Largely dismissive of concerns about the coronavirus, even suggesting it was a hoax designed to undermine the presidency. Then came the massive testing blunders, local and state officials calling on the federal government for help. Front line medical workers pleading for protective equipment. Now the president is warning up to 240,000 americans will die even in a rosie scenario where everyone stays home as much as possible through the end of april. Today Vice President pence said that the United States is on the same path as italy. Thats not good news. Theyve been ravaged while this disease while being totally locked down for four weeks and counting now. The number of cases in the United States today surged past 200,000. More than 4,500 deaths have now been recorded. Even the rosier models cited by the white house are now predicting the u. S. Health care system will be overrun at least in parts of this country. 93,000 will die. More than 84,000 people will not have access to a hospital bed that they need. The boston post is reporting Homeland Security officials are warning the National Stockpile of protective gear is now nearly depleted. Governors who initially dragged their feet on responding to the threat are now caught playing catch up. Joining the list of states ordering residents to stay home is now finally in the minds of some people, florida, after governor ron desantis, a staunch trump ally, relented to pressure from state officials. In washington there seems to be a growing consensus that the 6 trillion worth of emergency relief supplied by congress and the Federal Reserve will not be enough. There are now plans being drawn up for a federal jobs program, perhaps an acknowledgment that the average worker is going to need a lot more than 1200 stimulus check to weather this financial storm for one month. That storm could last a while longer because at the epicenter of the crisis in new york Governor Cuomo said even though some models have the crisis peaking in the next two to three weeks, the death rate could remain high through july. Remember, new yorks curve is likely weeks ahead of where other states could end up. So as we await the latest updates from the white house, here is a sobering look at the situation facing this administration. Written by the New York Times peter baker, quote, mr. Trump will see more americans die from the coronavirus in the weeks and months to come than president s harry truman, dwight eisenhower, john f. Kennedy, lyndon johnson, and Richard Nixon saw die in the korean and vietnam wars combined. The lowest estimate would claim nearly as Many Americans as world war i under president Woodrow Wilson and 14 times as Many Americans as iraq and afghanistan together under president s george w. Bush and barack obama. Joining me now from the white house where we could see the Coronavirus Task force at any moment is my nbc news colleague, and digital senior White House Reporter shannon pettipiece. Vice president pence comparing us to italy. A week ago that would have drawn a rebuke from President Trump. It would have been seen as, whoa, whoa, way too pessimistic. That is quite the acknowledgment when you consider what we heard yesterday and then today where Vice President pence admitting, yes. Were like italy. Yeah. That is not the trajectory we want to be on. We want to be a south korea and that is what we were promised we would be on a trajectory like south korea where there would be testing, there would be plenty of protective equipment for health care providers. South korea where you have everyone wearing a mask not italy where the country has been on lockdown and seeing a 10 mortality rate. It is certainly something we are going to press the president on today and one of the questions we plan to ask him is that very question about the situation with italy. You know, as far as what well get out of the president today, his tone has been so back and forth in the past 48 hours going from that press briefing in the rose garden where it was almost like an informercial to yesterday when it was really the most somber i have ever seen him in the dozens of media avail ablts ive had with him in my three years here. Well see which President Trump comes out today. And the other thing i was wondering if well get clarification on today, shannon, is the fact that the Surgeon General this morning went on television and essentially said the president s 30day guidelines might as well be received as a stayathome order around the country and while he admitted he cant tell every governor what to do, that is how he is hoping they all interpret it. I mean, so are we living in a nationalized stayathome order just not in name . Reporter well, i mean, ive asked the president this. Are you planning to issue a nationwide stayathome order and he called that unlikely. I mean, he cant force people to stay in their homes although a governor or mayor could as weve seen them do essentially force people or issue some sort of fine or penalty if they leave. But the president could give a very direct nationwide stayathome order. He has resisted doing that. Just as of yesterday when he was asked again what about florida, which at that time hadnt issued a stayathome order he was not directing the Florida Governor to do that. He was saying, you know, he thought they were handling it