Transcripts For MSNBCW The 11th Hour With Brian Williams 202

MSNBCW The 11th Hour With Brian Williams May 3, 2020

To open back up for business, were far from the end of this scourge, and the mid crisis lesson to learn is that our past failures do not need to dictate our future actions. As Global Health official and former head of the World Bank Jim Yong Kim wrote in the new yorker last week, its not too late to go on the offense against the coronavirus. And there are promising signs that our nascent offensive efforts are working but will only succeed if were guided by one thing, and that one thing is data. There is no other way to defeat coronavirus. All of our decisions must be based on the evidence available to us, not on the basis of political advantage nor on the basis of misdirected protests. We can only succeed if we follow the science, and that much is going to be our focus in the hour ahead. Tonight in a week with so many medical and science headlines to keep track of, i am once again grateful to be joined by dr. Zeke emanuel for the hour. Dr. Emanuel is an nbc news and msnbc senior medical contributor. Zekes going to give us a much of needed reality check on the news of treatment, breakthrou breakthroughs. Also labs that are sitting idle, Antibody Tests that are wildly inaccurate and unregulated. Were going to talk about whats broken and more importantly, how to fix it. Also, miami mayor francis suarez, himself a covid19 survivor, is going to be here in a few minutes. Mayor suarez is at the heart of the reopening debate in the country. While florida is opening some aspects, the Popular Center of Miamidade County is staying shut. It is a difficult state versus city dichotomy that is playing out across this nation, and that is so difficult because 30 million americans and thats most likely an undercount are out of work, desperate for their next paycheck. Tonight were going to examine the push to open up, to get back to work, versus the concerns of triggering a second wave of coronavirus if we open up before the science, before the data tells us it is safe to do so. So lets begin with the numbers. The United States now has 1. 1 million reported cases of coronavirus. The United States has 64,950 reported deaths from the coronavirus. The fda has issued an emergency use authorization for Gilead Sciences antiviral drug remdesivir for patients hospitalized with a severe case of covid19. The fdas nod came after dr. Anthony fauci, the nations top Infectious Disease expert showed that the trial data showed that the drug had a clear cut significant positive effect in diminishing the time to recovery. We should note this does not mean the drug should be used for all hospitalized patients. Previous research suggested the drug may have potentially dangerous side effects in some patients. But the maker of remdesivir, Gilead Sciences, is hoping that they can expand the drugs use for patients earlier in the course of their illness. Heres the ceo of Gilead Sciences on the today show. We were prepared and ready for this virus because of some of the work weve done with remdesivir for the past decade. At the same time that we put remdesivir in the Clinical Trials, we also made the decision before knowing it was going to be effective, to expand our capacity knowing the Global Crisis this was and knowing we would have to be ready in the event that this turned out to be effective for patients. So we have gone from around 5,000 treatment courses to today almost 100,000 treatment courses. And because of our development early, we think we will get to millions of treatment courses by the end of the year. Meanwhile america is starting to reopen. More than half the nations governors are relaxing pandemic restrictions in their states while hoping that the Novel Coronavirus doesnt spike, setting off another round of closures. But there is good reason for that caution. A new report from the university of minnesota suggests that the coronavirus pandemic could stretch on for two more years with recurring spikes until roughly twothirds or more of the population has developed immunity. And we have two pieces of news tonight from the white house. Nbc news is reporting that the white house has whittled the field of possible vablgs evccin its Operation Warp Speed Program from 93 to 14, which will undergo more testing in the next couple of weeks. And breaking tonight, the white house is blocking dr. Fauci from testifying before a house subcommittee thats investigating the coronavirus outbreak and response. The white house said it would be counterproductive to take him away from his work. But while hes been blocked from testifying before the house, nbc news has also learned late tonight that a spokesperson for the Senate Health Committee Says that dr. Fauci will testify before that committee on may 12th. Okay. Thats the catchup on where we are in the news. I want to bring in dr. Zeke emanuel. He is a physician who served as a Health Policy adviser in the obama administration. Hes now the vice provost for global initiatives at the university of pennsylvania. Zeke, great to see you as always. And as always, were loaded with questions for you. And the first one starts with remdesivir. Whats the situation with this drug . So lets first talk about how remdesivir works. The virus, remember, comes into the cell, into a lung cell, and then gets ingested and has to reproduce and make a lot more viruses. Remdesivir blocks that because it incorporates into the genetic code of the virus and basically breaks it up. And that stops it from reproducing. So what are these test results that dr. Fauci was talking about . Basically they started in the first of february, and theyve gone on for three months with over 1,000 patients involved in the United States, europe, and asia. The results were in relatively sick patients, those needing oxygenation or being on a ventilator. And they left the hospital sooner, after 11 days. Patients who got the placebo left after 15 days. When you look at the mortality, 8 of patients died who received remdesivir, and about 11. 