not doing that. At least isolate so he is not infecting other people. As a general rule in a democracy, we should all get more information about the condition of the president when he is in peril like this. Appreciate your insights. Thank you for joining us. Up next, coronavirus in the white house, yes. Across america now, coronavirus on the rise. Tired of overpaying for your prescriptions . Try optum perks. Its a new way to save up to 80 . And everyone can do it. Its from optum, a Health Care Company thats trusted by millions of people. You dont have to sign up for anything. Just go to optumperks. Com. And get a coupon to use at your pharmacy. Thats it. I opted in. I opted in. You can, too. Opt in and save big today. Coronavirus trend lines are troubling across the country. Might be an understatement. Look at the 50 state trends as you pop up the map. 25 states, half of the United States now reporting more new covid19 infections now compared to a week ago. Thats the red and orange. You see it, a lot of it in the west, a lot of it everywhere. 25 states, half the states trending the wrong direction. 23 States Holding steady. Better than trending up but not trending down. Only two states, alabama and hawaii are reporting fewer infections than a week ago. You see a lot of trouble spots, lot of smaller population, but case count is growing. If you look at the case time line, this is what is troubling. Peak of summer surge, we were 60,000 infections a day. A month ago, 24,000 infections, but there was some hope, pushing the baseline back down. It was about 20,000 before the summer surge. The goal was to get it back down, push it down further. Something very different is happening. You see it now trending back up. Trickling up, not a straight line. Trickling back up. If you call it a plateau, it is a high plateau. 50,000 new infections in the United States yesterday. The average between 40 and 50,000 new infections a day as we head into colder season, which has Public Health experts worried. Among things they worry about is the death count will go back up. 915 deaths yesterday in the United States of america. This trickled down some, now roughly in a plateau just below a thousand. The question is if that case count keeps going up, will this as projections suggest start to go up as well. One of the big issues, you need to get the Positivity Rate down. The higher the positivity, the more cases. Look across the plains and in the west. 24 positivity in idaho, 20 in south dakota, 20 in wisconsin, 15 in kansas, 15 in nevada. Double digit positivity means more cases today and means more likelihood of cases tomorrow because of infection in the community. Because of that, you see some states saying wait a minute, we need to add or delay when comes to restrictions. Wisconsin putting restrictions back in place. Governor of kentucky reinstating a mask mandate. In massachusetts, Boston Public Schools planned to get back in school learning. Thats been put on hold. In new york city, several zip codes in the city where case count is going up, Positivity Rate is going up. The mayor says we need new restrictions and i need you to cooperate. We can overcome this challenge. The data and science make very, very clear, we can stop this challenge from turning into a full blown second wave, and we must, we must. Our businesses are coming back, our schools are back. We need to protect the progress all over new york city. And the way to do that is to focus on the areas having the challenge, work with them, support them, Work Together and overcome it. Joining us, associate professor of emergency medicine at columbia medical center. Doctor, it is great for you to join us. Grateful for your time. Lets start in new york city where you are and pull it out for a national conversation. The mayor says the Positivity Rate is going up in certain areas, case count going up a little bit. New york went through this early on and shoved the case count down pretty good. What is the source of the problem and how significant is it . The problem is significant for us in new york and it is about behavior of new yorkers around the virus. It is coming from a cluster of places where people are not wearing masks, theyre not social distancing, and theyre not getting tested. Were realizing that if you dont listen to Public Health metrics, no matter how many times we try to advocate for new therapeutics and a vaccine, it will undermine the ability to keep the virus at bay. Whats interesting is we know about the cluster because of the number of tests done in new york. That doesnt prevent the spread. We are learning testing doesnt prevent the spread, it identifies cases when we see them and shows us what we need to do once cases are identified. And i just went through the numbers in the National Baseline of new infections is above 43, approaching 45,000. 50,000 new infections reported yesterday. Dr. Fauci who has for months been saying it is critical to shove that baseline down now says because we havent, this is the months ahead. The models tell us that if we do not do the kinds of things that were talking about in the cold of fall and winter, we could have from 300,000 to 400,000 deaths. That would be just so tragic if that happens. It is hard to disagree, impossible to disagree with that. That would be tragic if it happens. What is interesting through this is listening to the exasperated dr. Fauci wishing and continuing to urge people to please listen, but not getting backup from his boss, the president of the United States. I mean, were seeing it everywhere, even last night on the debate stage when the second lady came out without a mask. Even though the venue required masks to keep people out. The modeling of behavior matters, even when it is inconvenient. If you look across the United States, you look around the world, we all have been told this, having this conversation for months. When winter comes, it is going to come back, it is a virus that thrives in colder temperatures. If you look, you hear the president say the United States is doing great compared to the rest of the world. Theres the proof it is not. Theres japan at the bottom. Flat line consistently. European union is in green. United states in orange went up a hill about the same time together. The European Union came down quickly. It is trending back up, spain, netherlands, czech republic, other places, they have a problem at the moment. Look at the u. S. Case count, it stayed above, this is average of confirmed cases per 1 million residents, it stayed up higher because it is obvious looking at the chart, we never shoved the curve down. It is about leadership and behavior. We have seen every other country in the world respond better to the virus than us. Now were okay with case count of 40 to 50,000 a day when the weather is helping us, and the opportunity to be outside, but some businesses shutting down. Going into winter, it will get worse. Dr. Fauci is right. We didnt do a good enough job through the summer getting where we needed to be. I wish i could Say Something to refute the idea it will get worse. All of the numbers and data and positivity suggest sadly youre correct because youre relying on science to do that. Grateful for