well and doing what was appropriate and of course we see the Florida Governor come out and issue a stayathome order today. There is this line they have been walking and this balance and this shifting messaging that continues to go back and forth. Shannon pettipiece, i know you have to get in there. I learned a lot today by the way. I did my podcast today with a White House Press corps colleague of yours and mine john carl and he told me the elaborate rotation that were all in these days. Yes. Continue to practice safe reporting and safe distancing there. I will. Its not easy in that press room, shannon. Thank you. We just got some sad news. The American College of Emergency PhysiciansJust Announced the passing of the first e. R. Doctor from covid19. He was a doctor in new jersey. So now i turn to a couple doctors at the front line of this coronavirus fight. Joining me now is an Emergency Room Physician and associate professor of emergency medicine at Brown University and a pulmonary and Critical Care doctor at brigham and Womens Hospital in boston. Doctors, i dont think either one of you knew that news before we just reported it. This just got reported. This is the nightmare that so many of you and others in the medical community have been concerned about, which is the protection of medical personnel on the front lines fighting this virus. That is exactly right. Many of us in the emergency Medicine Community knew the man who was in the intensive care unit in new jersey. He was a leader within the emergency medicine field. I didnt know it before you just said it. It breaks my heart. I hope he is the first of only a few Emergency Physicians to die. But if italy and china are any guide, unless our government steps up and gets us the protective equipment that we need, he will be the first of many of my colleagues to seccumb to covid19. Tell me what is missing right now, dr. Ranney, i am sorry to be the one to break my news to you. This is not my place to do that. I know he is a friend and colleague of yours. But tell me the equipment. Just reiterate again for folks to understand what is it that you guys need right now that the federal government has to be the one to procure . Absolutely. So let me make a very long list of things we need. We need masks. Regular procedural masks. We need n 95 masks. We need gloves. Gowns, hand sanitizer. We also are increasingly running out of durable medical equipment. Things like the disposable blades we use when we intube ate patients. Things like the spacers we use for the pumps for inhalers. Were also running out of course of ventilators and noninvasive positive pressure ventilator machines and starting to run out of critical medications. The medications we give patients to put them into a medical coma when we intubeate them are running low in many centers in new york city as well as many of the other hard hit areas across the country. Really if you name a type of equipment that is essential to Critical Care, and to emergency response, were running low on it. Doctor, besides adding to the list if there is anything dr. Ranney left out, patientint a pe of what you are seeing on the front lines there. Yes. In the icu talking about these shortages is particularly tragic because we are good if we have the medications and the protection that we need at managing respiratory failure. Even the small percentage of people who are unlucky enough to get critically ill from coronavirus, we are good at managing the ventilator. We are expert at managing some of the sequella of the virus. If we have the staff, if people flatten the curve enough that our system isnt overwhelmed. Unfortunately it is already becoming sort of overwhelmed and that is what were seeing at the front lines. Dr. Lamas, what are the chances massachusetts can flatten the curve enough thaw wont run out of beds . You know, right now i think we are in a position where we have enough beds. Were right now in a position where we have enough ventilators. To dr. Ranneys point though we see things like critical medications if the numbers are as high as they are projected to be could become shortages in our state as well. I think that we remain worried. Were planning for high numbers of patients. And i think it is perhaps excessive to say that were sort of cautiously optimistic but i think that we are Still Holding out hope that our system wont be overwhelmed while trying to make the best plans in case it does happen. I want to stick with you, dr. Lamas, in boston because i can tell you two weeks ago there was a lot of fear in the boston medical community that, you know, due to whether it was the biogen conference that boston could be where new york is. It didnt happen. Whats the data telling you . Is it possible boston is going to dodge a more lethal bullet than they thought . You know, i think people are definitely looking at sort of what happened after that biogen conference and why we havent seen more than we already have. That being said, the most recent projections in boston are still that in about a week or two weeks behind new york so a week or two from where we are now and our intensive care unit were still expecting to see a hundred or more intubated patients which is far from where we are now. I think were not able to say yet that we dodged a bullet. If that ends up being the case, i