Seen throughout this pandemic, 46 in south dakota. What does that mean . That means if you test 100 people, 46 of them have come back positive. It should be below 3 . More importantly it means youre not watching nearly enough of the people out there who are positive. Now, i use this example, hopefully it makes sense, but i think we talked about this before on your program. If youre going fishing with a net and you put your net down and pull the net up and you just have one fish, what do you think . Theres probably not a lot of fish in this area. If you put your net down and have a lot of fish in your net you think theres probably a lot of other fish out there that im missing. You can think of pos tifts rates the same way. 46 Positivity Rate in south dakota means there are a lot more people out there who are not getting tested, not getting counted, have the virus, dont know it and are continuing to spread. Thats the problem. Thats when you start to see this exponential growth. People Pay Attention to the numbers of cases going up. What these Public Health officials are looking at is the pace at which theyre going up and then these Positivity Rates because thats your closest thing to trying to anticipate the future the next couple of weeks a little bit. An jay, just so i understand, these they are not doing randomized testing in many of these places, these are people who had symptoms, right . Right. These are people who had symptoms and wanted to know if they had the cold, flu or coronavirus and are finding out half of them in south dakota have covid. Thats right. Thats exactly right. And then there is a lot of people out there as you know, alisyn, who dont have symptoms or who have minimal symptoms, say i dont need to get tested and they can still spread the virus. I mean, this is just such a fundamentally different and important point about this virus. Typically when you think of respiratory viruses, youre coaching, sneezing, hopefully youre staying home, thats when you are most contagious. As we know and have known for some time, really since late february about this virus is that even before you develop symptoms in that presymptomatic phase, thats when you could be the most contagious. You dont have any idea, you didnt get tested, youre feeling pretty good, thats when you could be the most contagious and thats why masks are so important for people because they help you protect those around you. Really means that these states are on fire when it comes to the pandemic right now and the spread of the virus. And these are the very states, some of them, sanjay, where President Trump is holding mass gatherings. Thousands of people, many of them largely unmasked. You and the medical team here have done some extraordinary reporting looking at the effects of some of the rallies that the president has had over time and what you found is in the location where these rallies have been that in 82 of the cases that the number of cases have risen, have spiked, in the month after the president held a rally in these sites and these counties rising disproportionately, half of them at least, than other counties in the very same states. What does that tell you, sanjay . So we sort of went into this investigation sort of eyes wide open and i have to tell you it surprised me a bit. What i expected to see was that the numbers were going up because the numbers were going up just about everywhere. When i first saw that i thought, okay, the numbers are going up, thats not that surprising, but then, as you said, john, we said, okay, lets look and see a comparison county, other counties in the same state, that seemed like a pretty good sort of control group, if you will, and just as you stated, john, all of a sudden this started to pop out which was quite startling that the counties in which these rallies were being held were going up sometimes way out of proportion compared to the surrounding counties. Again, with similar demographics, similar viral dynamics before these large gatherings of people. So it makes a difference. It shouldnt surprise people. And, by the way, regardless of whether its a rally or a protest or, you know, a bunch of people clustered together in a bar, the virus doesnt care. If youre bringing a lot of people together and if theyre going to be together maskless and sitting next to each other, staying next to each other for a period of time, that virus, which we show these images on television, i wish people could see the virus, but that virus is moving out of peoples mouths and noses and loves to find other hosts and thats whats happening. This investigation sort of really revealed that. Look, it stands to reason obviously we suspected that is correct you told us that was happening, that was the hunch of all medical experts that we talked to at least, but now youve rochb it. And its just the equivalent of if they were Still Holding being music festivals, you know, they canceled those. I had tickets for that last month. You take it personally. I take it personally. Those were canceled. You dont go to big arena shows, big music festivals, big packed sports stadiums right now. All of thats been canceled. The only thing that still, you know, approximates to that are these big trump rallies. Yep, and people sitting that close to each other for that long maskless, it is a prescription for the virus to spread. Again, it shouldnt surprise anybody, like you said, but when you really sit there and look at the numbers and when we look back at these numbers ten years from now, 50 years from now, its going to be a real a statement about how we handled things. Let me get this straight, the numbers were going up 80,000 plus people were being infected every day and thats when you said lets bring thousands of them together in some sort of mass gathering . It makes no sense. There is a great tracker on the website where you basically you