FRONTLINE

S2020 E10 | FULL EPISODE

Coronavirus Pandemic

How did the U.S. become the country with the worst known coronavirus outbreak in the world? FRONTLINE investigates the American response to COVID-19 — from Washington State to Washington, D.C. — and examines what happens when politics and science collide.

AIRED: April 21, 2020 | 0:54:22
ABOUT THE PROGRAM
TRANSCRIPT

♪ ♪

♪ ♪

>> When somebody is the president,

the authority is total.

>> He's not doing everything he can do.

>> ...bidding against one another...

>> ...can't tell you how frustrating it is.

>> NARRATOR: Amid the escalating crisis between the president

and the states over the coronavirus pandemic...

>> It has nothing to do with the president

or federal policy or anything.

>> NARRATOR: ...the inside story of how the outbreak

began in the United States.

>> The reason Washington state found that first case

'cause we were ready for it.

>> NARRATOR: Correspondent Miles O'Brien on the ground

with those who detected it first.

>> Within the first five days we had 32 positives.

We then knew that this was a much bigger outbreak

than you could have imagined.

>> NARRATOR: And, the tale of two Washingtons.

>> That governor is a snake. Okay. Inslee.

>> We are not going to be distracted by any rhetoric

that the president or anyone else uses.

Facts and science, that's the only thing that's going

to get us through this.

>> NARRATOR: Now on "Frontline," "Coronavirus Pandemic."

♪ ♪

(seagulls squawking, siren blaring)

>> It was one of the most vibrant cities in America.

Our economy was strong, a port that was one of the leading

ports in the country.

We had one of the most vibrant restaurant scenes,

small businesses flourishing.

And we went from that to almost zero overnight.

(ship horn blares)

>> MILES O'BRIEN: I arrived in Seattle in mid March,

a city and state in the process of shutting down

before that was the norm in the rest of the country.

I've covered science stories for nearly 30 years,

but this felt more like science fiction.

The deadly disease COVID-19 was about to bring the country

and the world to its knees.

>> It's like watching a slow-moving landslide

move towards you.

>> O'BRIEN: How did it evade our warning systems,

our best science?

>> A lot of people died because we weren't ready.

>> O'BRIEN: Why was our government so slow to act,

so unprepared?

>> I haven't cried ever as much as I have in the last week.

>> O'BRIEN: And what lies ahead?

♪ ♪

♪ ♪

I came to Seattle looking for answers.

My first stop...

How are you?

...Providence Regional Medical Center in nearby Everett.

>> And have you traveled outside the U .S. in the last 30 days?

>> I have.

>> Okay, so we're gonna ask you to put on a mask.

>> O'BRIEN: Okay.

This is the hospital that treated

the first known case of COVID-19 in the country.

>> There we go, 97.6.

>> O'BRIEN: I met Dr. George Diaz,

an expert in infectious diseases who treated patient one--

a 35-year-old local man who'd flown into Seattle

on January 15.

>> He was having a cough, he had been having fevers at home,

he hadn't been eating well, he generally felt poorly

and he had been complaining of diarrhea at home.

>> O'BRIEN: He is 35 years old and otherwise healthy.

>> Totally healthy person.

He began developing symptoms the day after he arrived.

>> O'BRIEN: He went to this walk-in clinic

and described his symptoms and told them where he had been

for about six weeks: Wuhan, China.

>> A preliminary investigation into a mysterious pneumonia

outbreak in Wuhan, China, has identified...

>> O'BRIEN: That was a crucial detail.

>> The mysterious new pneumonia virus has sickened

dozens of people...

>> O'BRIEN: For weeks, Wuhan had been the center

of a growing storm.

>> Scientists in China trying...

>> O'BRIEN: ...as news trickled out

about cases of a strange new pneumonia.

>> Still a lot that is unknown, the W.H.O. has said...

>> O'BRIEN: In Seattle, a city known for cutting-edge medicine

and technology as well as ties to Asia,

officials told me they had been on alert.

>> It clearly had the attention of our public health folks,

and they in turn were starting to line up

the other departments, starting with Human Services,

about how we're going to respond when and if

it arrived on our shores.

>> O'BRIEN: At the clinic where the man returning from Wuhan

was seeking treatment, they took no chances.

>> At that point the clinic appropriately isolated him.

The health district contacted the CDC, who advised testing.

And fortunately that clinic had the appropriate gear to be able

to safely test the patient.

He was then advised to go home and quarantine.

>> O'BRIEN: The clinic sent a nasal swab they'd taken

from the man to the Centers for Disease Control and Prevention

in Atlanta.

>> And then, within 24 hours, we had a call from the CDC saying

that the test was positive and that they wanted us to admit him

for observation.

>> O'BRIEN: The first COVID-19 patient had been confirmed

in the United States.

Around 10:00 p.m. on January 20, patient one was brought

to the Providence Regional Medical Center.

This is a photograph of his arrival,

encased in what's called an isopod,

designed to keep a patient quarantined.

>> Patient number one arrived here in this?

>> He did. When we were going through

the transportation plan with the ambulance company,

they wanted to keep their staff safe.

Completely contained,

doesn't allow any possibility of infection.

So our patient was placed in this by EMS

and brought to our hospital and unloaded in his room.

So, it took us about two hours from the time the CDC called

for us to get all our staff personnel, supplies,

and the facilities all in place to be able to give

the EMS folks the greenlight to come in.

