Good evening. Im ali velshi picking up msnbcs continuing coverage of the coronavirus pandemic. Lets begin with the numbers. There are now more than 1. 1 million confirmed cases across the United States. More than 66,000 americans have died, and this comes as parts of the country are starting to reopen. More than half the nations governors are beginning to lax restrictions in their states despite warnings from experts that more testing is needed before we reopen safely. And the state of the economy is growing more dire each day. More than 30 million americans have filed for Unemployment Benefits for the past 6 weeks. Senior advisor to the president kevin hasitt joins me in a few minutes. Meanwhile there are glimmers of good news to report. The fda has rightsed an emergency use authorization for the antivirus drug remdesivir for patients hospitalized with severe cases of covid19. And nbc news reports the number of potential vaccines under development has been whittled down from 93 to 14 as part of the administrations efforts to fast track one for use as early as january. Joining me now dr. Vin gupta actually using remdesivir to treat some of his patients. Hes a professor at the university of Washington Medical Center and an nbc contributinger and dr. Sarah koreshy an assistant professor at the Georgetown University school of medicine. Good evening to both of you. Thank you for joining us. Dr. Gupta, lets start with you and remdesivir. This is drug we knew about, we heard about, we heard it wasnt successful and then we heard it was another test and it was successful. For people like me who dont know anything about medicine tell me what this is. Reporter so theres glimmers of hope, ali. And let me parse that out. What were seeing there was a study done by the National Infectious institute that dr. Fauci leads, and what that study showed is that there was a significant finding of clinical improvement, shorter days required to get to clinical improvement for those critically ill if they receive remdesivir by four days. So dr. Fauci said 20 more rapid faster recovery which is great. Thats fantastic. But lets keep that in context four days is four days. There was a trend towards improved mortality if you got remdesivir in this trial approved by the nih, but there was only so much we could look into that result saying yes, lets give it, were very confident in it. Which is why dr. Fauci said we need to build on this study, we need to learn more. More studies are in the pipeline like this so hopefully its going to either confirm or deny. One quick qualification the same day this study was released there was a study published out of china and that arguably contradicted parts of the nih study. It said there was no clinical benefit broadly speaking. But when you looked and saw those patients with remdesivir within ten days of symptom on set it mirrored some of the findings from nih it actually seemed they got better faster. There is optimism here, but the devils in the details. We need more information. Dr. Koreshy, lets talk about vaccines. Theres a lot of talk about different vaccines. The white house has narrowed it down to a few, but there are really just a handful that are in actual trials. Yeah, so i mean yeah, so theyre fast tracking everything. Just to let you know theres a really strict process that vaccinevise to go through to actually go from the prevetting to being a syringe in a doctors office. It started off there was about 102 candidates. It looks like theres about 8 that have enrolled human individuals, and they have to go through three phases and they have to prove three things. That vaccines have to be safe, and they have to show theres some immune response or you have to identify an immune response and identify they actually protect an individual from the virus or disease. And so most vaccines take years. I mean the hpv vaccine ten years and so we are really looking at this pandemic, fast tracking it, and we want to make sure we put something out there that is safe and effective. We dont want this to be a negative, but we want to fast track it, but we also want to balance it. Its a balancing act. Vin, what should people think about this because theres remdesivir which is i guess a therapeutic of sorts, but its not a treatment for most people for coronavirus, so we dont have a treatment per se. We are starting to get pretty good serology testing, Antibody Testing but were not even 100 about that. If you get one of these tests to see if you had coronavirus apparently a lot of them are coming out with false positives. Yeah, thats right, ali. To your first question what should people think about the vaccine dr. Koreshi just discussed, remdesivir if we think theres going to be a magic bullet in the pipeline were going to start leing down our guard. Were going to start perhaps engaging in behaviors we shouldnt be. Its dangerous. Its uncertain, so we should act as though nothings changed. Theres not a hail mary, not a savior, not a magic bullet coming down the pipeline. If it does its going to be unprecedented from a vaccine standpoint. We all hope it happens. We all hope remdesivir is maybe as promising as these initial studies suggest. Remdesivir showed initial promise in ebola, and that was ultimately debunked in better studies. We need to be focused on the here and no. Your second question i think we need to be following what ohio is doing. Ohio has laid out very clear guidelines how we can normalize life in phases with Public Health and Infection Control at the top of mind. So thats where i think we should start. Antibody testing still lots of problems there. I am not a big fan of that. Its an intellectual exercise at this moment. All right, thanks to both of you. As always dr. Vin gupta pull monologist and professor. Now, despite the positive Scientific Data theres already growing political divide over the antiviral drug remdesivir we were just talking about. Politico reports, quote, on the heels several