6 died who received placebo, but that wasnt what we call statistically significant. It didnt mean that it was enough. It could have happened by chance, so that was the result. That led the fda to say theres enough folgs here. Probably the benefits are better than the risk, and were going to give this an emergency approval. Dr. Fauci among others said that this was an encouraging first step. Its clearly not a home run for anyone. Let me just say a couple of words in caution. This is good but not great. Were probably going to need multiple drugs to treat this virus again. We might have to move remdesivir up earl year. And the last thing i want to say is now that weve approved a drug, its going to be hard to do a placebocontrolled trial. So were going to have to test all new drugs against remdesivir, and that makes it harder and will require more patients in they trial. For this trial we needed three months. That gives you a sense for how long these next trials of new therapeutics are going to be. Right. And a statistic we talked about a little last week, that it is much harder than you think when were trying these new drugs, if you want to try to get a result out of it thats statistically significant, you actually need a whole lot of people in the trial. So theres complexity in developing therapeutics and vaccines. Thanks, zeke. Lets continue this discussion with miami mayor francis suarez. In march, mayor suarez was quarantined for 18 days after testing positive for coronavirus himself. Hes joining us now. Mayor, its good to see you. Hows your health first of all . Im doing well, thank you, ali. I had to quarantine, like you said, for 18 days. Ive been out of quarantine since then. Thankfully i have not had any sort of aftereffects or relapses of any kind, so ive been very fortunate. Mayor, we wanted to talk to you tonight because what you go through is reflective of a lot of the country. You are the mayor of a major center that has a lot of interchange with different people. You were you started restrictions in miami earlier. You are not ending them as early as other people are. But its porous, right . Boundaries between your city and neighboring cities are porous. Tell me about your concerns, about people who continued going to the beach, people who want to go back outside, enjoy the great weather, but the fact is youve got a city that is still under stayathome orders. Right. And its not only porous, but we also have a very Large International airport. And to give you a perspective, our International Airport receives 50 million passengers a year. That is twice the population of the state of florida. Even now when its operating at a diminished capacity, maybe 10 of its capacity, its still 5 Million People, which is twice the size of our county, which is a large county of about 3 Million People. So its almost twice the size. So were grappling with not only internal threats of, of course, maintaining social distancing, staying at home and making sure that our residents stay disciplined so that we can continue to reduce the number of new cases, but were also dealing with external threats. So, you know, its a very challenging, you know, dynamic, and were doing the very best that we can. And were trying to be as proactive and as careful as possible because of so many lives are at stake. Mayor, let me ask you about the idea that in many states, theres a tension between those residents who dont live in Major Centers like miami or like atlanta, where the mayors of these cities want to keep things a little more tightly controlled for a while. And there are people in other more spread out areas where theyre not seeing the same incidence of coronavirus, and they are putting pressure on their governors to open things up. How is that working for you in florida because youve got a governor who is ready to open things up. Yeah. Thankfully this week, although he did open up a large part of the state of florida, he gave the mayors in the southern part of florida, which is the densest part of florida, the ability to remain closed. And thats why weve done that. The data that were looking at is kind of all over the place. We had yesterday the ninth highest amount of new cases in the last basically two months, and then the two days that preceded that, we had some of the lowest number of new cases since the beginning as well. So part of the issue is were trying to interpret the data. The criteria that everybodys talked about is, of course, 14 consecutive days of diminishing covid19 new cases and also diminishing complaints of influenzalike, you know, symptoms. And were not quite there in terms of how we feel the data should be interpreted. Were looking at it every single day. We get two reports a day. We get two reports on the hospitalizations every single day, and were looking at all of that to make a prudent decision. Its a very, very fine balancing act that we as a major city have to make. Are you worried about a second wave, and how are you going to handle it if you do get a second wave that everyone seems to worry about . Of course we are, doctor. You have to understand that i was patient number two literally in all of Miamidade County. I was the second person at least that we knew of that tested positive. I was an asymptomatic person, and i was tested because i happened to be in the same room with one of the early, you know, people who had said publicly that they tested positive for covid19 from a delegation that came from brazil. So we are absolutely concerned that there could be a second wave, and we realize how quickly you can go from patient number two, which was me, to patient number 12,257, which is where were at right now. So, you know, were trying to be careful and do everything that we can to avoid that second wave from happening. 