The president on friday sirened 2 trillion Economic Relief package fork cussed on providing aid for workers and businesses. The bill passed with bipartisan support in both the house, and andrew cuomo will be giving a press briefing. New york has become the epicenter of the pandemic here in the u. S. We have a team of correspondents and analysts joining us this hour. Were bringing you the laters. Lets go first to ron allen, who is in new york city, the epicenter of this u. S. Outbreak. I know youre at elmhurst hospitals, not real long lines. People are being allowed to wait until tents. We cant see them, which is a good thing. We dont want people chilled, perhaps adding insouth to injury, but it appears to be ground zero here in new york. Reporter the hospital is not saying much. Were getting some adeck dotal information from doctors and other medical staff who are speaking out. They want the world to know whats happeningthey feel here,e extent theres been some relief. Its still relentless, still just in a dire situation, but there has been some relief. The city has been swarming supplies here, more staff has arrived in recent days, as more han learned about whats going on here. You see the ambulances going behind me. Theyre going back and forth, because theyre transfer a lot of patients out of the elmhurst to other hops who are noncoronavirus patients. This hospital is becoming almost 100 dedicated to treating patients with the virus. You see the center up there. There are some people who have shown up. Its raining outside, so theyre getting in out of the weather. We understand theres a very High Percentage of people who are testing positive who are showing up. Its a big concern, obviously, because it just overwhelms the system, but speaks to its an immigrant community, very densely populated. Theres a lot of illness, a lot of sickness in this community. Theyre seeing that as well. Theyre getting more supplies, but vent its just relentless. I understand that at the emergency room entrance there are doctors there waiting for people walking up and walking in. Theyre trying to screen them and see how ill, how sick they are. Unfortunately theres a number of people being turned away because the doctors are so overwhelmed by whats going on in the e. R. And iicu. The numbers of hospitalizations are rising at a slow rate. Hey, let me ask you, ron, ivan around parts of these networks for a long time. Can you put this into perspective how this crisis compares to other u. S. Disasters you have witnessed . What is so stunnic and shocking, this is happens in new york city. Yell when you walk up here, you see what looks like a thirdworld country, a war zone its a tragic situation. Its really bad out here. Its almost ive been saying its like a disaster unfolding in slow motion, because people, space themselves out, and they theyre desperate to be tested. Its on and on every day, alex. Ron allen, thank you very much for that perspective. Joining me right now is dr. Gene nobel, the director of the covid19 response. Dr. Noble, when you see whats happening around here, you see sick people, waiting in line for hours, what we were just talking about throughout this week at elmhurst, what you go they your find. Did you ever think this could be possible here in the United States . No, i did not. My heart goes out to my colleagues and all the people of new york. I never thought we would see this kind of epidemic, this kind of response here in the United States. Ive done a gloat of Global Health work arounded world and frankly i thought the United States as an industrialized country would be somewhat immune to this type of response and the scarceities. What its like for you and your colleagues, patients with coronavirus, they are coming through those doors. Do youo do you feel like you have enough protective gear . The proper treatment to treat, identify and isolate . So from the beginning weve had scarcities, so the rollout was delays and slow. Were still not completely out of the woods, though the last several days weve been performing more than 100 tests a day. So were getting there. But we are months into the epidemic. Thats a late arrival. Regarding ppe, we are continually facing shortages. We now perhaps have a months supply. Thats great news for us. Many of our neighbors institutions are not so lucky. We continue to have shortages in other areas, though the powered air respirator device, really the highest protection, when were intubating and putting them on vents lators, we are a limited supply of shields. We have a gown shortage as we have. We have moved to washable gowns. Each provider has an average of two gowns per shift. We are doing better than a lot of institutions. Our community is rallies. We have Donation Centers that are open. Were doing all that we can, but ppe scarcity were facing at ucsf just like everyone else. I like at least the Silver Lining nugget, that you guys at least have masks for 30 days. Its a bright spot comparatively to what we have heard elsewhere. Dr. Jean nobel, we are a grateful nation. Thank you. A lot of us have looked to this man, new york gierschor andrew cuomo. Lets take a listen in. You know how i know today is saturday . Because my alarm clock set saturday when i woke up this Morning Saturday is the day that the traffic is lighter, but the traffic was lighter yesterday. So its literally one day blending into the other. Just as a matter of perspective, a matter of context, it feels like its been going on forever, but it really hasnt. New york state had its first case of covid just 27 days ago. New york schools closed only ten days ago. The new rochelle cluster, which was the highest cluster in the United States which thanks to the good work of our health department, has now come down, that was 18 days ago whether we started the School Closings in new rochelle and we started the testing and the drivethrus. Is the overall shutdown was only eight days ago. It feels like a lifetime. Perspective, how long does this go on . How long