can say, okay, if i have this many people gathered, whats the likelihood the virus is there at that gathering as well. Just about everywhere in the country if you starting to into a few hundred people gathering there is a 99 chance that the virus is there as well because people are carrying the virus, they likely dont know it because they havent been tested and theyre likely spreading it because they feel fine. They think, hey, im good to go and theyre likely spreading the virus. We dont see the ramifications for weeks after. When we did this investigation we had to go four weeks earlier and four weeks after and really crunch all that data to get a picture because you dont get tested right away, you may not have a positive test result right away even if you do so it takes time. When you let that message of time occur you see the impact of this and it is frightening and startling. Sanjay, lets talk briefly about halloween, if we can. Alisyn and i will wear the same costumes as last year, shes dana bash, im jake tapper, hence all the gray in my hair. Mine is anderson cooper. How should we try to pull off halloween tomorrow, an jay, if at all . I dont think you should cancel it. Im saying this more as a dad than a doctor because this is the topic of conversation, we love halloween in our household, probably one of the biggest days of the year. I dont think you should cancel it. I think this idea of canceling things is psychologically its hard. But i think you cant do it the way that it was in the past. Weve looked at a lot of these guidelines, i mean, the idea of going facetoface trickortreating for all the reasons that we are talking about is hard to justify. I think its just really hard to do that, even if you say, look, as my parents as my kids have said to me, weve bubble up, it will be us kids together, we wont touch anybody or get too close to anybody. Its hard to do. Errors will be made and its going to be a lot of anxiety to get it right, but were doing you know, were doing costume contests and were going to do smores outside. Dont cancel it, figure out other ways to make it fun, but safe. I mean, im really be more of a dad than a doctor, but the reality is the virus is out there, it doesnt care, the masks that people wear with costumes arent the same sort of masks that people need to wear to protect themselves against the virus. Find the other fun things that you like to do and do them still, just avoid actually coming in contact with people outside your household that you may spread the virus to or may spread the virus to you. Its a little cold outside for my flapper outfit so im going to go with dana bash again. Bobbing for apples always sucks so no one will miss that. Talk about a super spreader event. Exactly. Sanjay, thank you. You got it. Have a good weekend. You, too. New reporting this morning on a change to President Trumps plans on Election Night. We have the details next. All right. Time is running out for President Trump and former vp joe biden to make their cases. Both candidates are barn storming battleground states in the midwest today in their battle to get to that magical the time is running out. Developing right now, new reporting in the New York Times by our colleague may goy haberman, she reports that President Trump has called off plans to appear at the Trump International hotel in washington on Election Night and is likely to stay at the white house instead. What does that mean . Joining us now cnns senior political commentator david axelrod, a former Senior Advisor to the obama campaign, also with us abby phillip. This is an interesting wrinkle, abby, because President Trump and his campaign had been fundraising off of the idea that they were going to go to President TrumpInternational Hotel for this big party on Election Night. In fact, in the fundraising solicitation according to maggie it said four more years, this is going to be absolutely epic in all caps and now theyre canceling that. What should we make of this . Well, one thing i should say is that our colleague kevin liptak had reported last week that the president had planned to spend most of the night at the white house, but was going to stop by this Election Night party that was being planned over at the Trump International hotel. Now its a little up in the air as maggie is reporting, shes reporting the president is no longer planning to go, so were also looking into whether that drop by plan had been canceled. I will say that all of this seems to indicate that this is not a campaign that is planning on some big grand celebration. And its not as if they wouldnt do it because theyve been having big grand Campaign Rallies up until this point. Its not an issue necessarily of the coronavirus preventing them from holding a party. Theyve been very eager to do that many times in recent days. I do think that this is a campaign and a white house thats planning for something low key. The numbers are what they are. There is a path for the president , but it is extremely narrow. And this seems to be a recognition at least in part that they have a chance a shot at this, its a real shot, but its not a big window of opportunity by any stretch of the imagination. If he pulls off a victory im sure they will find a way to celebrate and a place to do it. I dont think there is any question about that. David axelrod, this just in from cnns jeff zeleny. He reports the Biden Campaign is making clear pennsylvania is their critical focus in the final days of the campaign with joe biden, Kamala Harris and their spouses scheduled to campaign in all four corners of the state on monday and joe biden also setting up a Campaign Stop tomorrow in pennsylvania. Why . Because pennsylvania is the tipping state for them. Thats the state they really need to win in. Its related to the previous discussion because, you know, the president has a narrow pathway to