What’s Happening on Hospital Frontlines

Week on iTunes, SoundCloud, or Bloomberg dot com. You can also listen to our radio show weekdays at two pm Eastern only on Bloomberg Radio. Back with us, I want to get right to him is Dr Ian LUs Bader, clinical Associate Professor of Medicine at n y U Landgoing Medical Center. He is on the phone from there where he's been working at one of the I c U units at the hospital. UM. Dr LUs Bader, and nice to have you here with us. I hope you're staying

safe and sound. Tell us a little bit about where you are right now and some of the work that has been facing you in the last twenty four hours. So thank you again for having me, and I hope you guys are are all stay safe as well. UM. I was surrounding earlier at the hospital and some of the I c U s with the with the medical teams, and you know, I think we have some good news and less good news. The good news is that the

case volume is dropping, their more discharges. I think the overall mood of the staff is more positive still obviously in the midst of crisis and a number of patients on ventilators and with a high mortality once you are intubated. UM. But I think the spirit is very good, and I think there's a real commitment of the doctors and nurses and the scientists and some of the researchers to really figure out what's going on and try and come up

with some solutions. UM. I think some of the less good news are limitations who are a little limited in the office in testing to try and diagnose someone who you know, for example, clinically has COVID nineteen h point of care testing is very limited. And we also know that about of those patients are false negatives. In other words, they hadn't and you may have to test them once twice. And we've even had a patient who needed a third nasal swab in order to make the diagnosis when it

was obvious that's that's what they had. And the reason you need to be sure is to enroll patients and studies and that as you know today in the news exciting about GILLIAD. But I think some of that excitement is a little premature. You know, all of these UH studies are really unlimited number of patients. UM. Most of them are not placevo control trials or randomized placebo control trials where you can really say is this the right

treatment to use? Their encouraging results or they may drop their hospitals stay by a day, UH, they may drop their fevers earlier. So people are getting excited, but the reality is we don't have a consensus as to the best way to treat patients with coronavirus COVID nineteen. We can't determine which patients are going to do well in advance.

So thank thankfully most of them do well and have the patients who deteriorate and then who need to come into the hospital, they're on randomized studies now because it's hard to know, and those studies can include the hydroxy chloroquine with without a zettermycin, something called i le sex inhibitors which decrease inflammation. Ran dezevie, which is an anti

viral similar to the HIV drugs. It's an RNA nucleoside analog and that Gilliad is working on and that had some excitement, but again, no controlled studies and convalescent plasma where you capture the antibodies and plasma of patients who have documented to recover, infuse that into sick patients. And there have been some studies out of China on that, and there are a few places in the United States

that are also working on that. That also seems encouraging, but at this point we don't really have a huge consensus as to this is the best way to treat someone. Well. I want to go back to to something you said there at the top of the conversation in which is around you know, sort of the mood of the healthcare workers, you know, in New York City where where you are. I mean, this is the undisputed epicenter at this point.

So what your painting is is it does give me and I think a lot of our listeners a little bit of hope. Talk to us about how they are feeling about PPE, how are they feeling about sort of having the the materials both protective and otherwise that they need to deal with. Still a significant amount of patients coming in. Oh for sure, no, no question, this is not going away soon, and we certainly don't know if there will be a second wave or even a resurgence

in the full um. So typically in the old days, when you see a patient with say tuberculosis or UH transmissible disease, all of your PPE was disposable, in other words, from your mask, to your gloves, to your gowns. Now, uh, some of that is rash and gowns get disposed. Masks, Uh. The N nine masks have to be fit tested to make sure there are no leaks. A leak would not serve you well. And patients generally, or rather doctors are usually given one per day, not one per patient, so

you do have to be careful with it. You do have to Usually people put a mask over the mask of disposable surgical mask, where we have more of those. So there is PPE, but it's not it's being conserved. Let's put it that way. You know, I want to go back to what you said, I mean, does the majority of our population need to be tested? In order for us to really get a handle on this virus and and to ultimately understand what works and what doesn't.