>> O'BRIEN: You did that in two hours?

>> In two hours. We were ready for it.

>> O'BRIEN: One of the reasons they were so ready:

less than three weeks earlier, Diaz and his colleagues

had conducted an elaborate simulation-- pandemic training.

>> We were aware of what was going on in Wuhan at that point,

but it was part of our routine structure already to prepare.

>> O'BRIEN: You really had a go-to plan.

>> We had a game plan in place already.

We had everyone involved, including the local EMS,

those people that bring the patients from point A

to point B, public health officials, and other partners

we have in the community to drill.

So we had a variety of scenarios we went through.

>> O'BRIEN: By the time patient one was hospitalized,

local public health officials were going into high gear.

>> The reason Washington state found that first case

'cause we were ready for it.

The ambulance service was ready, they knew the right personal

protective equipment to wear, it was one of those

absolute coordination between the health care,

local health, state health, and the CDC.

It went perfectly.

That's how we were able to find the first case in the country.

>> O'BRIEN: It was a critical early warning sign

that the highly contagious coronavirus could be spreading

in the U.S.

But in his first public comments,

President Trump dismissed any threat

to the rest of the country.

>> Have you been briefed by the CDC?

>> I have.

>> Are there worries about a pandemic at this point?

>> No, not at all.

And we're... we have it totally under control.

It's one person coming in from China,

and we have it under control.

It's going to be just fine.

>> All right. Safe travels... >> Thank you.

>> ...on your way back.

>> O'BRIEN: In Seattle, doctors and scientists weren't so sure--

they didn't have a way to test for coronavirus on their own.

And while the CDC had been able to test the sample

from patient one, it didn't yet have a test it could deploy

on a massive scale around the country.

>> The way to really know the burden of disease

in your community is to be able to test.

So the testing piece was a huge piece of the puzzle

that we didn't really fully...

we weren't fully able to address.

>> O'BRIEN: By early February, with the virus spreading

around the globe, the World Health Organization

was recommending test kits that had been developed in Germany.

But U.S. officials made a fateful decision

to go their own way.

>> If you look at a moment when the United States may have lost

its ability to control what's happening,

it begins with the decision early on in 2020

by the CDC not to utilize the test kits and the capabilities

that were being shared by the World Health Organization

and other nations.

>> O'BRIEN: The CDC wouldn't talk to me on camera,

but told me they took the swiftest path

and using another nation's test would have caused worse delays.

Former CDC director Tom Frieden said the decision made sense.

>> There's never been a time previously when there was a need

to use a test from outside because the CDC system

has not failed in the past.

>> O'BRIEN: The CDC began shipping its own test kits

to public health labs around the country.

But in Seattle and elsewhere, it was quickly obvious

that something was wrong.

One of the three chemical probes was faulty,

generating inconclusive results.

>> There were checks and balances within the test.

And when we validated can it detect the virus

and can it not overdetect it, that balance was not correct.

>> Research and implementation laboratories said, you know,

"This doesn't work.

You've given us a bogus kit,

and we're not going to use it.

Fix it, fast.

You know, or give us the right to use our own kits."

>> O'BRIEN: At the University of Washington I met virologist

Alex Greninger, who'd been trying to do just that.

>> You got to have the supply of testing, absolutely do.

We need to be able to detect where the virus is and then try

and snuff it out, I mean, right?

Prevent its transmission, that's the name of the game

in the coming months.

>> O'BRIEN: But he ran into a bureaucratic brick wall:

the Food and Drug Administration had instituted

emergency procedures to make sure any new tests

were accurate.

>> You can make your own tests,

but you have to send it to the FDA and get it reviewed

and then authorized.

And I'll admit, I'm in my first couple of years here

in this particular job, I had not been through

this process before.

>> O'BRIEN: The FDA application was 28 pages long,

and required him to run tests that would take

at least two weeks.

And that wasn't all.

>> One of the things is they needed a document FedEx-ed

across the country before they could look at the document.

>> O'BRIEN: You couldn't electronically transmit it?

>> I could electronically transmit it,

but they couldn't look at it until it was FedEx-ed.

And then they changed that regulation.

And so from a couple days after February 4 all the way

to February 26, they didn't have a test,

they were completely blind, too.

>> O'BRIEN: This had to be incredibly frustrating.

>> It was frustrating, it was.

So we try to prioritize things in the top tier.

>> O'BRIEN: The FDA told me it did review

Greninger's application but it was incomplete.

They also said they were balancing the need for tests

with concerns about accuracy.

>> Major developments, a global health emergency

as the coronavirus reaches its 20th country.

>> O'BRIEN: In Seattle and and around the world,

the clock was ticking.

>> The coronavirus is now considered a global

health emergency and the U.S. is warning people

not to travel to China.

>> O'BRIEN: The W.H.O. had declared a global emergency,

and the CDC was beginning to screen passengers

at U.S. airports, including Seattle.

>> We are coordinating with the Chinese government

and working closely together on the coronavirus outbreak

in China.

>> O'BRIEN: President Trump was still not raising alarms,

though he banned foreign travelers from China.

>> My administration will take all necessary steps to safeguard

our citizens from this threat.

>> O'BRIEN: But, by that time, flights from the outbreak zone

had been landing at U.S. airports for weeks.

>> The travel ban may have bought us some time,

but in all actuality, you know, people were leaving Wuhan,

going to Beijing, traveling to Western Europe

and ultimately to the United States in late 2019

and early 2020 anyway.

