The California health system is coping.

We have, ah, sufficient bed capacity sufficient.

I see you and ventilator capacity.

And for now we are holding the fort.

What kind of difficulties are 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 health care 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.

I see you 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, ah, the situation to get much worse before it gets better, and that 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 New York, which I think was you were formally at the Department of Health there.

Why do you think New York State is so badly hit?

New York state is badly hit because it's such an international city and so densely packed A CZ.

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 there 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, don't from backs away from quarantining the entire state of New York.

Was he right to do that?

Do you think 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.

What?

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 Ah, it's two weeks till we get widespread testing available.

I know that here a TTE Stanford.

We have over 1500 tests we can do per day.

My hope is that with Abbotts Rabbit test rapid testing kit and other tests available, we will start to get the 1,000,000 or so tests today 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, ah, 100,000 to 200,000 Americans dead, potentially by the end of this.

Do you concur with that figure, or do you think that is it?

Even Thio conservative Dr Fauci is one of the most trusted names in here.

When he said 200,000 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% more cases in the community.

We must act now.

That's why I've started cove it back now dot org 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 than the scale of deaths might be?

In the end, we know that from the best estimates across the world, approximately 1% of cases eyes leading to mortality that 1%.

Today we have approximately 143,000 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 cove it 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 locked down in place.

We will see ah, widespread spread of the disease.

We don't from four weeks tried Thio downplay the severity of Corona virus.

He's had to reluctantly backtrack from his original aim of opening up America by Easter, has his stance in your view Will it have contributed to an increased death, right?

Yes.

And 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 lively hoods.

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 toe work and people are gonna be physically inactive during locked down, 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 controllable.

But it takes a much more serious, concerted public health.

That effort that 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.

Does he Does he understand what's going on?

Do you think the scale of it now?

He's surrounded by some very good advisers, 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 s o 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.

And just finally, obviously, your health care system there is very different from the British health care system.

Is it the case that the poorest in America will end up being hit hardest by Corona?

Virus was they don't have access to the same kind of health care.

Yes, The N hs has been a wonderful example of what we should learn from and in the US we do not have a health care system.

We have multiple small areas, each approaching healthcare differently.

The homeless on 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.

Nah, Rochelle, thank you very much for joining us.