do we expect it . China, which was the first test case, right . First case was 12 weeks ago. Thats when it started in china. South korea started nine weeks ago. Italy about eight weeks ago, so all keep it all in perspective during this disorienting time when one day is just blurring into the next. A lot of people ask me why is there so much talk about ventilators, i never heard about a ventilator before. Youre not alone. I never really heard about a ventilator before either, but every emergency situation is unique, and every emergency situation winds up focusing on an issue you would have never thought of before weve been through Superstorm Sandy where we needed 1,000 portable generators immediately whoever heard of needing portable generato generators. We had flooding in the north part of we needed 700 miles of sandbags . Whoever heard of needs so theres always a particular circumstance that winds up that winds up developing that you could never really anticipate. In this situation, its about a ventilator. Its all the same. Its a respiratory illness, their lungs are damaged. Theyre having trouble breathing, they have a cough, and they all need a ventilator. Thats the peculiarity of this situation. Compounding it is usually when we equip a health care system, people are usually on a vitt lators for three, four days. With covit, theyre on for much longer. People are on then longer, so you need even more. That increases the problem. I think the president was right to use the defense production act. What it basically says is im not going to ask private companies to help out. But it giving the federal government it significant leverage to say i need think produces and i need these produced by x date. The federal government still pays an nicked cost, but it gives the federal government the ability to do that. When cit comes to ventilators, these are the necessity. Basically i ask people who know, the experts, a lot of questios. S what do we do if we dont use ventilators, then you use bag valve masks. What is that . This is a bag valve mask. This is what you do if you have a person who needs a ventilator, and you dont have a ventilator. The way this works is that its basically a manual ventilator. And someone squeezes the ventilator, the bag, continuously. This looks easy i guarantee if you do this for any length of time eel see how difficult it winds up being. This is the alternative if you dont have the ventilator. We are actually buys these t weve been bought about 3,000. Weve ordered about an additional 4,000 were even talking about Training National guard people to how to operate this division, which is relatively several to operate, but you need a lot of people to operate this 24 hours a day theyre the alternative. The short answer is, no thank you. If we have to turn to this device on any largecase base thats not an acceptable situation, so we go back to finding the ventilators. Even the medical experts cant tell you what you need here at the high point. They do numerical projections, and then you plan based on the projection, you plan based on the data the data says at that high point of need, you could need 30,000 ventilators. So were planning for that, quote unquote, worstcase scenario, which the models predict. Maybe we flatten the curve, and were working on that day and night, you hit that apex, make sure youre ready for the apex. Thats where the 30,000 ventilators come in. I have no desire to procure more ventilators than we need on a practical basis, the state is buying the ventilators. They cost between 25,000 to 40,000 each. Theyre very expensive, and youre that you coulding about a State Government that frankly is already from a position of revenues in a terrible position. I dont want to buy any more than we need on a parochial basis. I dont want to pay for them. After this is over, well have a great stockpile of ventilators whatever we do, but the state has no interests in inflating the number of ventilators that we actually need. Something interesting about the price of ventilators. When we started buying them, they were about 25,000. Now theyre about 45,000 . Why . Because theyre in such demand and theres such competition to buy the ventilators, which ill touch in a mom. Those are not currently innee. What we are doing is were planning for were planning for the critical need, and make sure we have the equipment to staff the beds for that critical need. Were days away from the apex. When that curve hits the highest point, it is too late to try to acquire what you need. Acquire what you need now, thats the process of a stockpile. Thats what were going through now. Do everything theres an old express, you go to warrick with what you have, not with what you need. Until youre in that situation, do whatever you need to do to prepare for it. If they tell you youre going to war in 14 to 21 days, so spend the next 14 to 21 days getting everything you need to be ready. For us the war would fully engage if we hit that apex, so everything were doing is in anticipation. Gourd forbid the apex haps, but make sure we have what we need for that moment. A few updates, they still forecast the apex tore 14 to 21 days. Again that changes on the modeling. Every time the caseload goes up or down a bit, that affects the calculation on the apex. What do you need at the apex . 