tv The Rachel Maddow Show MSNBC March 11, 2020 9:00pm-10:00pm PDT
signalling the gravity of the moment. recent times in the oval office has been more common. he talked about the oil spill. president bush served eight years. he actually delivered a dozen oval office addresses. his first was the night of the 9/11 attacks. since president trump has been president, he has spoken from the oval only once before, and looking back at it, it's hard to believe it deserved it. it was for a government shutdown for funding the wall on the mexican border. tonight comes a cascade of closures. again, these are decisions that have largely been made, as we were saying, from the state and federal and local level, as they make decisions about what schools ought to be closed and when, what events ought to be
stopped and when. this all happening as fears about the coronavirus, fears about the economy have begun to take hold. the president will address those fears now. >> my fellow americans, tonight i want to speak with you about our nation's unprecedented response to the coronavirus outbreak. it started in china and is now spreading throughout the world. today the world health organization officially announced that this is a global pandemic. we have been in frequent contact with our allies and we are martialing the full power of the federal government and private sector to help our people. this is an ability to confront a foreign virus in modern history. i am confident that by continuing to take these tough measures, we will significantly reduce the threat to our citizens, and we will ultimately and expeditiously defeat this virus. from the beginning of time,
nations and people have faced unforeseen challenges, including large scale and very dangerous health threats. this is the way it always was and always will be. it only matters how you respond, and we are responding with great speed and professionalism. our team is the best anywhere in the world. at the very start of the outbreak, we instituted sweeping travel restrictions on china and put in place the first federally mandated quarantine in over 50 years. we declared a public health emergency and issued the highest level of travel warning on other countries as the virus spread its horrible infection. and taking early, intense action, we have seen dramatically fewer cases of the virus in the united states that are now present in europe. the european union failed to take the same precautions and
restrict travel from china and other hot spots. as a result a large number of new clusters in the united states were seated by travelers from europe. after consulting with our top government professionals, i have decided to take several actions to protect the health and well-being of all americans. to keep new cases from entering our shores, we will be suspending all travel from europe to the united states for the next 30 days. the new rules will go into effect friday at midnight. these restrictions will be adjusted subject to conditions on the ground. there will be exemptions for americans who have undergone appropriate screenings, and these prohibitions will not only apply to the tremendous amount of trade and cargo but various other things as we get approval. anything coming from europe to the united states is what we are
discussing. these restrictions will also not apply to the united kingdom. at the same time, we are monitoring the situation in china and south korea, and as their situation improves, we will re-evaluate the restrictions and warnings that are currently in place for a possible early opening. earlier this week, i met with the leaders of health insurance industry who have agreed to waive all co-payments for coronavirus treatments, extend insurance coverage to these treatments and to prevent surprise medical billing. we are cutting massive amounts of red tape to make therapies available in record time. these treatments will significantly reduce the impact and reach of the virus. additionally, last week i signed into law an $8.3 billion funding bill to help cdc and other government agencies fight the
virus and support vaccines, treatments and distribution of medical supplies. testing and testing capabilities are expanding rapidly. day by day, we are moving very quickly. the vast majority of americans, the risk is very, very low. young and healthy people can expect to recover fully and quickly if they should get the virus. the highest risk is for elderly population with underlying health conditions. the elderly population must be very, very careful. in particular we are strongly advising that nursing homes for the elderly suspend all medically unnecessary visits. in general, older americans should also avoid non-essential travel in crowded areas. my administration is coordinating directly with communities with the largest outbreaks and we have issued guidance on school closures,
social distancing and reducing large gatherings. smart action today will prevent the spread of the virus tomorrow. every community faces different risks, and it is critical for you to follow the guidelines of your local officials who are working closely with our federal health experts, and they are the best. for all americans, it is essential that everyone take extra precautions and practice good hygiene. each of us has a role to play in defeating this virus. wash your hands, clean often-used surfaces, cover your face and mouth if you sneeze or cough, and most of all, if you are sick or not feeling well, stay home. to ensure that working americans impacted by the virus can stay home without fear of financial hardship, i will soon be taking emergency action, which is unprecedented, to provide financial relief. this will be targeted for
workers who are ill, quarantined or caring for others due to coronavirus. i will be asking congress to take legislative action to extend this relief. because of the economic policies that we have put into place, over the last three years, we have the greatest economy anywhere in the world by far. our banks and financial institutions are fully capitalized and incredibly strong. our unemployment is at a historic low. this vast economic prosperity gives us flexibility, reserves and resources to handle any threat that comes our way. this is not a financial crisis. this is just a temporary moment of time that we will overcome together as a nation and as a world. however, to provide extra support for american workers, families and businesses, tonight i am announcing the following additional action.