>> Chinese health officials said today another 46 people

have died from the coronavirus.

>> O'BRIEN: In those critical first weeks

after the arrival of the virus in the U.S.,

administration officials-- and the president himself--

continued to insist that the risk was small.

>> I want to emphasize that this is a serious health situation

in China, but I want to emphasize

that the risk to the American public currently is low.

>> How concerned are you?

>> Well, we pretty much shut it down coming in from China.

We've offered China help, but we can't have thousands of people

coming in who may have this problem, the coronavirus.

So we're gonna see what happens, but we did shut it down, yes.

>> O'BRIEN: That attitude didn't sit well

with Washington's senior Democratic senator Patty Murray.

She spoke to me from her home.

>> I felt like at the time I lived in two different worlds.

I lived here in Washington state, where people were going,

"Oh, my gosh, we have a problem,"

and in Washington D.C., where they'd say, "Oh, you guys

worry too much out in the West Coast."

>> O'BRIEN: A tale of two of Washingtons.

>> Yeah.

We should have pulled out all the stops and checked

everything, but it was more like,

"Oh, you guys quit worrying out there."

>> O'BRIEN: There was a lot to worry about.

In isolation at Providence Hospital,

patient one was deteriorating.

>> He began developing more shortness of breath.

And because of that we got an x-ray which looked like

he had a developing pneumonia.

His oxygen levels in his blood were also decreasing.

>> O'BRIEN: That worried Dr. Diaz, who'd been following

the dire medical reports out of Wuhan.

>> It appeared, based on their data, that once patients

begin developing pneumonia that many of them end up

in the ICU on a ventilator and die.

>> O'BRIEN: Patient one was slipping fast,

and there was no known treatment.

Dr. Diaz told me he'd heard about an antiviral drug

called Remdesivir that some experts thought

could potentially help.

It would be an experiment, he said,

but the patient was willing.

>> At that point, I contacted the FDA and Gilead,

the manufacturer, to see if they would approve it.

So the FDA gave us an approval to try it on a compassionate use

basis, knowing that it had not been approved yet

and that there were no trials available to base

that decision on.

We infused it the next day.

He was still having very high fevers

and still was requiring oxygen the day

that we gave it to him.

By the next day, his fevers resolved and they stayed gone.

He felt much better.

He felt like he had started beating the virus.

>> O'BRIEN: No one knew if the drug had an impact,

or if the virus was taking its natural course.

Here's the thing, you have one data point here.

>> One person in the world.

>> O'BRIEN: Yeah, in the world.

>> It was an anecdote, and so we were happy that the patient

got better and was ultimately continuing to get better,

able to go home.

So that part was fantastic for the patient.

We knew then that we needed to study this

in a formal clinical trial.

>> O'BRIEN: Although patient one was well enough to be sent home,

for public health officials in Washington state,

there were many more questions to answer.

They needed to find out who patient one might have come

in contact with after returning from China

and send samples from them to the CDC as well.

>> So, we find contacts, someone that you spend

at least ten minutes of time talking face to face with.

We identified 60-plus contacts.

We swab them multiple times to see

was there a transmission of this virus.

And we found absolutely no transfer amongst those contacts

that this first case had.

>> O'BRIEN: Washington's governor, Jay Inslee, remembers

this as a brief, optimistic moment.

I interviewed him remotely from his office at the state capitol.

>> What we were thinking is we were very much on top of it

because we did very extensive contact tracing

with all of the contacts that the person had who

was the first patient and did everything epidemiologically

that you could ask a public health system to do.

>> O'BRIEN: But soon more signs of trouble began to appear

across Lake Washington in the city of Kirkland

at the Life Care skilled nursing and rehab center.

Scott Sedlacek had brought his 86-year-old father there

to recover from a bad fall.

>> So, he hit his head hard enough that he had

some brain trauma and bleeding on the brain

and he broke his right ankle.

And the bed that opened up was at Life Care.

And so, on February 20, we moved my dad to Life Care.

And then we started seeing some of the staff wearing

respiratory gear, wearing face masks, wearing gloves.

It's kind of like, "What's going on?"

>> O'BRIEN: Inside Life Care, residents had been getting sick

with an unknown respiratory infection.

The sickest were brought to the nearby

EvergreenHealth Medical Center.

Dr. Francis Riedo is the medical director

of infection control here.

>> Remember, this was flu season.

And we'd already had a peak of influenza B in December,

and now we were going through the peak of influenza A.

And so the unit was full of individuals

with severe respiratory infections.

In the meantime, in the background,

we're watching these events unfold with increasing alarm,

not only in Wuhan, and now spreading across the globe

and wondering when our turn was coming.

>> O'BRIEN: Until that point, federal guidelines for testing

potential cases were very narrow--

patients had to have been in a hotspot like China

or in contact with someone infected.

Then, the rules changed.

Dr. Riedo wasted no time.

>> We settled on two individuals and we tested them

the following morning.

I had a regular day, saw patients in clinic,

saw patients in the hospital,

was sitting there as I usually do trying to complete my notes

and received a call at 7:40 p.m.

And both of the tests were positive.

>> O'BRIEN: What goes through your mind?

>> My initial honest response was skepticism.

I thought the odds of both tests in two randomly selected

individuals being positive with no history of travel,

no history of exposure to anybody

was fairly astronomical.