Great question, and the answer is absolutely yes, Uh, we really and healthcare workers. So it's going to be impossible in the New York area to send everyone to their local lab ten million people, uh and get antibody. So although ideally that should be done, but that would really overwhelm the system. Um. But certainly healthcare workers. There are doctors who would love to know whether or not they

have antibodies. Although I must say we are not adent sure having antibodies will protect you, because there are some mutations and there are have been some studies where people clear the virus theoretically cured and then at a later point are tested and have virus in there you know, naso pharynx. So that's a little ambiguous. But there are many physicians who work up close E n T doctors, dentists, um, gas ronturologists, you know, when the list goes on and on,

who who think they've been sick. Uh, maybe they had a mild virus, maybe they had COVID either from a patient or something else. And if they had antibodies, would feel much more comfortable going back to work. All right, stick with us if you can, Doctor less Bader, We're going to continue this conversation in just a minute. Dr Ian Lesbater, he is on the front lines making his rounds at the I see you this weekend at the n y U Lango Medical Center. We're going to continue

that conversation in just a minute. You're listening to Bloomberg Business Week, Jason Kelly, Carol Masser. You're on Bloomberg. Dr Ian les Baider is still with us, Clinical Associate Professor of Medicine at n y U Landgown Medical Center. He is covering the I See you at the hospital as we speak. He's there and he's on the phone. Um Ian,

thanks so much for sticking around with us. UM talk to us, because I think what we're hearing increasingly from governors from everyone is about how do we reopen in the criteria UM that has to be met to be able to UM reopen cities and states. How do you see it? What what does the other side look like to you? So you're exactly right that testing is really

key in this situation and we don't really have that. Uh, optimally you'd want to bring people back, such as healthcare workers who have that uh I g G positive showing antibodies to COVID. They think they had a mild infection or more severe infection, and presumably they are now safe. The problem is testing a large number of people and how accurate is it. As we've said before, thirty of nasal swabs or false negatives. We have patients who have COVID clinically and it takes two or three swabs. So

this is really unstarted territory. We've never really had a pandemic like this in the United States in recent memory.

We've never locked down states and returned people. So we really don't know the exact safest way to do this, and there's always some risk um But at the end of the day, I think people do need to return for a variety of reasons UH, financial and mental health, and my sense would be the most vulnerable people and we knew we know that population diabetes, hypertension, underlying disease, obesity, UH. There are a number of conditions that seem to make

the outcome is worse. Although we do still see young people who get into trouble. Those should remain on isolation until they can be tested. The reality is a vaccine is probably a year away. You cannot keep ten million people in the tri state area or in in the in the Greater New York area at home for a year until a vaccine comes out. So there has to be some way of developing a return before you can

get hurt immunity. And that's ultimately what we want is enough people either to have the disease in a mold form or vaccinated so everyone can safely returned. But as fought she says, there are people will have to wear masks and do some social distancing until that is achieved. Well, so, Ian, let's talk about that, you know a little bit further under the auspices of you're there in New York City. We work in New York City. We know the physical

plant that is Manhattan. Especially, what is a I'm asking you to purely sort of speculate here, but what is a New York City on the other side of this where social distancing and all of those things need to be in place for some measure of time. What does it look like and feel like. What what's the advice you would give to people in terms of moving around trying to you know, kind of live something akin to a normal life. Since we know about or so of

people generally UH do reasonably well with us. They have mild to moderate disease, relatively small percent come to the emergency room, and another smaller percent get intibated. Unfortunately, once you're intibated, a higher percent to not do well for a variety of reasons, and we need to figure out a better treatment. With those randomized control studies that we talked about, hydroxy chloroquine ile sex inhibitors from de severe

convalescent plasma. I think everyone will feel better when we have data about what really works, and at this point we have a lot of anecdotal evidence on us all number of patients. In the next few months we should be getting much the results of much bigger trials. But as people return, I think masks and gloves in the

subway are reasonable. It's very hard to keep six feet apart as as one can imagine um, and there will be some risk, and I think people who are ill and can't take that risk probably should not go back, and we'll have to figure out how to accommodate them. But the majority of people should be able to go back. But testing would be helpful. We still as an outpatient, cannot have someone come in who symptomatic, do a spit saliva test and get a result back. Hopefully that will

come soon. We so patients come in, you know they have the disease. Uh, you can't test them and we really can't offer them a good treatment. So I think when we get those two blocks in, I can tell you that you have it and not just tell you you have the symptoms of it. And I can tell you this works most of the time. I think people will be concerned, But I don't think either of that

data is very soon. It'll probably be a few months, uh, and that's probably the trajectory that people will safely return to work. All right, listen, thank you so much. And I know this was a hectic day for you and and you stepped away, so we really appreciate it. Dr Ian LUs Bader, stay safe, Be well, Clinical Associate Professor of Medicine at n y U Landgo Medical Center on the phone from there. He's been working at the I

c U units as we speak. This is Bloomberg Business Week with Carol Masser and Jason Kelly on Bloomberg Radio. Someone's had a lot of experience covering the global economy. Jason is our own Tom Orleck can't get enough of this guy. And I was so excited to get a chance, and I'm so excited to get a chance to to talk to him, because China remains just the big story. And of course Tom Arol gives Bloomberg Economics chief economis he joins us on the phone from Washington. All right, Tom,