i am instructing the small business administration to exercise available authority, to provide capital and liquidity to firms affected by the coronavirus. effective immediately, the sba will be providing economic loans in affected states and territories. these low-interest loans will help small businesses overcome temporary economic disruptions caused by the virus. because of this, i am asking congress to extend the amount for this program by an additional $15 million. using emergency authority, i will be instructing the treasury department to defer tax payments without interest or penalties for certain industries or businesses negatively impacted. this action will provide more than $200 billion of additional liquidity to the economy. finally i am calling on congress to provide americans with immediate payroll tax relief.
hopefully they will consider this very strongly. we are at a critical time in the fight against the virus. we made a lifesaving move with early action on china. now we must take the same action with europe. we will not delay. i will never hesitate to take any necessary steps to protect the lives, health and safety of the american people. i will always put the well-being of america first. if we are vigilant, and we can reduce the chance of infection, which we will, we will significantly impede the transmission of the virus. the virus will not have a chance against us. no nation is more prepared or more resilient than the united states. we have the best economy, the most advanced health care and the most talented doctors, scientists and researchers anywhere in the world. we are all in this together.
we must put politics aside, stop the partisanship and unify together as one nation and one family. as history has proven time and time again, americans always rise to the challenge and overcome adversity. our future remains brighter than anyone can imagine. acting with compassion and love, we will heal the sick, care for those in need, help our fellow citizens and emerge from this challenge stronger and more unified than ever before. god bless you and god bless america. thank you. >> president trump giving a rare oval office address tonight on the subject of the coronavirus. it was about 11 minutes in the oval office there. the president with a sort of strange affect. he doesn't have an easy time reading from the teleprompter.
it's got to be stressful for anybody to give a speech from the oval office with a teleprompter like that, but the president seeming to struggle a little bit getting the words out, but there was significant news in what the president just announced. the united states is suspending all travel from europe to the united states for the next 30 days. he said that will go into effect friday at midnight. he said there will be exceptions. he didn't spell them out, but he talked about people who are adequate many screened will be excepted from that, and something about cargo. it wasn't clear, but he said that there would be exceptions. and then he added that there would be an exception for the u.k. so travel from europe will be suspended to the united states for the next 30 days. there will be exceptions. they're a little woolly, but specifically the u.k. will be
sing he wou singled out from that. when i look at the u.k., they've got 456 cases, slightly less than half the number we've got but with a significantly smaller population. eight deaths reported already, i think, out of the u.k. why they've been exempted from this radical and otherwise unprecedented action, i don't know. let's bring into the conversation once again my friend, chris hayes. and robin cane had an acute role in the obama administration. he was also chief of staff. ron, i've been meaning to have you here for a long time. leet talk about your travel suspension to europe.
sdplz the president boasted about a ban put in from our excitement. the ban was a very friendly business ban. it didn't take people gross needs. there haven't been very public results in these travel bans, and the fundamental point, rachel, is this. this disease is here. we don't know how much is here because we haven't tested to find out how much is here, but it's here. someone who restricts foreign travel may help, but the president didn't talk about the foreign people here already with the disease. >> that is the way they've
approached this from the beginning. we have reporting inside the white house that there was sort of self-congratulatory talk. it's profoundly worrisome to me that the president is still talking about this the way he talks about the migrant caravan, about some foreign invasion that can be kept out with strong measures. it's in the country and transmitting now. we are on the epidemic. it may be, at the margin, smart or not to do the travel ban. spending the last few days, there is disruption to daily life that didn't make up more
than 1/20 of that speech. >> i don't mean to fixate on the u.k. exception, but it appears to show the irrationality of what he's doing, but just looking at confirmed cases from various european countries, which are now going to be subject to a travel ban. countries like belgium has fewer cases than the u.k. does. austria, portugal, ireland, romaine yr romania, u.k. >> donald trump wants to see progressives debate the travel ban, so on and so forth, and not come after where he has failed. we have tested five people out of every million in this country. . it doesn't have technology we don't have, or a health system we don't have.
