Hot spots wear cloth masks whenever theyre out in public. But even that recommendation came immediately with an admonition from dr. Deborah berx. One, masks are not a substitution and, number two, still not enough people are practicing social distancing. As a result, she says, were not succeeding and we are not bending the curve. Part of the problem may be the refusal of the president to establish national standards. Even dr. Fauci said, i dont understand why theyre not doing that. At least ten state still have no statewide stay at home orders in place. All of those have republican governors and, as we saw with florida, the president is loathe to tell a gop governor what to do. Where they are stay at home orders, some governments and local leaders are cracking down. Couple instances here, in maryland, violators can be imprisoned for up to a year and fined 500. In newark, new jersey, they issued hundreds of summons and in Georgia State parole officers are prepared to deal with people who ignore the orders. As frustrated as they are with violators, the president is frustrated with hospitals who are desperate for supplies that previously the president promised were coming. Were not an ordering clerk. Ideally those hospitals would have had all this equipment. Ideally those states should have had all this equipment. Another change in policy points to just how dire the situation has become in the epicenter of the pandemic, new york city. The Emergency Hospital at the Javits Convention center was supposed to be for noncoronavirus patients but the number of covid positive patients has increased so dramatically they need those beds. New york times reports another facility meant for overflow the usns comfort has accepted almost no patients because of military protocols and bureaucratic hurdles. One more gut wrenching vivid reminder of whats to come. Fema has requested 100,000 body bags expecting that deaths could soar in the coming weeks and Funeral Homes are saying they are overwhelmed. Joining me now is the director of the Harvard GlobalHealth Institute and professor at the Harvest University school of Public Health and nonresident fellow at the Brookings Institution and practicing internist dr. Patel. She was formally a White House Health policy director in the Obama Administration and is an msnbc medical contributor. Legitimate arguments for and against masks, but what does confused messaging do at a time when leaders from deborah birx to Governor Cuomo are frustrated that enough people are following recommendations. Absolutely, chris. As you stated, we dont have even a uniform policy around staying at home and just in the span of about 30 minutes, you had highlevel federal kind of leaders telling you different or mixed messages. I think for everyone here, the bottom line is keep the Health Care Workers well equipped with masks that are suited for them and stay at home, High Priorities and then think about some benefit from having these cloth masks, but it does create a false sense of security. Remember, they protect others from you, not the other way around. The governor of georgia delayed shutting down his state based on claims he hadnt heard, commonly reported information. The Florida Governor only shut down his state at midnight, whatever it was, 13 hours ago. Dr. Fauci has argued, in fact, most of the day yesterday whenever he gave an interview he argued this. There needs to be a national response. Is he right . So dr. Fauci is completely right about this. We are one country, we are one United States. And people travel across states and we need a uniform policy around us. The virus not only does not respect International Borders and it doesnt respect state borders. The sign is very clear. A disagreement about science that some people think its one or the other. Its very clear. Everybody needs to be at home. Everybody needs to be washing their hands. And we need to gear up our Health Care System to take care of the sick people who are coming to a hospital near you. And it is to me a travesty that there is any state that isnt following those rules. You know, there have been republican governors who have been fabulous about this, dewine, hogan, baker, others. There are people on both sides of the political aisle doing this and a lot of people who are not lisening to the science. The head of the cleaveland clinic was on today and he was praising the governor in ohio and places where they started very early. So, we have on one hand this whole idea of a uniformed response, dr. Patel, were still, all these weeks later talking about supplies and youre an internist, you know what is going on out there. Governor cuomo was on with Rachel Maddow last night advocating for a sharing approach. Take a listen to what he said. I need roughly 30,000 ventilators. Which i cant get. But i only need 30,000 ventilators for two or three weeks at the top of my curve. I need backup Public Health professionals. But i only need them for two or three weeks at the top of my curve. Why dont we have use our National Unity and our commonality and say, lets be smart. Lets go help this place when this, when that town goes over its curve and then well go to the next and then well go to the next and go to the next. Dr. Patel, how great is the need youre seeing right now and could that work . Yeah, chris, ive spent my nights talking not only to colleagues i work in the district area, the dmv, we call it. I spent talking to colleagues on the medical side in california and florida. The need is great. In denver, colorado, for example, people have already said that theyve identified ventilators and