140,000 beds, thats hospital beds, dormitory beds, were working on that every day and were getting closer and closer to were still talking to the federal government about acquiring more ppe. Theres still a concern among Health Care Professionals, because the cdc guidelines suggest a different protocol for ppe and masks, depending on the condition, and parent there is a crisis that the cdc sets forth, and the cdc has put those crisis guidelines in place, and Many Health Care property felt always are concerns that the guidelines do not adequately protect the nurses, doctors, Health Care Staff that are working on this issue. Dr. Zucker is are looking at though. If we believe the cdc guidelines dont protect the professionals, well put our own guidelines in place. Were working on bringing in more reserve staffing excise in place, thats going very much, back to our favorite or ventilator quest s word to the local Health Systems, we need the local Health Systems to think more holistically. In other words, youll have a Regional Health system, western new york, central new york, new york city and theyll have a number of hospitals. You can have a single hospital gets overwhelmed within that system. You can have the staff get overwhelmed. The local Health Systems have to change their orientation where its not hospital by hospital, which is the normal culture. Every hospital is freestanding on its own, and is it its own entity. I need the local Health System to change their orientation, and operate and plan as if that system is one. If you see a local hospital getting overwhelmed, shift to an adjoining hospital. Unfortunate public and private hospitals, we have to stop operating as individual hospitals, and they have to operate as a system. I need the local officials to do that. So patients can and should be moved among those local hospitals as the need requires. Staff can and should be moved as circumstances require. State department of health has not only advised that, but has mandated that. Its not the normal operating culture, but it is a necessity in this situation. Depending on where you have hospitals getting overwhelmed. Maybe theres no other hospitals around that area, or its a cluster zone, that hospital gets overwhelmed. Shift, cooperate, plan as a local Health System. There may come a point where the state steps in and actually allocates among local Health Systems sudden may have patients from downstate new york to being move to upstate new york. Why . Because if the entire local Health System in downstate new york gets overwhelmed or the local Health System gets overwhelmed, and the lodge island Health System says to me, look, we have allocated, we have eight hospitals. We have allocated everything we can among or eight hospitals. Were still overwhelmed. Well, then well you shift the bird to a different Health System. Ref asked the pharmacies to cooperate above and beyond and do free home delivery. There are long lines at pharmacies right now. Thats not good for anyone. I will be speaking with some of the major pharmacy chains to ask if they would be cooperative i understand its a hardship on the pharmacies to provide home delivery. Im asking them to do it free of charge, but it would make a very big difference. Also the department of health is monitoring the density and activity in the new york city parks, specifically on the playgrounds this has been a problem. The new york city mayor de blasio and the speaker Corey Johnson have spoken to this. They gave us a plan. We accepted the plan. The plan is premised on the fact that people will reduce the density in playgrounds. No basketball, no contact sports, social distancing. There have been reports that that is not happening speaker johns everyone has made this point. If the voluntary compliance is not working, we can get to a point where we will close those playgrounds, so i again ask the people in new york city, especially young people, please take this seriously for yourself and for others, and lets do it on a voluntary basis. Were also now administer 1100 tests of the hydroxy chlohoquine. We will be getting results soon. Javits will open soon. It is amazing what the on army corps of engineers did in a short time, about one week. The progress they made is extraordinary. I want to thank them from the bottom of my heart. The army corps of engineers, the National Guard, which is our work force that we call out in all these organizations. I have worked with many of them, and know them after so many situations together, but they showed up and they have done a great job. This should open on monday. The usns comfort will be on its way, im told. The president will be seeing it off. It should be here on monday. That will bring 1,000 beds, it also brings medical personnel, which frankly are more important than the beds in this case, and is it has operating rooms, et cetera. Well use this to backfill and take pressure off a hospital, so a hospital can backfill onto this 1,000bed facility. I hope it gets here monday, and i will greet it with open arms. I spoke to the president this morning, actually just before i came in today. I apologize for being a few minutes late. The president approved four new sites for emergency medical facilities, one in brooklyn at the Port Authority cruise ship terminal. Its call one in queens, one in aqueduct racetrack, one in staten island, one in the bronx at the expo center. I went and toured the sites yesterday, they are perfect well, none of this is perfect. They are appropriate and suitable to bring in largescale medical facilities, the 100,000 square feed, 120,000 square feet. Theyre open, they have electric. They have climate control, et cetera. So this is going to be big advantage. This will at another 4,000 beds, and theres one in every borough in new york city, which was important to me. Every borough knows that they have a facility and theyre getting the same treatment that everyone else is getting. Im a new york city outer borough person. You dont know that classification also youre from new york city. Everyone is being treated the same. Were adding to that be capacity to get to the 140,000 beds. Weves added 695 additional beds. South beach is opening up. The Westchester Square is opening up. So you see, again, were trying to have facilities all around the geographic location thats experiencing the increase. Were making another shift to covidonly hospitals, where people in those hospitals will only have the virus. So the staff that is there is working with one type of issue as opposed to a normal hospital setting. Its smarter to keep the covid statements separate. This is smart and were going to isolate 600 beds for just this treatment. South beach