it is a failure of the leadership pd of thely. >> even tonight, in that oval office address, we're going to get there. that's job one. >> it also struck me to hear the president bluntly say for the vast majority of americans, the risk is very, very, very low. ensuring americans you're not going to get it. and what we hear from pale folks, from epidemiology part of the country to deal with that. >> our health care system, as wonderful as it is, has very limited capacity. . we want to overwhelm those systems, to have happen here what is happening in northern
italy. once again, i heard the president make some slight references tonight, but i think if a competence and getting our health history ready for this influx of dasz. in the meetings he's had with various ceos and connected groups? p he -- are you going to just tell the treasurer. >>. we need to see from this looks like from an efficacy standpoint. what is it actually helping people from a distribution standpoint. including what his owners are connected to.
>> i think it is fair. often with trups p. where this money is going. give this track record, it's not unfair to ask those questions tonight. we're going to take a quick break. ron, i have lots more questions for you tonight. thank you so much for letting me step on your toes. the president cleegt an overall address on the coronavirus. it was a weird one. we'll be right back. stay with us.it was a weird one. we'll be right back. stay with us.coronavirus. it was a weird one. we'll be right back. stay with us.
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and corruption. those kind of facts from a senior leader, that a very corrupt official like that would actually end up last weekend at mar-a-lago. where else? the president of brazil was in mar-a-la mar-a-lago. he brought himself a make brazil great again hat. you see their arms pressed up against each other, big smiles from both of them. today that government official has been quarantined and is waiting for the results of a coronavirus test, according to local press in brazil. he is suspected of having the virus. again, that was him at mar-a-lago this past weekend, saturday, with the president of the united states. the president's new white house chief of staff is also under quarantine, as we speak. this republican congressman rode on air force i with the
president on monday, as is this congressman who shook hands with the president on friday and met with him face to face. the president is in his 70s. that age puts him at particular risk for serious illness. if he himself actually contracted the coronavirus, the president does seem to have a lot of face-to-face contact with a lot of people who have been exposed to the virus in the past week or so. the eerie thing is that the physical person of the president, not just as a leader, but as a vulnerable person himself and potentially the vector of transmission himself is part of what we have to think about in our national news. even tonight as the president gave a rare oval office address, announcing that elderly people need to be particularly careful and should avoid unnecessary travel, even as the president announced tonight that his latest action on coronavirus will be banning travel from europe to the united states,
starting friday an ininexplicab excluding the u.k. from that ban. the u.k. has nearly 500 cases of its own and a number of deaths, so nobody knows why he would not allow travel from the u.k. and other european countries, especially when those countries have fewer cases. today the sergeant in arms announced they would stop having tours of the capitol. those are off for the time being. the state department also announced they would limit all travel for state department personnel unless it is considered to be, quote, mission-critical. the city of washington, d.c. declared a public emergency today. all the episcopal churches in the d.c. area announced they would close, at least for a couple weeks. that means churches inside d.c.