This was a huge shift.

Incident command was activated and we made a quick decision

to test nine additional people that night.

Eight of those nine were positive.

>> O'BRIEN: Wow. >> Right.

>> O'BRIEN: Kind of stunning actually, isn't it?

>> It was, and within the first five days, we had 32 positives.

>> O'BRIEN: Many were from Life Care, but crucially,

some had no connection to the nursing home.

>> We then knew that this was a much bigger outbreak

than you could have imagined.

>> O'BRIEN: At least 41 Life Care residents

and two visitors would eventually die

with more than a hundred others linked to the home

testing positive, including Scott Sedlacek's father, Chuck.

>> He has never shown symptoms.

>> O'BRIEN: So, how worried are you that symptoms might appear?

>> Extraordinarily.

Because we don't know, this is new, it's uncharted waters.

>> O'BRIEN: The Sedlaceks' story hit home for me:

my 84-year-old father is in assisted living in Florida.

Hello there.

Can you tilt down a little bit? >> I'm sorry what?

>> O'BRIEN: Tilt down, tilt down, a little more down.

There you go, that's good.

How you feeling?

>> Well, I'm fine, how are you?

>> O'BRIEN: No coronavirus so far,

but he's pretty much in isolation, no visitors allowed.

It's the same at Life Care, but the Sedlaceks have found a way

around that.

>> My sister is here and we'll go up

and will say hi through the window.

We brought a big white board today so we can actually write

notes for him because they're double pane windows

to seal the noise out.

(laughs)

Can you hear us?

(laughs)

>> Okay, we'll let you finish then-- love you.

>> Keep getting better, keep listening to the nursing staff.

They're looking out for you.

He has to get the love from the family to get better.

Without it, he will become not just physically

but mentally ill. >> O'BRIEN: Yeah.

>> It's the worst thing you can do to an older person.

>> O'BRIEN: Yeah, right.

>> Yeah, the worst thing you can do.

>> O'BRIEN: Scott himself also got the virus.

Unlike his dad, he got sick.

>> I was hospitalized through the emergency room

with the full-blown list of symptoms--

extraordinary difficulty breathing, light-headed,

dizziness-- you name the symptom, I had it.

>> O'BRIEN: What was it like being in isolation,

sick with this disease?

Were you scared?

>> Hell yes, I was scared, it's an unknown.

I was hooked up to an IV and they started

an albuterol nebulizer, which they had to give

two full rounds of it.

But after those two full rounds, I was breathing normally

and after six hours, they had all my symptoms under control.

Within 12 hours, they moved me to a full isolation unit,

and ten hours later, they released me with zero symptoms.

>> The number of coronavirus cases at home and abroad

continue to climb, the financial markets rocked,

and more aggressive steps to fight the spread...

>> O'BRIEN: By this time in early March,

COVID-19 cases were multiplying here and around the country.

>> Breaking news-- Washington is in a state of emergency...

>> O'BRIEN: Governor Inslee had put Washington

under a state of emergency...

>> Washington state has declared a state of emergency...

>> O'BRIEN: ...the first governor to do so.

>> The governor declaring a state of emergency...

>> O'BRIEN: But like many here, he was increasingly concerned

that President Trump was continuing to downplay

the threat.

>> It's going to all work out.

Everybody has to be calm.

It's all going to work out.

>> O'BRIEN: Inslee, a Democrat and former

presidential candidate, tweeted that the administration

should stick to science and tell the truth.

It would ignite an escalating war of words.

>> O'BRIEN: During a visit to the CDC, Trump fired back.

>> That governor is a snake.

Okay. Inslee.

Let me just tell you, we have a lot of problems

with the governor and... the governor of Washington,

that's where you have many of your problems.

I said, no matter how nice you are, he's no good.

That's the way I feel.

>> O'BRIEN: At that point, did you get the sense

that you as governor and the state of Washington

was sort of on their own and the federal cavalry was not coming?

>> Yes, but we didn't ever depend on that leadership

coming out of the White House, so it's not something

that we were surprised by.

We always knew that we would have to lead the charge,

given the president's reluctance

to really exercise leadership on this.

And we sort of knew that he had an intent of downplaying

what was an emerging problem.

That, you know, could only be explained by someone

who had their eye on the Dow Jones

rather than an eye on the epidemiological curve.

>> O'BRIEN: Seattle's mayor, Jenny Durkan,

shared those sentiments.

>> We are not going to be distracted by any rhetoric

that the president or anyone else uses.

We've got to act.

We've got to act to protect the people

and I think those actions are what matters.

Facts and science, got to rely on them.

That's the only thing that's going to get us through this,

and, fortunately, we've got a really vibrant

health and science community here in the state of Washington

and Seattle and we listen to them.

>> O'BRIEN: She and other political leaders here

had some hard decisions to make after hearing grim predictions.

>> We had researchers here telling us

that within six weeks, we would have over 70,000 positive cases

and hundreds of deaths if we didn't act.

And so we had a choice to make.

The choice was know that you're going to have enormous pain

in shutting down parts of your economy,

or have those same impacts later and overrun your health system.

As we move forward, it will be increasingly necessary

and important that we are unified in our efforts.

>> O'BRIEN: Seattle was starting on a trajectory

that the rest of the country would soon follow.

>> There is no magic silver bullet at the moment medically,

but there is a very successful effort that we can take to slow

the spread of this disease and that's to reduce

the social interactions that are not necessary in our lives.