personal equipment as the most immediate needs theyre not getting. When they go to their hospital leadership, all just a source of confusion. To be candid a white house that says that the Strategic National stockpile is meant for the private sector and not directly for the hospitals and then somehow blaming the states is, its not only unconscionable, chris, but just an insult when you have people working such as myself who have identified these needs clinically and now we know at least one in four people are asymptomatic carriers. Its not just hospitals, chris. We have to do this in our urgent care clinices and the Community Health centers that are also truly a front line in this battle. Dr. Jha, this is not my area of expertise, but the way Governor Cuomo talked about it this morning made so much sense. Look, if you have a hurricane and all the utilities go down, utility trucks from all over the country flood into that state or that area until that is fixed and then if there is a problem somewhere else, then they move on. Is that an oversimplification . What can we do at this point . Given what the administration has said that, you know, were not a supply chain here. Were not the ones you should be coming to. You should be going to, you know, your states. Given that, what can we do . Yeah, so, first and foremost. This is a disease and a challenge for our country that were not going to get through if we have 50 states competing with each other. But we are going to get through it if we have 50 states cooperating and working together. And, so, i think Governor Cuomos idea is one that a bunch of us have been talking about for several weeks which is that when new york has a surge, lets back up new york. And then when new orleans has their surge, lets back up new orleans. And lets remind everybody the old phrase by president obama, there are not red states and blue states and were all United States and facing this together. I think its doable. The question is, who will coordinate that . If you expect or want the federal government to be the coordinator that moves resources across the country. If that doesnt happen, again, im hoping it does, there will be a lot of ad hoc and just going to be a much less sufficient and effective. Im hopeful we can find a way to coordinate and have states working together. You know, i also want to ask you, dr. Jha, i mentioned the head of the Cleveland Clinic was on morning joe earlier today and one thing he said is that they started early in january putting protocols in place, doing their own modeling. Making sure that they had the supplies they needed and when he was asked why in january, he said, well, we watched what was going on and he feels like in cooperation with the governor, that got ohio in a better place than many other states. But even if their models and we know that these can very widely suggest that theyre not going to peak until Something Like midmay to midjune and maybe mid to late july until they see that curve starting to flatten. So, when the administration is talking about this 30day extension that they gave to the 15 days, should we be bracing ourselves for something much longer than that . Its a really good question, chris. I think what every epidemiologist will tell you is that this disease does not come to an end until we have an effective vaccine that we can deploy widely or a large number of americans have gotten infected where we have immunity. That is a 12 to 18month time period. Whatever we do now, i think we will be on lockdown for several more weeks even to a couple months. Even when we open up, were still dealing with this virus. Its going to be a long battle. And we need to communicate that to the american public. Doesnt mean were going to be in lockdown for 1 months, but we need to start planning for how were going to live our lives whil we contin whil we deal with this virus and we need to communicate to get us ready for what is going to be a tough year ahead. I want to bring in the professor former u. S. Attorney barbara mcquaid, very similar to our audience as an msnbc legal analyst. What people probably dont know, barbara, you have a lot of experience in crisis response. I want to end this with sort of a big picture. We talked about the mixed messages, the administration pointing fingers at governors, at hospitals, at businesses, 3m is now a target and Front Line Health Workers are desperate. What do you see that is going on here . I see a lack of leadership from the federal government. There is something known as the National IncidentManagement System where the president or his dessingnee should be taking charge. Fema is equipped to do the logistical work that is being discussed here. Obtaining the ventilators that are necessary and working through a progression where states like new york at the front of the curve get them now and other states can get them later. The president also should be communicating with one voice. Using his bu using, and the president can lead and urge states to enter such orders, can model things like mask wearing and sheltering in place using his pulpit to encourage that leadership speaking with one voice, the united leadership. The defense production act to buy up ventilators making sure that foreign nations arent getting them ahead of the United States and then di them most. And, so, im hopeful that we can still see someind of coordinated campaign where the president leaves it to the professionals as we work through this crisis so that we can all be safe rather than the kind of ad hoc mixed messaging that weve been seeing so far. Barbara mcquaid, dr. Jha and kavita patel, thanks to all of you. Good to see you, senator. The president , im sure you saw backed up by his soninlaw, is doubling down on this idea and im quoting him here. Were not an ordering clerk. Youve been on both sides of government. Youve been on the local level as a county official. Obviously now in the u. S. Senate. What do you make of those comments . Chris, one of my grave concerns here is a lack of a coordinated National Strategy around how to make sure that states and cities that are in crisis or that are coming into crisis have access to the personal protective equipment, the medical machinery, the test resources that they need. And trying to avoid responsibility is not a way to lead our nation. Frankly, the congress came together in a strong and bipartisan way. The president signed an important bill that was a 2. 