win and if he wins florida and North Carolina and georgia, that pathway will still exist, but were not going to know about pennsylvania, wisconsin and michigan on Election Night. So theres not going to be much for him to celebrate. If biden were to win one of those states they would have plenty to celebrate, but pennsylvania remains a key battleground state, 20 electoral votes, one of the big three that tipped the presidency to trump in 2016. Biden has a great appeal, one of the attributes of his candidacy is a stronger appeal than Hillary Clinton had in these northern states, in these industrial states, and he needs to win this state. I think the other element of this, john, is we have a tremendous early vote, but theres still going to be an onday a election and there are indications that republicans are more likely to vote on election day than democrats. I think that biden wants to make sure if there are democrats who havent voted that they do find a way to go to the polling place if they can. David, i just want to stick with you for a second because of florida. So there is information that the early inperson vote in at least miamidade county, which Hillary Clinton won handily but lost the state, that the republican turnout is far outpacing the democratic turnout and it is so concerning to the congresswoman, Fredricka Wilson who covers that region that she says she has been trying to sound the alarm to the Biden Campaign. She said they havent been doing door to door canvassing because of the pandemic, they havent invested money in the people there on the ground who know how to turn out the vote. She says i screamed, hollered, called, lobbied from the top to the bottom. Wilson said of her efforts to turn out operations started in the community sending written proposals to bidens campaign and virtual zoom meetings with his advisers. She thinks theyre not listening to her. Im sure theyre looking at these early vote numbers from florida. The one that struck my eye is that miamidade is much lower than the rest of the state in terms of a percentage of early voters coming out and that is a place where he has to joe biden has to mount a huge advantage going into election day. The other thing you notice if you look deeply into these numbers is that where the falloff is appears to be among africanamerican voters, and that is a concern. That has been a concern for the campaign. I think its one of the reasons why president obama was sent down to florida some days ago. So, you know, im sure they are aware of it and will be trying to address it in various ways. I think Kamala Harris is going back to florida as well. Abby, interesting today where joe biden is going because it tells two different stories, hes going to iowa, which is a state that donald trump won by nine points four years ago and joe biden finished fourth in in the iowa caucuses, but hes also going to minnesota which is a traditionally democratic state. Yes, donald trump got relatively close there, but it is a state that well, joe biden needs to win to win the presidency, but should win depending on what you think of the polls. So why these two stops . Well, yeah, youre right, that they kind of tell two different stories and its two sides of the strategy for the Biden Campaign. One which is to defend that upper midwest region, which is really at the heart of the matter. Pennsylvania, michigan and wisconsin and minnesota are basically the territory that if biden is able to keep that area away from donald trump, hes likely more likely to win and probably likely to win at that point, but then at the same time you have iowa, which is a state that is a bit of a reach for biden, its a state where there is a Competitive Senate race and its one where youre looking at democrats wanting to say, lets not only stretch the map, but lets try to give our down ballot races as much lift as possible, and that is why youre seeing biden going there. I think a Biden Campaign aide told jeff zeleny yesterday he was in the neighborhood so he might as well go. I think we are in that phase of the campaign where youre going to see more of this hopscotching to neighboring and nearby states because any opportunity to kind of be facetoface with voters and to encourage them to cast their ballots when they can is going to make a difference in these tight races and you Better Believe that senate race in iowa is going to be extremely close, so all of these stops really matter. Go ahead, da i have had. And i think that they also remember 2016 when Hillary Clinton didnt visit wisconsin, assumed wisconsin, never visited after the convention and ended up losing narrowly in wisconsin. So hence the minnesota visit. I quite agree with abby, though, i think this is a lot about the senate race in iowa. Joe biden is going to have a much different governing reality if he wins with a Democratic Senate or a Republican Senate and that iowa race is emerging as one of the top tier races that republicans and democrats are looking at that could tip the senate. His presence there and his performance there will have something to do with how the democratic candidate theresa greenfield performs there against joni ernst. I think there is there are dual goals for that visit. Look, things dont happen in a vacuum, either. If joe biden is doing well in wisconsin he should do well, relatively speaking, in iowa, in minnesota, all of these things should move sort of in the same direction. So there is a chance there. David axelrod, abby phillip, thanks so much for being with us. Abby and david will both be a big part of cnns special coverage of Election Night in america, thats tuesday starting at 4 00 p. M. Eastern time. So one state that we didnt talk about which is fascinating today is texas. Early voting there has just seen a record surge in early voting. We have a live report and we will speak to someone from a county that al