so we woke up this morning. We saw some of it actually as we were going to bed last night, things happening in China. This is a momentous moment, right, I think it's it's really unprecedented. Jason. We have a six point eight contraction in China's GDP in the first quarter of the year um and of course that's against the backdrop of an economy which typically is expanding around

six percent a year. So really an extraordinary drop in China's growth and sort of a vivid illustration of the magnitude of the impact which lockdown with the lockdowns which of course we now have not just in China, but in the US, in Europe, around the world are having on output well. And Tom, this is a nation that thrives and grows un demand from the rest of the world, and right now they really have to rely on local

demand right to kind of bring about a recovery. That's right, Carol, And so I mean, if we dig into the details of the Chinese Chinese data, what we see is actually they came back quite strongly at the end of the quarter. February was terrible, massive contraction. March they regained a lot of the lost ground. So there was an optimistic sort

of note there. But thinking into the second quarter, the point you make, Carol, about the rest of the world and what's happening here in the US and in Europe, it's really going to come into play. Who is trying to going to export to when the US is contracting, when Europe is contracting, when all of these other emerging markets are in trouble um And so for that reason, even as the lockdown eases in China, we don't expect

an aggressive recovery. And so Tom some historical context of it, it it feels like is important here, both recent and maybe not so recent. From a recent perspective, you know, this is a country that that was already especially given or in the context of its relationship with the United states already in in a little bit of a difficult position. Clearly a superpower, but one that has been in a state I don't know if I would go so far as say existential crisis, but but at least sort of

searching for itself in some ways. This has has really thrown so much into question what does it tell us

about the economic might going forward of China. I think that's a really critical question, Jason, And for me, the interesting thing is to think about how we've had the trade war, which really sort of highlighted the split between China and the US UM, now immediately followed by this pandemic, which of course illustrates how governments need to work together to fight against global risks like disease outbreaks and climate change UM, but unfortunately has also illustrated the potential for

that conflicting, conflicting relationship, with government squabbling over who gets access to medical resources, who shares what data, UM, and so on. UM. So I think that that the pandemic, following hard on the heels of the trade war, is really going to be another factor which drives slow slowing in globalization or even deglobalization, as governments become more self reliant as governments get more suspicious of each other and

of companies and supply chains which cross borders. So it's broken, tim the relationship between the U. S And China, between trade between the virus, or at least between these current administrations, it's broken. So I think there's certainly something to be said for the idea that the current administration in the United States UM, and the current administration in China part

of are important factors of work. Um. The guy we've got in the White House, the guy we've got in John ann High, China's leadership compound, Um, they've got very distinct of kind of muscular, nationally oriented views of the world, and I don't think that's really helping the bilateral relationship. At the same time, here we have these two major powers, a democracy, a single party states, a free market economy,

a state dominated economy. There's a lot that they can disagree about, and the trade war and now the pandemic have really brought those disagreements to the surface. I think even after the outbreak is over, we're going to see that challenging relationship remaining very challenging. And that's going to be Frankly an overhang on global growth going forward, not

just for the next few months, but for the foreseeable future. Well, and that's such an important point here, Tom, that you know this isn't just about these two countries only about thirty seconds left. What does it mean for the rest of the world if you're sitting outside of these superpowers, either in Asia or in Latin America, or certainly in Europe or maybe even in Africa. How does it change

your playbook? Just got a minute here for thirty seconds. So, I mean, the first problem that all of these country's faces there is their domestic outbreaks. They need to get those under control. Even when that happens, though, they're not going to be able to look to China as a powerful driver of growth, all the open trade system as a sort of a force for lifting them out of lifting them and driving development. Yeah, it's such a great point, man,

h muscular interpretation of the world. Is that what he said before? He said I'm going to go back and listen to it, because there was the most eloquent description of presidency and President Trump that I've heard and explains so much. Yeah, it explains a ton alright, Tom Warlick, what a treat Bloomberg Economics Chief Economists. This is Bloomberg Business Week with Carol Mazer and Jason Kelly on Bloomberg Radio. It's just favorite on favorite here in the three o'clock

our Bloomberg Businesses. We turned out of Max Abelson, Bloomberg News Finance reporter. When I saw this scoop late yesterday, I was just blown away, and not surprisingly Max's name was on it. Canter Fitzgerald hundreds of job cuts in a break from Wall Street. That's the headline. Max joins us on the phone to tell us what's going on. As Carol Master would say, Max, whoa, this is a big story. Wow. I am so glad that you like it, and it's so nice to be with you guys, and

you feel connected to YouTube despite all this separateness. Yeah, you doing okay? Max? I am on hanging in there and writing fun stories thanks to Street our Natarajan and Jillian can who I teamed up with for this one.