2 trillion stimulus bill. Thats because cities and counties and states all over our country looked to the federal government for resources and leadership. When theres a Natural Disaster or a tornado or earthquake. We look to our governors and our state Emergency Management personnel to be the sort of front line and the first deciders. But this is a global pandemic, chris. And this is something where the response requires federal coordination and leadership of what is a Global Supply chain. We dont have enough manufacturing in the United States today of the critically needed material and we should be having a federally coordinated resource and i frankly think to say were not an ordering clerk misses the gravity of the moment and misses the significance of leadership. I join would a Bipartisan Group of senators last week in a letter in urging the president to take on federal leadership in organizing and coordinating our response. So, i want to make sure i understand what you say when youre talking about federal coordinati coordination. Are you talking about one set of rules . We have 10 or 11 states that are not ordering shelter in place right now. In your state, i think it happened 10, 12 days ago. Now, each state does have unique circumstances. Their level of concerns and their level of cases are different. But is it time for the federal government to say, everyone shelters in place. Everyone wears a mask. Does there need to be unanimity given the kind of travel that people do in this country . Chris, i think there has to be coordination. What you heard from Governor Cuomo about planning and coordinating the development and the deployment of critically needed material like ventilators and how there could be a shifting response across the country as conditions change on the ground is a great example of how we really could have a better federally organized and coordinated response. I recognize the Critical Role that governors play in our federal system in making their own decisions about Disaster Response locally. But as you just said, this is a virus that is traveling around the world. That is traveling across state borders. And, frankly, i think it requires a federal standard and a federal response that is rooted in science and that is led by Public Health professionals, not based on wins or allegiances or partisan politics. And i do think its time for us to have a clear, coordinated federal strategy. You were one of the negotiators of the 2 trillion package that came out of congress as a member of the Small Business committee. Im sure you know well the details of the nearly 350 billion spa loan program that starts today. From what you know and from what youre hearing, how ready are we, how ready is the government and banks for the onslot of applicati applications . Im optimistic, chris, that the sba and their lenders and their staff and partners around the country are as ready as they can be. We are asking them to push out the door 350 billion in loans and grants to Small Businesses and nonprofits. This is several times more money than the sba has ever tried to put out on the street in loans and grants. I hope folks will be patient with them. But in the past week, ive been doing calls with other senators, with the head of the sba and the head of secretary treasury and the head of sec to get insight and offer encourage around the quick disbursement of checks from the irs and the funding for Small Businesses and nonprofits and Decisive Action to backstop our National Economy and urgent action by the department of labor to make sure that the unemployment federal add on, the additional federal resources for Unemployment Insurance that we provided for in the bill is made available. Chris, im hearing from delawareans every day up and down our state who are concerned either because theyre First Responders or Public Health workers who are not adequately, that are concerned about whether or not they will have adequate supplies. And im hearing from folks who just lost their jobs or whose companies have had to close. I respect the leadership of our governor john carney who has had to make a tough decision to close restaurants and hospitals and schools. But we frankly owe it to the American People that when congress and our president come together to quickly enact such a big federal stimulus that we also ensuring it is being pushed out the door as quickly and responsibly as possible. Im optimistic on how the irs and sba will get out individual checks and support for Small Businesses and nonprofits in the coming week. Senator chris coons, thank you so much. You take good care. Our best to you and your family. Thank you, chris. And coming up, were going to be zeroing in on a growing hot spot of covid19. Jersey city, new jersey. Are local hospitals ready