>> O'BRIEN: You, the county executive, and the governor,

were early out of the box on taking these actions,

pretty proactive.

Did you feel at the time a little nervous about all that?

>> I think it was... all of us felt a great deal of...

sense of obligation and concern because we were the first to go.

>> O'BRIEN: Mayor Durkan actually had a pandemic response

plan on the shelf, which she and her cabinet had updated

in early February.

>> We pulled out the pandemic planning and knew that one

of the first things we had to do to separate people from another

was have them telecommute, those that could.

So our largest employers acted immediately.

>> O'BRIEN: That included Seattle icon Microsoft,

with a workforce of more than 50,000,

one of the largest private sector employers in the region.

>> So, we had a call on Sunday afternoon, March 1.

We had the business leaders...

>> O'BRIEN: Microsoft president Brad Smith spoke to me

from his home.

>> We went from Monday telling people they should work

from home if they were more comfortable,

Tuesday telling people, you know,

feel free to work from home,

it might be better, to Wednesday work from home

unless it's essential you come to work.

>> O'BRIEN: The decision you made was a big one.

Did you hesitate?

>> No, it was interesting.

Once we decided at Microsoft that we would be decisive

and base our decisions on public health advice,

then we knew what to do.

>> It's the hardest decision I've ever had to make

because all of our instincts are to grow the whole economy

for your city, to make a stronger community

for everyone.

And what we're saying is we've got to stop that kind

of community and we have to stop doing work.

>> O'BRIEN: Almost overnight, the vibrant city shut down--

businesses closed, storefronts boarded up, empty restaurants,

the famous Pike Place Market nearly deserted.

♪ ♪

At a local soccer field usually filled with kids and families,

preparations for a surge of COVID patients.

>> We knew already that one of the biggest challenges would be

having the hospital system overwhelmed by a wave of cases.

We were trying to figure out how we could get testing,

we were trying to figure out whether we would receive

material help in the form of field hospitals or

large facilities, encampments, for people who were unhoused.

And there wasn't a lot of concrete offers of help coming

from the federal government.

So we were left with the reality that we're going to have to take

on a lot of this ourselves.

>> More than 140 people lost their lives yesterday,

bringing the death toll to over 590 in this country.

>> He's not doing everything he can do.

>> O'BRIEN: As coronavirus was sweeping the country

throughout March...

>> And I can't tell you how frustrating it is...

>> O'BRIEN: ...so was the frustration among governors

scrambling for resources they needed to respond.

>> We're bidding against one another,

it's really not a great system.

>> All of the states are taking action to try to find

these things on our own.

>> O'BRIEN: The president was now feuding

with multiple governors...

>> 400 ventilators?

I need 30,000 ventilators.

>> O'BRIEN: And like he'd done with the virus

in the beginning...

>> I don't believe you need 40,000 or 30,000 ventilators.

>> O'BRIEN: ...he disputed there was scarcity

of crucial medical equipment, like masks and ventilators.

>> Many of the states are stocked up.

Some of them don't admit it, but they have,

we have sent so many things to them, including ventilators.

>> O'BRIEN: Amid the feuding, doctors and nurses

have struggled to get the personal protective equipment,

PPE, they need.

>> Good morning, and welcome, everyone.

>> O'BRIEN: In Seattle, that's been the top issue

for Dr. Amy Compton-Phillips, the chief clinical officer

of the Providence Hospital Network.

>> Last year, across all of Providence,

we used 250,000 masks.

In the first three months of this at Everett,

they've used 250,000 masks.

We cannot have our own caregivers going down from COVID

while they're trying to take care of the community, because,

you know, the supply chain is just not keeping up

with our needs.

>> Amy, I have to say if I can't assure them that they are safe

then I don't think the rest of this is worth anything.

>> O'BRIEN: Inside Providence's emergency department,

tensions around PPE have been high.

Dr. Ryan Keay is the department's medical director.

>> It's exhausting to constantly think about the sequence

that you put things on and take things off and where you're

sanitizing during that sequence.

Every nurse, every tech, every physician I've talked to

has said, "I've been working for years

and I've never been so exhausted."

And it leaves people just on edge all the time.

>> We have enough N-95 masks that people should not have

to be able... should not have to bring in their own masks

at this point in time.

>> Is the recommendation still one N-95 per five patients?

Or are we using it the whole shift now?

>> We're using them with a face shield

for as long as you need to use them.

You just store them in a paper bag

until they become moist or soiled.

>> Okay, so forever? >> Well, not forever.

(chuckles)

>> O'BRIEN: Reusing masks and storing them in paper bags

wasn't the only DIY workaround I saw.

I caught up with Dr. Compton-Phillips

at the otherwise vacant Providence headquarters.

Inside a large meeting room, she and a handful of her team

were spread out a safe distance, cranking out face shields.

>> Our caregivers would normally have protective goggles

on and a surgical mask underneath this

and then this goes in front and basically protects

against droplets.

>> O'BRIEN: They had raided a half dozen craft stores

to scrounge up supplies.

>> We're at 288 now, we're going to get to 1,000 by tomorrow.

>> We're retooling our resources going into war against COVID.

>> I feel like Rosie the riveter.

>> 499, 500!

(cheering)

>> O'BRIEN: On the one hand, this is really...

it's kind of heartwarming, but it's also really sad.

>> Desperation.