You know, basically, I think it's probably fair to say over the last few weeks, what we've heard from Wall Street is this pretty unified voice saying like, look, we are not going to let people go during you know, basically first of all, a public health crisis and also be clearly the worst on unemployment catastrophe in decades, if not, I think ever, and Cantor Fitzgerald, the you know, which is obviously survived this horrible devastation after nine eleven, and

then Howard Lutnick we built it. Now Candervid Gerald is going to lay up hundreds of people. We uh we exclusively reported late last night. Why what why are they making this move when others are just battening down the hatchets here Max, Well, you know, I think that one of the reasons that this piece of news was big is that it's about um Lutnick, you know, trying to

shore up his empire. Um. You know, we spoke to a lot of people, and you know, so if you if you take a step back, you know what you see is first of all, just the deepest reductions at a Wall Street bank that we've seen since this this operator began. But you're also seeing something a little bit bigger than that. Inside of Howard Lutnix world, which don't don't forget includes we have canderrids Gerald on the one hand, but another thing that that Shery and Jillian I reported

on is BGC Partners, which is an affiliate firm. Their share is just absolutely collapsed, uh in the last few weeks because they announced that they were splashing their dividend I think, to like a penny or something like that, and probably more importantly, that they were drawing down hundreds of millions of dollars from from their revolving credit facility. That that's that's in the last few months. And then of course there's also Newmark Knight Frank, I don't know

if you folks know that name. That's a commercial, real steet firm. People they're being ousked to take pay cuffs. So the reality is it's a big news story because it's it's bigger than just Cantor. It's sort of this whole lut Nick, this Lotnic empire. So would this have happened may beyond a longer time frame even without the virus where their problems already brewing, or is it really just because of the virus. Well, one reason that I love working with Street are who you both know and

our golden sax feat reporter. But of course he does terrific work across the wall. Street That guy called me up this morning. I think literally, I want to say, maybe seven thirty a m. I was still in bed. You know, we we published our story last night, and this morning he looked me up because he said he wanted to update the story with a detail that touched on exactly that. And the detail there, Carol, is that

you know, the there there. You you often see job cuts on Wall Street like this, Um, you know earlier in the year, you know there's that van flow of sort of layoffs on Wall Street, but that that tends to happen before bonuses are given. So that's that's a reason to think that this is sort of out of the ordinary, not part of the normal evan flow that we would have normally expected to be earlier in the years. That start thinking on that, and so Max only got

about a minute and a half or so left. That should give you time to answer this massive question I'm about to ask you, how do you think Wall Street will be changed, even in the short to mid term by this? Because you you guys do such a nice job putting this in the context of everything else that's been happening. But there's something afoot here, and I wonder if you're starting to get your head around it. Well, I'm glad we only have ninety seconds of that day thing.

It's a very very important and wonderful question. Christina Harper at Marcus Magazine and I are trying to think about that for a project long term. But look, I'll say this, you know, what we're facing in the United States, obviously, on the one hand is a public health crisis which is devastating and lethal and very scary. On the other hand, we're facing what could be, uh, you know, some sort

of long term financial crisis or reception. But then you know, on Wall Street, I think it's probably also fair to say that we're seeing this sort of a different kind of almost like an existential crisis, where on the one hand, as I reported a few weeks ago, and I think, talk to you folks about you know, these sort of Wall Street culture of aggressiveness, we saw really clashing with the needs of public health, and we saw people piling into trading floors because there were billions of dollars to

be made. Michelle Davis and I report on that tree, and I reported about fevers on the wall on the Puban Fact trading floor, and I think there's a real question you know, will we see a different kind of Wall Street culture to a merchant. Thisis one that has people working from home more often, one that has this sort of much much much less than the sort of

the macho undertones even overtones. I think that it would be crazy of me to try to make a guess, But all I can tell you is Tree and uh and and the folks on the finance team and including editors like Christine Harper, are gonna keep our eyes open and really try to report hard on that over the next months and years. I gotta say that fear versus greed theme is something that Jason and I have been talking about constantly since I hit the Bloomberg terminal because

it's just so relevant to today's environment. All Right, Max Abelson, you are literally the best. Thank you so much, Have a great weekend, get some rest. Just doing some unbelievable work and uh he was cited with with some of his team. Is is just doing standout, standout work across the whole New York bureau, uh last week so and just delivering another great energy. He's just love it lean and he gets people to talk to him in just this amazing way. It's it's a marvelous to watch. Thanks

for listening to Bloomberg Business Week. You can subscribe to the podcast on iTunes, SoundCloud, or Bloomberg dot com. You can also listen to our radio show every weekday at two pm Eastern, only on Bloomberg Radio