prominent trump boosers are downplaying results and joining me now former acting administrator for the centers of medicare and Medicaid Centers under president obama. Lets talk a bit about the testing regime. The bottom line whether you deal in medicine or health care as you do or economics as i do you need a denominator, you need to know what youre solving for, and we still havent quite understood what our testing regimen is in this country. Yeah, i think thats right. And i think we have put ourselves in a position where should we choose to relax our guard, should we choose to take may and say you know what things arent that bad were doing it with a lot more risk than we would be doing it if we had rapid abundant available testing and the ability to trace and track the disease as it goes. As your previous guest said, thats not a silver bullet. Thats actually just a set of tools that allows us to make sure we dont get a raging bond fire again which is what weve been living through. Instead we get a small camp fire and surround it and make sure it doesnt grow. That will allow us to go back across our lives in a more normal fashion. Andy, i want to read from you you know these things better than i dwroosh but theres a poll from gallop that said that one in seven, about 14 of u. S. Adults would avoid treatment for covid19 symptoms or suspected Coronavirus Infection due to the cost of care. Now, thats complicated because in theory people shouldnt be paying for the testing, and in most cases people shouldnt be pay frg the cost of care, but the complexity is the thing you suffer from may be an underlying condition, which you may not be covered for. Right. I mean, you think about that, 40 to 45 million i think is the number i calculate when i see that, and we have 40 Million People who are hungry right now, we have have third of people that arent paying their rent right now. Congress needs to act and sustain people through this. Joe kennedy has a bill that i think would just allow people to stop worrying about the payment for health care that has to be put through. I think we need to fix about people from an income standpoint to get through these times. Were a wealthy country. We know this is marathon, not a sprint. Everybody tells us that. I think we have to make sure and by the way, theres also a good bill that Chef Jose Andres worked on i think will help with hunger and food banks. Those are the Things Congress has to Pay Attention to. I think theyve got a lot of great priorities but its time to focus on these right now. Andy, thank you for joining me as always. Andy slavt, a former acting administrator for the center of medicare and medicaid services. Coming up senior advicer to the president kevin hacitt says an additional stimulus package might not be need. Im going to ask him about that and his prediction of whats to come in the months ahead. And his prediction of whats to come in the months ahead im a work in progress. So much goes. Into who i am. Hiv medicine is one part of it. Prescription dovato is for adults who are starting hiv1 treatment and who arent resistant to either of the medicines dolutegravir or lamivudine. Dovato has 2. Medicines in. 1 pill to help you reach and then stay undetectable. So your hiv can be controlled with fewer medicines. While taking dovato. You can take dovato anytime of day,. With food. Or without. Dont take dovato if youre allergic to any of its. Ingredients or if you take dofetilide. If you have hepatitis b, it can change during treatment with dovato and become harder to treat. Your hepatitis b may get worse or become lifethreatening. If you stop taking dovato. So do not stop dovato. Without talking to your doctor. Serious side effects can occur, including allergic reactions,. Liver problems, and liver failure. Lifethreatening side effects include lactic acid buildup and severe liver problems. If you have a rash and other symptoms of an allergic reaction,. Stop taking dovato and get medical help right away. Tell your doctor if you have kidney or liver problems,. Including hepatitis b or c. One of the ingredients in dovato may harm your. Unborn baby. Your doctor may prescribe a different medicine. Than dovato. Your doctor should do a pregnancy test. Before starting. Dovato. Use effective birth control. While taking dovato. The most common side effects are headache, diarrhea, nausea, trouble sleeping, and tiredness. So much goes into who i am. And hope to be. Ask your doctor if starting hiv treatment with dovato is right for you. [ siren ] doug ask your doctor if starting hiv treatment with dovato give me your hand i can save you. Lots of money with Liberty Mutual we customize your Car Insurance so you only pay for what you need only pay for what you need. Liberty. Liberty. Liberty. Liberty. The Economic Data here in the United States continues to get worse. This week the Labor Department reported that another 3. 8 million americans filed for unemployment claims. That means more than 30 million americans have now filed for unemployment since the lockdown started in midmarch. And according to the Economic Policy institute the current claims level likely drastically undercounts by as much as 12. 