>> O'BRIEN: Yeah, I can't decide which way to go in this.

What are your thoughts?

>> I would rather offer

our caregivers something than nothing

and at the moment, you know, if the choice is not having PPE

or having homemade PPE,

we're going to offer them homemade PPE.

>> O'BRIEN: Right, right. >> So...

>> O'BRIEN: That's what motivated Jeff Kaas--

his small family business builds and sews furniture for aviation

and retail customers.

He decided to pitch in and start making masks.

There's not a shortage of the raw materials at least,

that would be... or not yet?

>> There will be.

There will be, yeah.

So, I think we've enough to make two million masks.

>> O'BRIEN: But how long will that take you to do?

>> Well, it depends on how fast we want to go.

>> O'BRIEN: How fast do you want to go?

>> We want to solve the problem.

My assumption is that we will be ramping up for several weeks

and then drop off a cliff.

Nobody will need me in the healthcare business anymore

and then survival becomes a question for my company.

That's probably the next scary thing, which is less scary

than what our healthcare friends are going through right now.

That's the bigger issue for me.

>> We knew in January what we would need-- we knew.

We would need gloves and masks and respirators,

and ventilators.

Two-and-a-half months later,

we're dependent on sewing circles

to supply our frontline heroes with what they need.

It may be a nice American story; I find it pathetic.

>> O'BRIEN: Washington state officials,

like others in the country,

say this was an avoidable crisis.

>> Because we've lacked the federal leadership we needed,

it's been mayor versus mayor, city versus city,

state versus state, trying to get access

to the limited resources to protect our communities,

whether it's ventilators or masks

for our health care workers,

all of that has become this Hunger Games process

where everyone's trying to figure out a way

to outbid each other.

Washington state had a line on masks that were coming

to the country and at the port in California.

Suddenly, multiple states were bidding on them.

That shouldn't be the way that it happens.

>> We're searching the world for every potential warehouse

that have any of this personal protective equipment.

That has been a constant struggle

and we are bidding against each other,

and I'm sure that the suppliers are having a field day

bidding the price up while states are bidding against

one another.

It would be much more efficient

economically and otherwise if the federal government

was playing a more vigorous role in that regard.

>> O'BRIEN: The tensions between states

and the federal government have been escalating.

>> Another five million Americans file for unemployment

benefits last week.

>> O'BRIEN: Not just over the response to the outbreak...

>> The market down ten percent in relatively short order.

There's a lot of bad news still to come.

>> O'BRIEN: But now over what it will take to get the country

up and running again.

>> This is a massive meltdown on a national scale.

>> More jobs lost in a matter of two weeks

than in the entire 18 months of the Great Recession.

>> Our team of experts now agrees that we can begin

the next front in our war,

which we are calling "opening up America again."

>> O'BRIEN: The president has been pushing governors

to re-open soon, even as soon as May 1.

>> Or country has to get open.

And it will get open.

And it'll get open safely.

And hopefully quickly.

>> O'BRIEN: But some of them have been pushing back.

>> We cannot be guided by emotion.

We need to be guided by where the facts on the ground,

science and public health take us.

>> What's best for the people of Illinois,

their safety and health,

and listening to the scientists and the doctors.

>> Because if you do it wrong, it can backfire.

>> O'BRIEN: And many like Inslee say it will come down

to one thing: mass testing.

>> This is the number one challenge for the United States

right now, is we need a huge ramp up of our testing capacity,

even greater than was needed early in the outbreak.

>> O'BRIEN: To increase testing,

Inslee says Trump needs to order U.S. industry to help

using the Defense Production Act,

which the president has only just begun to do.

>> We need the president to help ignite a national mobilization

of the manufacturing base of the United States,

that is absolutely imperative so that we can restart our economy.

>> O'BRIEN: But President Trump has also thrown

this back on the states.

>> The governors are responsible,

they have to take charge.

They have to do a great job.

>> O'BRIEN: There are limits to what a state can do though,

as I saw at Washington's health department laboratory.

They can only complete about 300 tests a day,

and that requires a mad scramble.

The raw materials for test kits are hard to come by.

>> We have a lot of testing lab capability but we don't have

the equipment to swab everybody's nose.

I think the current status in Washington state is limited

by the supplies to actually run the test.

>> O'BRIEN: They also don't have enough PPE

for the health care workers administering the tests.

>> If we don't have enough gowns, gloves, masks,

to treat patients, how are we going to prioritize a gown,

a glove, and a mask to swab somebody?

Because that is the requirement.

>> O'BRIEN: The state health department isn't alone

in struggling to meet the demand.

>> We can't have that level of cross-contamination...

>> O'BRIEN: After getting approval for his test

from the FDA, Alex Greninger has dramatically ramped up

testing at the University of Washington

School of Medicine virology lab.

>> For inpatients, health care workers,

institutionalized populations, but mostly inpatients,

people who need supportive care,

we've got to get that fast turnaround time

that reduces the use of protective...

>> O'BRIEN: Because they're in the hospital.

>> Yes. >> O'BRIEN: On this day,

they completed about 3,000 tests.

>> To get 3,000, 4,000, 5,000 specimens a day, you know,

it takes a lot of focus.

>> O'BRIEN: Just like in the state lab,

Greninger says it is difficult to get

the raw materials he needs.

One of the hardest things to find:

the single use plastic tips that contain the chemicals

and the specimens.