think it really will be a testament to social distancing or personal distancing but i think its right now were still on the cusp i think of being able to see where that is going. Yeah. Dr. Ranney, you were part of a joint oped today encouraging people to update their living wills. Explain why you believe this is so important right now. So looking forward and looking at whats already happening in new york and detroit and washington state, were seeing that as the number of critically ill patients gets higher we are using up the available ventilators and intensive care beds. We know in emergency medicine and in the Critical Care unit where dr. Lamass practice is that many patients when provided with the choice would prefer to pass peacefully and not be put on longterm, life maintaining ventilators and other really heroic measures. So were suggesting to people that they update their living wills or their desires for how they would want to die if that moment, that horrible moment were to present itself so that people have the choice ahead of time. We know that when people get sick with covid19 right now in most hospitals across the country were not letting family come in for more than a few minutes at a time if at all. And we want people to be able to make these decisions proactively with family around rather than in the heat of a moment in a crisis situation. Right. Dr. Ranney, i want to stay with you and talk about the situation of testing overall but particularly for front line medical personnel. Dr. Joseph fehr who is one of our contributors here, he believes until we have the capacity to do a million tests a day well never be able to knowingly lift these restrictions. We are still so far behind on medical personnel. Are we still at the point where the only people getting tests are people showing symptoms and people that may have been exposed to people showing symptoms . My own state of rhode island has extensively expanded its testing over the last few days under the direction of governor raimondo. Weve been working with commercial labs to ek panned the number of people who can get tested. But the Testing Capacity is still not where we want it to be. We are still prioritizing Health Care Workers, known contacts of people with covid19, and slowly trying to ebbs pannxpand it. I agree that in order to get control of this epidemic we know somewhere between 20 and 50 of people with covid19 dont have symptoms. So if we cant test people, and say, oh, you have it or you dont, then were going to have folks Walking Around and spreading it. We absolutely need to expand testing immensely. Dr. Lamas, tell me the situation at your hospital and in boston in general about medical personnel and how susceptible they are. So we do know that were susceptible. You know, the current numbers are that sort of over a hundred of our hospital employees, and thats not just medical personnel but hospital employees largely have tested positive and to amplify what dr. Ranney says, for us people who are Health Care Workers, first responders, who are showing symptoms are still the people who are prioritized for testing, so, clearly, that number reflects who is being prioritized to be tested. Currently, we wear masks in the hospital at all times, surge ka surgical masks unless we are wearing an n 95 respirator for some reason acknowledging the fact that any of us could be asymptomatic characters. This is obviously a work in progress and changes quickly but that is where were at in terms of testing. Do you have a strong opinion about whether all americans should be wearing some sort of Face Covering . Some people have been concerned it could deplete the surgical mask stockpile not n 95. Right. I think it would be hard not to be concerned about that knowing that our masks are short and so i think taking a view of whether all americans should wear masks has to take into account the reality. I think rather than worrying about whether people should wear surgical masks what is most important and we know this from data, hand washing, physical distancing, coronavirus is spread by droplets and by contact. And we can mitigate both of those risks by doing the things we know how to do. You know, so i would say that had we unlimited masks in the world, would it hurt for everyone to wear one . Probably not unless it made them detract from some of the things like social distancing and hand washing. But given where we are now i think we should focus on that for the general public. Dr. Ranney out of Brown University in rhode island and dr. Lamas brigham and Womens Hospital in boston, thank you both. The white house Coronavirus Task force briefing is set to begin a short time from now. It was pushed back from 5 00 to 5 30. Once it does start well bring it to you live. Also ahead are we starting to have some success in some places at flattening the curve . Why there may be a little bit of good news about our response to this crisis. I know we can all use it. Well be right back. Good mornin. Good morning, blair. [ chuckles ] whoo. Im gonna grow big and strong. Yes, you are. Im gonna get this place all clean. Ill give you a hand. And im gonna put lisa on crutches wait, what . Said shes gonna need crutches. She fell pretty hard. You might want to clean that up, girl. Excuse us. 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