city limits are closed. the national cathedral is closed. as we reported last night in the middle of our election coverage in the great state of michigan last night, they reported their first cases of coronavirus, the governor declaring a state of the emergency today. the supreme court in michigan said all jury trials, all civil trials and criminal trials that have juries in the state of michigan should be adjourned, should be put off for the duration of the state of emergency unless there is actually a person being held in jail awaiting that trial as jury trials will all be put off. again, those are state courts in michigan, not federal courts. i believe it's the first time we've seen that sort of closure around the country. in congress, one of the most trusted health officials, tony fauci, the president of the infectious diseases at nih, was
asked to please give his perspective of how bad this was going to get in this country and what we should do rationally to improve our prospects here. the line of questioning swiftly and sort of oddly turned to basketball. >> okay. based on the current trajectory, how many people do you think will get this new virus and how many people do you think will die? >> cannot predict. >> i know you can't predict, but we have a graph. we have the beginning of a graph. we know this is going to get up. we have the experience of china. we have the experience of italy. can you give us some projections? >> it is going to be totally dependent upon how we respond to it. i can't give you a number. if we now sit back complacently -- >> i'm not asking to be complacent. i'm asking for a realistic number. >> i can't give you a realistic number until we put in the factor of how we respond. if we are complacent and don't
do real aggressived confrontation, the number could be up in the millions. if we contain, we could flatten it. there is no answer to your question until we act on it. >> everyone talks about every night they play eight to ten nba games and no one talks about shutting them down. is the nba underreacting? >> we would recommend that there not be large crowds. if that means not having any people in the audience where the nba plays, so be it. but as a public health official, anything that has large crowds is something that would have a risk to spread. >> we would recommend that there not be large crowds. anything that has large crowds is something that would give a risk to spread. if that means not having any people in the audience when the nba plays, so be it.
we sort of knew we were heading here, but there it is, a senior nih official saying there shouldn't be large crowds in the united states anymore. we as a country should no longer have events with large crowds including professional sporting events. i should tell you just as we got on air tonight, the oakland thunder was set to host the utah jazz. they had announced a 30-year-old st staying home after beitesting positive with the coronavirus. it's not just the utah jazz game being postponed tonight, it
looks like an overabundance of caution on these matters. they're making sure it includes golden state warriors. tomorrow the golden state warriors play the brooklyn nets. there will be no one in the audience. santa clara county are banning gathers of a thousand people. that would include san jose hockey games, among many other things. governor of washington state today, jay inslee announcing that from here on out the government will ban gatherings of more than 250 people. all seattle schools are also being shut down for two weeks. new york today, the governor announced that city university of new york, sunni, and all
other sunni campuses will be shut down. american officials are still playing at the very low end at the kinds of interventions in daily life may be tried. in recent days we have seen italy try to quarantine people and avoid gatherings of any kind. weddings and funerals, banned. today the federal government made stores and food. the upward ufsh -- i'm taking
these draconian measures, right? the curve of the epidemic in italy, particularly for us. what does expoing one to two others is not at all devastating. >> look at little italy. that have two. they were up to 17 people. two days later, just over a week later, mark is 216 cases. yesterday he was annoy.
that's the mushroom cloud he can ploegd in italy. it's not like italy had its head buried in the sand. we saw all those nunsers. italy is in a nationwide border to boreer slow the spread. imagine an order in this country to close every restap that is not a pharmacy or a food store. that that's. >> but the virus seem to be prf, how numbers go up.
february 26, they had one case. day after that. that was two days ago. there's 356 there are five new deaths all associated with nursing homes and health care communities. i asked mr. sharp about that, and he said we've probably got close to a thousand dacases, whh means next week we expect washington to have 64,000 cases. in that one state. our government still has not gotten it together to test people at any emotional level. south korea has been testing 10,000 people a day since february. we found out about our first cases around the same time that
south korea did. they're testing 10,000 people a day and have been since last month. we still haven't tested 10,000 people total over the entire course of this epidemic in this country. we've got more than six times their population. so imagine how big our mushroom cloud can get. but the federal government, the trump administration botching the rollout of testing for this project. they're wondering how people are doing, tracing their steps to stop the violence from spreading further. the only reason france is below us on this graph is because they're only test lg the rate of politicians. france says they're doing about a thousand tests a day which
actually put people in the hospital. even with a basically zero usable information on the side of the american epidemic, because of zero testing. it's still wrapped. from the publicly available data we got a couple cases ago. over the weekend, we're at 545 cases, then what's relationship of people who can. the attending physician of congress on the u.s. first reported by "axios" and
confirmed by. ultimately the number of americans who. 130 on the high end. which means approximate if it continues to be the case and needing ill. if those estimates mp right, that would mean we're looking for hospital beds somewhere 12w50e7b. 3100 people acquiring hospitalization for a serious illness, on top with theover things we need to use people? 31 million americans actually that you get intew bigs, being put on a blender and all that.