>> Some automated pipettors use four tips a test,

and others use three and, so, just getting the tips

into your facility so we can run that many tests...

This is what we're looking for, basically.

We tweeted at Roche and the world to get these things in,

like you would tweet like Delta lost your bags

or something like that, right?

I mean, we have two people whose entire job right now

is to manage our FedEx shipments.

Basically, we blow up our hallway

and it goes down to a single file.

And then it takes over the next six to eight hours,

we're able to actually move those boxes

into our local warehouses we bought other space here

in the building.

It's the supply chain has been really

the number one thing we do.

>> O'BRIEN: Despite the problems,

they are still managing to return results

the same day in many cases.

This is crucial to keep up with a fast-moving virus

and help healthcare workers on the frontlines

reduce their need for personal protective equipment.

>> When you send a test for COVID-19,

you have to treat the person as if they are infected

until we give you a result that says they aren't.

And during that time, you have to use

all the personal protective equipment.

So, the speed at which we get those test results back

allows us to conserve our personal protective equipment.

It really touches so many things.

>> O'BRIEN: So what do you envision the coming months?

>> I think personally right now, this will be with us

for some time, a long time.

There's no magic bullet just yet.

>> O'BRIEN: This testing marathon could go on

for at least a year--

that's how long experts say it could take to develop vaccines.

In the meantime, researchers are racing to finish clinical trials

of several therapeutic drugs including that promising

antiviral Remdesivir,

the one that seemed to work so well on patient one.

>> On trial? >> Yes, he's on trial.

He started on the 15th.

>> O'BRIEN: Dr. Diaz is now leading one of the trials

with patients at Providence Hospital.

>> These are still anecdotes because we haven't seen

the full study being completed, but we're certainly

very optimistic.

We want to get these questions answered as fast as possible.

>> O'BRIEN: And there may be another way to help people

fight off the coronavirus--

using the blood of COVID survivors themselves.

Hey Elizabeth, looks like you're on the mend.

>> Yeah, I've been recovered now for...

>> O'BRIEN: People like Elizabeth Schneider.

She was getting ready to become the first person in Seattle

to donate her plasma to researchers

trying to see what natural resistance she might have

developed and whether she can share it.

>> Scientists don't know how long we have that immunity

for this particular virus.

But signs so far look like, you know, we will have immunity.

>> O'BRIEN: Survivors' blood as therapy-- it's not a new idea.

Doctors used it in 1918 in the midst

of the Spanish Flu pandemic.

>> I do feel a little more sense of security going out

and doing my day-to-day task because I have already had this.

>> O'BRIEN: She was among the first documented COVID-19 cases

in the U.S.

A microbiologist who works for a biotech company,

she came down with flu symptoms on February 25,

three days after attending a party.

On Facebook she learned many of her friends who were there

were also sick, 15 in all.

She told me she and seven others ultimately tested positive

for COVID-19, which brought her to this moment on this morning

to the blood bank in downtown Seattle.

>> Hi, I am here for plasma donation.

>> O'BRIEN: The coronavirus antibodies in her plasma may be

a way for others to fend off the virus.

It's called convalescent plasma therapy.

>> Our goal is to get to 840 mL today.

>> I'm hoping that some of my plasma ends up

in another patient who is suffering from COVID-19

and this could potentially save their life.

♪ ♪

>> O'BRIEN: There are now signs that COVID cases

may be plateauing in some places, like here.

>> We have had some success flattening the curve,

that has taken place...

>> O'BRIEN: ...but also spreading to new areas

of the country.

Washington state recently returned

more than 400 ventilators it received

from the national stockpile so they could be used

where they're needed more.

>> Governor Inslee today announced that 400 ventilators

would be leaving the state of Washington.

>> O'BRIEN: But in recent days...

>> Trump's back and forth...

>> O'BRIEN: President Trump's feud with governors

has become an all-out war.

>> In a series of tweets he exclaimed "liberate Minnesota,

Michigan, and Virginia."

>> O'BRIEN: Encouraging protests

against social distancing restrictions...

>> Seeing these protests at state capitols...

>> O'BRIEN: ...even in Washington state.

>> ...protesters gather today in Olympia

demanding that the governor act now.

>> Sunday's protests in Olympia is the latest

in a wave of demonstrations.

>> These are people expressing their views,

I see where they are,

and I see the way they're working,

they seem to be very responsible people to me.

>> The governor of Washington state

says the president may be inciting violence.

>> O'BRIEN: In his own tweets, Governor Inslee said Trump

was "unhinged," "off the rails,"

and "fomenting domestic rebellion."

When I talked to Governor Inslee, he told me

it's no time to be rushing to re-open.

>> All leaders have the biggest challenge to make sure people

understand that as the sun comes up and the daffodils come out,

we've got to double our efforts.

Because if you relax too soon the curve just can rebound

and start right back up again.

The most dangerous element in my state today

is the virus of complacency

because we have to be just as diligent

for the next several weeks as we were the last several weeks.

>> O'BRIEN: I wanted to know what pandemic modeler

Chris Murray thought of all of this.

He runs the Institute for Health Metrics and Evaluation

at the University of Washington.

>> If you ask Chris Murray...

>> O'BRIEN: Its models are often cited by President Trump's

coronavirus task force.

So, really, when you think about it, Chris,

there's no scenario going forward that you can envision

that doesn't demand mass testing,

if not testing for everyone?

>> The issue will be, you know, the capacity to test.