2 million over a recent 4week period. Those who are eligible for benefits but arent getting them because of difficulty with filing. Joining me now kevin hassett, the former chairman of the council of economic advisers. I appreciate you going to the white house to talk to me, but i want you to know you can actually do it from home if youd like to. You were on fox this morning talking about the fact we may not need a phase four relief bill. What we have, though, is number of states saying to the president they need more backup because theyre losing revenue. And unlike the federal government they cant go into debt and they cant print money. So talk to me about the phase four as it relates to states. Right, well, i think first whats going on is that some of the states are under the guidelines from dr. Birx and fauci and the rest of the task force opening up and doing so in a cautious step wise manner. And what were doing is were monitoring the data both on the health side and economic side to see the impact of that. And so if the virus were to go away at a relatively quick amount of time then a lot of states could safely follow the guidelines and march through the phase and the economy would turn back on a lot earlier in which case it could be the amount of stimulus we put ipright now is enough. You know, my guess is looking at the burn rates there might well be a phase four deal necessary. This is definitely taking longer than many people thought, and the phase four deal would of course have to address the problems with states because since weve turned the economy off weve turned, you know, a lot of incomes off. You mentioned the epi study which is pretty welldone about how many unemployed might be out there. So that means those folks arent necessarily paying taxes so theres a massive crater. The president has said theres not going to be a bail out in the sense somebody who has a problem before the coronavirus couldnt come in a phase four deal and try to get that fixed as well. But anything related to the coronavirus hes open to talking about, should we decide we need a phase four bill . I would say right now were kind of watching for a week or two to see what happens as states slowly start to open up. I was surprised a week ago to hear the back and forth between Governor Cuomo and Mitch Mcconnell about mcconnell says states should file for bankruptcy. Is that a viable option as far as youre concerned . I dont know what senator mcconnell was thinking, and hes a really smart guy. So im sure there was something he was thinking of when he said that but my understanding is pure bankruptcy is sort of excluded as a possibility for the states and the constitution so they might have to come up with massive reorganization, and maybe thats what senator mcconnell had in mind. But an actual bankruptcy is something i dont think could happen. The epi numbers we were just talking about say that for every 10 people who said they successfully filed for Unemployment Benefits three other people tried to apply but could not get through the system to make a claim. Two additional people could not make a claim because it was too difficult to do so. We do know there could be some state backlogs because thats how you apply for the system. Whats your understanding of whether most people who are qualify today get unemployment right now are there, or as epi suspects there are a lot more we dont know about. I think the epi numbers could well be accurate. Its something that is hard to say. The problem is that many of the states have super antiquated Computer Systems so when you go out and apply for Unemployment Insurance the computer is broken or doesnt let you go through, or if theres too many claims going through at once it crashes. So i know theres been a lot of stories of frusation at various states, and by the way they arent just blue states or red states that have the problem. Its a little bit of both. Its these places where they have these sort of 40yearold computers that really do have a hard time when theres a surge of this magnitude. Again, think about it this increase in claims its historically unprecedented. This is you have to go back before the Second World War to see anything like this kind of change in unemployment, and its because weve sort of thrown the switch and stopped the economy for the a second and hopefully these people can rush back in and get to work. But yeah i think the epi study has probably got something to it. Paul krugman was up with msnbc yesterday, and he said the u. S. Is actually very similar to what you said. He said we may be heading for Lindsey Graham has come out vehemently about the Unemployment Benefits. I want to ask you about that, and at what point weve sort of done an emergency thing right now, a few months of extra benefits, the federal government padding what the states can do. How do you think about this because it doesnt seem like this emergency is over in a couple of months. We may have reopened, but we may end up having a good deal of structural developments it takes to absorb. The thing is we already passed a massive amount of stimulus and the fed has stepped in big time as well with the main Street Lending and other programs. So i think what weve done is weve bought ourselves time, and the good news is that the scientists out there had been using the time well. You saw remdesivir now is approved for treatments, and yet were learning more and more how to use ventilators wisely and so on. So were Getting Better at it gradually over time. Were using the time well. I think the question is do we buy enough time, and thats something we have to wait and see. I think its possible we didnt, and were going to have go back to the well again. I think its possible we did. And i think depending on the way the disease develops and the economy develops i think itll be pretty clear to everybody whether we need to do it or not. If you look again i think one of the Untold Stories about this episode has been, you know, that congress acted in this very, very divided time in a bipartisan way really, really quickly to get the stimulus out there and to help americans through this time. I would agree with that. I have every confidence they can do that again. Again, we tend to focus so much on the negative, but think about it things are passing with unanimous consent and so on that are really big major bills because Everybody Loves this country and theyre trying to do the best to help it turn around. We did something interesting. The federal government added to unemployment payments the states make, but there was an interesting thing and it was the airline deal, the money that went directly to the airline, a grant to thir airlines if they kept everybody on payroll through the end of september. Its an experi