12,257, and more than 350 deaths. Mayor, thanks very much for joining us and for your leadership on this right from the beginning. Miami mayor francis suarez. Still to come, youve no doubt heard the news out of oxford about progress on a Coronavirus Vaccine. Its being hailed add a breakthrough but should we believe the hype . Also the squeeze on workers who just cant work from home. President trump orders meatpacking plants open, and some republican governors say if you dont return to work, you wont get unemployment either. But up next, importance questions about accuracy of testing and a new theory about how long you could spread the virus if you have it. And platelet donations and asks all healthy donors to schedule an appointment to give. Now, with the corona virus outbreak, it is important to maintain a sufficient blood supply. Your Blood Donation is critical and can help save lives. Please schedule an appointment today. Download the blood donor app. Visit redcrossblood. Org or call 1 800 red cross today. You can make a difference. Your cells. Trillions of them. Thats why centrum contains 24 key nutrients to feed your cells, supporting your energy so you can take care of what matters most. Centrum. Feed your cells. Fuel your life. 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Since the coronavirus pandemic began, there has been one constant among all experts, the need for more testing. On march 6th when the United States had only 217 confirmed cases of coronavirus, this is what President Trump said while visiting the centers for Disease Control in atlanta. Anybody that wants a test can get a test. Thats what the bottom line is. Tonight the United States has 1,102,937 confirmed cases of coronavirus. Now, the actual number of cases is likely much higher, but we dont really know because we still do not have enough tests. There have been shortages at times of everything necessary to conduct those tests, including personal protective equipment, specialized swabs, the reagent chemicals needed by labs, and machines to run those samples. Across the country there are thousands of academic labs that could test for the virus that are being unused. Thats according to an oped in the wall street journal written by two neuroscientists from Michigan State university. They write that, our Research Team used food and Drug Administration guidelines and a scientific report from wuhan, china, to develop a covid19 test in early march. It took one week. Our test doesnt use the reagents other labs are desperately seeking, and it can identify levels of virus so low that a typical test could miss them entirely. Yet our lab sits idle. The Sticking Point is something called Clinical Laboratory improvement amendment certification, also known as clea. Most academic labs currently do not have this certification, but with it these labs could help drastically increase testing in the United States. Jack lipton is chair of translational neuroscience at Michigan State University College of human medicine, and he coauthored that oped. He talked to zeke about his labs diagnostic test also known as a pcr test and what a prompt accreditation from federal government could mean in americas fight against coronavirus. I wanted to talk to you first to explain to people what a pcr test is and what the steps we have to go through are. First you get a nasal swab or you get a saliva swab, and then you in the lab isolate the rna, the genetic code in the virus. Then what do you do to get the test and determine if the persons been infected or not . So we take that rna, and we turn it into something stable, which is dna. Then we take that bit, and we amplify it. And we take it, and we run it through several cycles with some enzymes, and those allow it to double for each cycle. And the larger that we amplify it, the more we start to develop a lightbased signal. And through that signal, we end up seeing whether weve amplified the genetic code of the virus. And if we did, we will get a bright signal, and that produces a reading on our machine. That tells us if we are indeed have the presence of the virus in the individual. Now, youve been reported to be out there saying that, you know, if we harnessed a lot of the academic labs like your own that arent doing research because of covid19, you could generate 500,000 to 1 million copies i think you were quoted as saying, 500,000 to 1 million tests a day. Is that really plausible . I think its absolutely plausible. I think its basic math. Theres easily 10,000 labs out there in academia that can run this kind of test. The realtime pcr system is very common in molecular biology laboratories, and anyone from a plant biologist to a neuroscientist i happen to be a neuroscientist. We all use these tools. And youve seen a barrier. Youve reported a barrier in getting your type of lab and your type of test approved and have the government sanction it, allow it to be used for clinical determinations. What are those barriers

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