Right, how many tests are practically feasible come June,

state by state?

And it may not be anywhere near enough to be able to do

full-scale mass testing.

So then if you take measures off May 1,

and there's a pretty quick rebound, so by mid-July,

we'd be right back to where we are now.

>> O'BRIEN: Really?

Exactly the rate of death

and hospitalization that we're dealing with?

>> Pretty much, yeah.

So, we're not going to want to take off measures May 1,

let's put it that way.

>> And the second wave won't be like the first wave.

>> O'BRIEN: That the president isn't heeding

scientific warnings, once again,

is causing alarm among those who've been dealing

with the outbreak since the beginning.

>> I am pessimistic about the next few months.

I think it's going to be really hard and we need to ramp up.

Ramp up, hurry, we need a leader at the top who's willing

to go well beyond where he is right now in saying,

"Here's what we need to do in terms of testing"

and giving people the information they need

to get the economy going.

Long term, I'm optimistic,

but it's a long ways between here and there.

♪ ♪

>> O'BRIEN: I went back one last time to where the outbreak

took hold here, Evergreen Hospital,

where those patients from the nursing home

were treated in February.

It is an apt window into where Seattle and the country

are right now.

I met a woman who was recovering from COVID-19, Rosanne Eskenazi.

>> I want to give you a kiss and stuff but I can't.

>> Nope.

>> O'BRIEN: At 63, with an immune system disease,

her chances of living to see her husband Maury again

were not good.

>> When they put her on the ventilator,

I never thought I'd see her again.

And I wasn't reading about people that were surviving this

and coming out of this, so I was... you know, it was over.

>> I don't even know how many weeks it was,

but I don't remember a lot.

>> When we brought her, when the day came that...

she looked horrible.

Her temperature was horrible.

>> It was like 105?

>> O'BRIEN: Oh, my God, really?

>> It was 105 and she was like coughing

and we had the ambulance come.

They sent two ambulances.

This was the beginning of the COVID, you know?

>> O'BRIEN: You didn't really fully appreciate how bad it was,

did you, because you were kind of out of it?

>> Yeah, I was out of it.

I saw my parents, my dead parents,

when I was here.

I don't know whether...

I was saying I don't know whether

it was a dream or a hallucination.

My parents were here and they were sitting across from me

and they all said, you know, "You're going to be okay.

Everything's going to be okay.

You're going to be okay and if something happens,

your children will be fine.

Everything's going to be great.

You have all this family and stuff, so don't worry."

So... and it really helped me not worry.

Oh, there, it says that way.

>> Yeah, sorry.

>> O'BRIEN: Rosanne was on her way home...

>> Bye!

>> O'BRIEN: But there were others still coming in,

needing urgent attention.

(people chattering)

I met critical care and pulmonary physician

Michael Bundesmann, who was focused on

one particular patient.

>> This is a person who has multi-organ failure

and ultimately required mechanical ventilation

and now needs dialysis, kidney replacement therapy,

they're in shock.

>> O'BRIEN: Three days earlier, he'd been awake, alert,

joking with his doctors.

>> Patients come in and they look okay on one day,

and some of them are kind of okay to be discharged

from the emergency room, and come back a few days later

much more sick.

That degree of unpredictability

I think is very unsettling for everybody.

>> O'BRIEN: Dr. Bundesmann says the pace has slackened some

since the darkest days.

>> We could feel the curve flatten a few days ago,

probably even last week.

It has allowed us to be able to see patients and

to take care of them at a pace that's a little more used to

what our ICU can handle, volume-wise.

And it's certainly made a big difference.

>> We are now I think at a state where I think we can

keep this pace that we have going,

and that's a good thing because how many people are still

susceptible to this infection?

It's going to be a long haul, I think.

Some of the things that worry us are, you know, what happens when

there's a next large outbreak in a skilled nursing facility,

the next time a susceptible population gets hit

within a tight community.

I don't know when that's going to happen,

I think that until there is some degree of herd immunity,

there are going to be people out there who have to be planning

this out very carefully and cautiously,

when people can start returning to work,

who can start returning to work, and what time frame.

Because as that happens,

the cases are going to start to pick up again,

and we have to be there and be able to support them

as best as possible without stretching the capacity

of our health care system.

Tough decisions for those people who have to make them.

>> O'BRIEN: There have now been more than three quarters

of a million confirmed COVID cases in the U.S.,

more than 40,000 deaths.

What began as a public health crisis here with patient one

has become a national crisis over response,

over science and politics,

and decisions with devastating consequences.

(siren wailing)

It's still a tale of two Washingtons,

the story that I found when I arrived.

But it's also a tale of Washington and the states,

and how the country will emerge from the crisis.

>> Go to pbs.org/frontline for our latest reporting

on the pandemic, including our podcast,

"The Frontline Dispatch."

>> So Miles, what does the governor think now?

>> Well he's concerned.

He says this is the most perilous moment

because people are inside and they want to get outside.

>> And don't miss the coverage by our colleagues

at the "PBS NewsHour."

Connect to the Frontline community

on Facebook and Twitter,

and watch any time on the PBS Video App

or pbs.org/frontline.

♪ ♪

>> For more on this and other "Frontline" programs,

visit our website at pbs.org/frontline.

♪ ♪

"Frontline's" "Coronavirus Pandemic" is available

on Amazon Prime Video.

♪ ♪

♪ ♪

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