Watch Rachel Maddow Highlights: April 2 | MSNBC

There's an alarming report today from the entity that runs New York City hospitals that if you go into cardiac arrest somewhere in New York City and paramedics show up and can't revive you at the scene, there's now a change in protocol where they won't take him to a hospital to try to resuscitate him there because the hospitals are so overwhelmed that it appears to have that hospital ship in New York Harbor with no coronavirus patients on board and, as far as we know, hundreds of empty beds and staff there to deal with it, they could be taking the few trauma patients, the few heart attack patients, the other people who now can't get into New York City hospitals, well, in theory, in theory, they can.

You know, this is all new. protocols that aren't really established and should be established theoretically, the US Navy ship comfort could accept an uncovered trauma case, so I don't know how that protocol works on that, but look, we're all doing the same. The best we can do is try to put together a system that can handle more than 150 to 200 percent of what the system is designed to do and the federal facilities are an advantage for us. volunteers, can we direct them to the right hospitals and the right places and then the equipment and these ventilators that I've never heard of now become the most precious equipment and the difference between life and death is that you literally don't can they acquire? and we are seeing that right now we have enough fans for six days at our current consumption rate, just how many we use, how many additional fans we use each day, we get past that point if we are not already at the top we will be in a bad place, we have a backup plan and extra fans basically macgyvering the fans but this is really scary.

I have handled many emergencies, many disasters as governor and in the federal government but this by far nothing comes close to this in terms of the need for an intelligent and rigorous force of government to respond quickly and intelligently it all comes down to whether your system of care medical can handle it there is no concept here there is no The philosophy is: can you handle the amount of people coming through the door? That's it, and if you can't, people die, that's what it is and the simplicity is what makes it so tragic, frankly, because we don't have someone's team.

We are going to die because we don't have staff someone is going to die, how did we get to this place in this country? we have to buy all our supplies from China. I can't get protective equipment because China is manufacturing it. China is manufacturing. ventilators we couldn't figure out how to make protective equipment fast enough we couldn't figure out how to make ventilators we couldn't figure out this continuous rollout that makes all the sense in the world and is frankly simpler for each locality. I said we have 20,000 volunteers from all over the country. I said I will return the favor when we pass our apex.

I will pack up all the ventilators, take our entire health team, and go to any community across the country. You will personally drive and provide assistance and thank them for what they did to New York, that's what we do. You know there's something called mutual aid in an emergency, in a flood, or in a utility company where the utility company is flexible, if you remember. See if you remember, you'll see big utility trucks on the road every time there's a national emergency. Trucks from Arizona heading to New York City. New York City trucks heading to Florida.

This is how we react to those emergencies. We help each other. You adapt to the need for what we could be doing here and the consequences are going to be devastating and what keeps me awake at night is not just the numbers but a deep sense that it didn't have to be this way, it didn't have to be, you know, governor, you talk. about the anxiety and the fear and the routine of the logistical work that you're doing, I feel like there's a basic fear when I think about these being seriously ill Americans even in the tents. let alone the hundreds of thousands who need to be hospitalized, who need to be in hospitals, who need intensive care to stay alive, who can't go anywhere to receive that care.

I mean, I know we talked about these numbers and these models. And I know a lot of states right now are looking at those curves and those projections and seeing how many more beds they're going to need, how many more ICU beds they're going to need, but I don't know how. prepare people for what it might mean when hospitals are full and what that's going to do in terms of us as a culture in a society that sees that kind of level of human suffering surpassed: God forbid we get there, God forbid let this country get to a point where you see people literally living in Gurney's in the hallways.