if we know now who is coming, how do you even start with the dreblt. he called it the direct trat in president trump got rid of it. got rid of the whole global health security eun at the health security team. the security teams existed. they were put in place for a reason. the government had seen fit because of the experience with ebola and other knowledge challenges to set those things up inside the federal government so we wouldn't be starting from zero so as to prepare us for a moment like this. president trump inexplicably
moved to fire those people and get rid of that function of the federal government for reasons that remain unclear and unexplained even this far into this per pet waitipetuating and crisis. the president tonight announced a ban on european travel. nobody will be able to travel from europe to the united states starting friday, unless you're coming from the u.k., in which case it's fine, even though the u.k. isn't any less susceptible to this virus than any other european country which is now going to be facing the ban. we'll be joined next by someone who knows what the federal government should be doing in a situation like this, because he used to command the efforts in a previous administration. that's next. stay with us. onstar, we see them. okay. mother and child in vehicle. mother is unable to exit the vehicle. injuries are unknown. thank you, onstar. my son, is he okay? your son's fine. thank you.
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i was just talking about the odd role that basketball is playing in our national confrontation of the reality of the coronavirus crisis and the need to take actions that affect daily life. the conversation came up when dr. fauci said, when asked about the nba playing in games full of stadiums of people, said the u.s. should avoid, at this point, large gatherings. he said, if that means the nba should play in front of no fans, so be it. since we've been on the air tonight, we've had a development along that line. the nba has now announced the suspension of thieir season. i'm going to read you the press release. the nba announced that a player on the utah jazz has preliminarily tested positive for covid-19. the test result was reported shortly prior to the tip-off of
tonight's game between the jazz and oklahoma city thunder at chesapeake energy arena. at that time tonight's game was canceled. the affected player was not in the arena. the nba is suspending game play following the conclusion of tonight's schedule of games until further notice. we heard that game was delayed and then called off. we know now why that was. a jazz player was found positive. also someone on the air tonight, someone you will know by name. academy winning actor tom hanks and his wife rita wilson announced they have both tested positive for coronavirus, tom hanks announcing it in a tweet. they were in australia and started feeling like they had colds, body aches. rita had some chills that came and went. quote, to play things right as is needed in the world right now, we were tested for the
coronavirus and were found to be positive. well, now. what to do next? the medical officials have protocols that must be followed. we hanks' will be tested, observed and isolated for as long as public health and safety requires. nothing to it but a day-by-day approach. we will keep the world posted. they were supposed to release a film with tom hanks. they said, the health and safety of our company members is always our top priority, and we are taking precautions to protect everyone who works on our productions around the world. there is someone who has worked with national outbreaks. he was chief of staff to vice president biden and al gore. ef he was the coordinator of the
ebola response in the white house. ron, good to have you here. >> thanks for having me. >> now that you've had a couple minutes to ab stosorb what the president said, what's the most important thing that he announced? >> i think the unevenness and inexplicab inexplicable details of this travel ban, people can still travel from the u.k. >> the president has been bragging on the travel ban he instituted related to china. he's now instituted a travel ban from europe to the u.s., excluding the u.k.? >> yes. >> but there's never been a travel ban from south korea to the u.s.? >> correct. and again, even with the china travel ban, the europe china ban, there's been exceptions for commerce to allow businesses to
ship things back and forth with the people that come along with the goods. these travel bans, i think they have some effect in slightly slowing the pace, but they're not a virtual wall to protect our country. we're seeing that. the diseases here are spreading. and i think the problem was this. it gave the president a false sense of security or maybe he tried to convey a false sense of security, and if it bought time, that time was squandered. we knew this was coming in december, we knew it was coming in january. the president talked tough on travel, and in the meantime, we weren't getting ready on testing, we weren't getting our health care facilities ready, we weren't doing what we needed to do knowing this was coming. we had warning. that's the real tragedy here. we had warning thfis was coming in the kind of numbers it was coming. tom hanks got tested because he was in australia. if tom hanks were in new york, it would be almost impossible for him to be tested. >> it is so enraging that the
u.s. testing situation continues to be a fiasco this far into it. i have read everything, i think, about what went wrong and what is metabolic stuff. but given that it has and what a crisis it is for our country that there continues to not be widespread testing, why can't we just copy the test and the test protocols that our allies around the world are using? the president just banned everyone but the u.k. from the travel ban. a utah jazz player was just tested positive. we seem to be in neutral and unable to improve in this situation. >> it's a failure by the president and his task force. what the white house has done in the past week is said, we're going to privatize testing. we're going to let the big
testing labs, testing lab corpse, get one of those. we really need to be doing testing on people who are not raising their hand to be tested. every person in the senior center, every people in one of theeds health care conditions, going out and looking for the disease. not just waiting for people to show up in their doctor's office and say, i need a test, and if that doctor can put you in a private room and give you a test. >> if they were going to do testing on that scale, could they stock up on tests nationally? >> obviously those tests are in high demand in other countries, too. but we could do more to produce tests in this country.
