now I shall just tell us what the
situation is in California at the moment
whether the healthcare system there is
coping at this time the California
health system is coping we have a
sufficient bed capacity sufficient ICU
and ventilator capacity and for now we
are holding the fort what kind of
difficulties our medics facing there in
terms of the kind of life-and-death
decisions that they're having to make
today thank goodness we don't have to
make those decisions we have sufficient
capacity but we are starting to run out
of personal protective equipment the
masks the golf gloves the gowns the
things that will keep us safe as
healthcare workers and so at this point
we are rapidly trying to scale up our
sourcing of these supplies it hasn't
been as successful as we hoped but there
is light at the end of the tunnel do you
anticipate that you know in the next
couple of weeks things will get more
challenging there or you fairly
confident that you've got enough
resources in place to handle it well we
always say plan for the worst and pray
for the best
and we are planning for the worst we've
at Stanford University we've opened up
our old hospital and we will have about
90 more ICU beds available as well as
many more regular beds we've sourced
dozens of extra ventilators should we
need it so at this point we are still
planning for the situation to get much
worse before it gets better and it will
only get better as we do much more rapid
and broad testing of patients across the
community I'll come back to that in a
minute but I just wanted to ask you
first about in New York which I think
was you were formerly at the department
of health fair why do you think New York
State is so badly hit well New York
State is badly hit because it's such an
international city and so densely packed
as as you know people come from around
the world to New York so there are cases
across the region and without adequate
testing these cases each case spreads
very quickly to many more cases the
density also facilitates that rapid
spread so at this point they are trying
to do their best to get their handle on
the situation they have excellent
leadership in Governor Cuomo and they're
firing on all cylinders in terms of a
public health response coordinated with
the
clinical response well Donald Trump
backs away from quarantine in the entire
state of New York was he right to do
that do you think or are more stringent
measures potentially needed here
ultimately I think we will all need much
more stringent measures in the United
States I think that stay at home orders
or shelter-in-place
will need to be enacted for longer
periods of time until we have adequate
testing to really catch each case in the
community and stamp it out well is there
any prospect of testing we've got the
same issue here in the UK is there any
prospect of testing being ramped up soon
enough in different states in America we
have been told that it's a it's two
weeks till we get widespread testing
available I know that here at Stanford
we have over 1500 tests we can do per
day my hope is that with Abbott's rabbit
test rapid testing kit and other tests
available we will start to get the
million or so tests a day we'll need
ultimately it'll be much greater than
that so I'm hopeful that again within
two weeks we will start to have that
capability the problem is that every day
of delay means much more spread in the
community well what does that mean for
potential death numbers because you've
had a White House adviser talking about
a hundred thousand to two hundred
thousand Americans dead potentially by
the end of this do you concur with that
figure or do you think that is it even
too conservative dr. Falchi is one of
the most trusted names in heat when he
said two hundred thousand American lives
lost I think he was being conservative I
think that the if Americans don't start
to act now we will be in much worse
shape than we are today every three days
the virus doubles in the community we
know that and so even a day's delay
leads to 40 percent more cases in the
community we must act now that's why
I've started Cove attack now so are G to
start to get a few of the governor's
that haven't yet acted in line I mean
these are astonishing figures do you are
you able to put a figure on what you
think the death then the scale of deaths
might be in the end we know that from
the best estimates across
world approximately 1% of cases is
leading to mortality that 1% today we
have approximately a hundred and
forty-three thousand cases diagnosed in
the United States that is a vast
understatement of actual cases in the
United States I know in my own clinic I
probably sent home a dozen people who I
could not test because they didn't meet
criteria and yet they probably had kovat
in the community so my unfortunate
prognostication is that we will have 1%
of whatever number of cases we
ultimately have every day we delay every
day that Texas and Florida and other
large states do not put a shelter in
place strict quarantine and lockdown in
place we will see a widespread spread of
the disease
McDonald from four weeks tried to
downplay the severity of coronavirus
he's had to reluctantly backtrack from
his original aim of opening up America
by Easter has his stance in your view
will it of contributors to an increased
death rate yes and the the problem is
there's a false choice between lives and
livelihoods and if you're trying to keep
the economy going and you think that the
only way is to have people working the
reality is we need to first catch the
disease tamp it down and then let people
get back to work we have no coherent
policy across the US on how to do that
my my belief strongly is that we have to
err on the side of saving lives and then
we can get back to livelihoods but I
mean Donald Trump expressed the view
that the cure could be worse than the
initial problem I mean there is a sense
isn't that if you're forcing people not
to work and people are going to be
physically inactive during lockdown
there are serious consequences to that
on their health consequences this is
unprecedented we have nothing to compare
this to so when we're trying to say that
this is going to be bad yes it's going
to be bad it's going to be much worse
than any of our collective experience
the only glimmers of hope in places like
South Korea Taiwan and elsewhere where
they've started to control the disease
is that this is
but it takes a much more serious
concerted public health equity efforts
it includes self isolation quarantine
and other measures that we simply have
not done as a nation so it's outside our
realm of experience that's why it's so
hard for people to understand how
serious this is and how important it is
and it is going to have tremendous
long-term consequences to our economy do
you think Donald Trump actually gets it
now I mean he was seen handing out pens
for example to his you know his advisors
around him when he was signing off the
bill the other week I mean does he does
he understand what's going on do you
think the scale of it now he's
surrounded by some very good advisors
and his message changes daily I am
optimistic that he understands the
gravity of the situation we've now
talked about not going back to work
until at the end of April at the
earliest and so the there is learning
involved there is movement in the right
directions but if he'd acted earlier
more lives could have been saved I
believe that every day of delay leads to
lost lives just finally obviously your
health care system there is very
different from the British health care
system is it the case that the the
poorest in America will end up being hit
hardest by coronavirus because they
don't have access to the same kind of
health care yes the NHS has been a
wonderful example of what we should
learn from and in the u.s. we do not
have a health care system we have
multiple small areas each approaching
health care differently the homeless and
those without insurance are the ones
that I worry most about they will be hit
the hardest
they will harbor the virus longer than
other populations and we don't have good
solutions today on how best to address
them near off Michelle thank you very
much for joining us
you