I just died from this state. I'm not. I am not going to accept that we are doing everything possible to mobilize, where we are trying everything that will come. Until the beds, it will be EGH staff and it will be ventilators, you know, most of almost all of these people now at this point are almost all ICU cases, they all need ventilators and the ventilator becomes a matter of life and death and We have been talking about these ventilators for a long period of time and it is impossible to get them, so we have come up with an elaborate plan on how to move the ventilators and divide them and use them, as well as the anesthesia and BiPAP machines. machines and we stopped all elective surgery to free up ventilators, but first we have to prevent it, second, I think we have to be smarter, the only silver lining here is that not all places in this country are affected at the same time, right, it's going to There will be a different curve for the disease in different areas depending on when it started and those curves will have a lag, the problem for each area will be the apex of the curve where it will simply overwhelm the healthcare system, but New York will have one apex Detroit will have another New Orleans will have another Texas will have another Los Angeles will have another.

Why don't we design a national strategy that moves with that mobile vertex if you will? I need approximately 30,000 ventilators that I can't get, but I only need 30,000 ventilators for two or three weeks at the top of my curve. I need backup public health professionals, but I only need them for two or three weeks at the peak of my curve. Why don't we have a Nash? We use our national unity and our commonalities and say, let's be smart, let's go help this place when this, when that city gets over its curve, then we'll go to the next one and we'll go to the next one and we'll go to the next one.

I think Americans have a lot. More common ground and volunteering than we are using. I asked for national public health people to come to New York. We had more than 20,000 volunteers in three days. 20,000. I have 60,000 volunteers in the state. There is more American goodwill and spirit than we are using. and I think there's a smarter deployment that you've been advocating for federal deployment of resources for the mutual support type of deployment of resources to the places that need them most, understanding that not all of them are going to peak at the same time. time. Has that resonated with the federal government at all?

I know you have a mixed relationship with the Trump administration right now and they've been able to talk to you about some things and you've been critical of them and others, but does that make a point that you've been getting it to them? absolutely. I don't see any other way for other states and other cities to approach what New York is right now. I don't see any other way that the country is going to deal with those undulating vortices that you are describing well, first you are right in saying that I have a mixed relationship with the president, may he be very kind, there probably has not been any governor in the country who has been more critical and There is probably no governor in the country who has been more aggressive with his tweets, but in this one the president and I have said: look, this is not about politics, if you helped the state of New York, I will tell you to be kind, thank you and to be cooperative. and if it doesn't help the state of New York, then I will say you are right, the states can organize this continuous deployment on their own, it would have to be organized at the federal level, but I don't see how it can be done any other way. otherwise you're telling every state, every locality, that you have to be prepared on your own to handle this, the federal government will give you some support, but it's up to you, it won't, it won't work that way or it might works better the other way around, let's put it that way Rachel, which lets the federal government say look, this is like the hurricane that's moving slowly across the country and we know the path it's going to take, let's go to New York, tackle it, do what We have to do, we all go to New York and then we all go to Detroit and then we all go to the next place.

I think that's the only way to do it where now we're 50 states all trying to buy the same equipment from China. and then the federal government comes in with FEMA, which is trying to buy the same equipment. This is not the way to do it. I mean, obviously, if you could design a system, no one would design a system where you tell states that they're fine. you are only going to buy equipment, everyone buys from the same manufacturers in China, you know the emergency management rule. Oh, rule 101 is to leave it to local governments. Local government knows best that it's emergency management rule 101.

I was in the Clinton administration as secretary of HUD as you know, I worked in emergency management for eight years. Rule one is to leave it up to the localities. Rule two is that if localities can't handle it, then the federal government steps in. Remember what happened to President Bush with Hurricane Katrina. He blamed the mayor. Because? because that was rule one, the mayor didn't know how to handle it and it's the mayor's fault, yes, but there was rule 2, which said if it's beyond the capacity of the local government, then the federal government should step in, no state is equipped to handle it.

This situation, the management of state emergencies causes hurricanes, floods of moderate size, if they are really large, the federal government comes in, that's what FEMA is about, the states don't do public health emergencies, there is no capacity in my state health system that works with fifty thousand beds to create and maintain fifty thousand additional beds in case there is a once in 20 years pandemic, you know it doesn't work that way