i think there's been a decision to kind of highly prioritize it. we have a lot of our seniors in nursing homes. a lot of other countries take care of it people congregated in these nursing centers. more and more nibble, it's very frightening. >> given the epidemiology curve, but with the increase we're seeing nonetheless, a very large corps of americans, as will see we're looking for serious illness rate among those who get infected. should we expect that american
hospitals will get flush with sickness? >> even if we got anywhere near what you're talking about, we have a million hospital beds. >> how many hospital bed? >> a million. of course, people come in and out of them, so we can help about 35,000 people in the country, but as you said, rachel, people were hospitalized with this. if you're serious enough to go to the hospital with this, you'll be there for a while. this isn't a two-day hospitalization thing. if you get a crush of katsz in a particular city, a city like new york, where capacity is limited, we have limited numbers of ventilators. we have 65,000 ventilators during the whole country. if this really kicks up and creates even a small in particular places overwhelmed.
it seemed like aim worried about getting care. often people die not from the epidemic but the ability to get. the line is too long because they're afraid of getting the virus when they go to the hospital and coronary instances go up. this is going to have effects on the health care system that go beyond even dramatic effects of the illness itself. >> does the word pandemic mean we should expect it to be domestically as well? >> i think we should expect it to be everywhere, but not at the same time. with this testing, you want solace in where it's been and where it's going. you'll see there's states with many cases and states with zero cases.
there are cases with zero cases, there's cases with zero tests. we're fighting an enemy and we don't even know what it is. >> what should the government do to surge capacity in american hospitals examine prep for that now before we see it start to happen. we've all seen talk about the lombardi region and knowing it was going to happen because there was a large section off florida in that visit. she still doesn't come from the ultimate numbers that turned up. we're in a polt now. it feels like gold. can we do something to it if anything happens? >> the one thing i put a star on here, i think inquisitively rkts these are state and local problems. we're here to provide expertise.
i think they're going to have to push this problem downward. we have tools they can use. they're really good at building things after earthquakes. they might ask you to go places they don't need them. governors could be at the national guard when there's a superfly can do that. we need to be really create i have about -- trying to get the testing out of the health care center, protect you from being create ty. what we're seeing from the white house is kind of vague students and vague direction, but not the push to action. >> when you found out the president was going to give the oval office address, did you
expect him to give a cloolossal administration? >> i don't care what label i puts on it. he hasn't acted like it's a public health emergency. he can call it whatever he wants to call it. call it a frock. where are the ten to-dos. how much money from obama was spent in the last week. it's just some basics on clocking and it will enging. accountability. >> in terms of what happens
next, lloyd garrett is a pul iti -- pulitzer winning actor. turn the telescope the other way, when i go home from here tonight, when people start thinking about what they're doing. i don't think i've been exposed, but should i limit my contact with people inside to give rise right now, and who should we trust? >> i absolutely trust dr. fauci, i trust the career people.
the woman who said he was reliable. when you have a crisis like this, the deep state is what fisz who were permanent governor servants, they're great people, great scientists, they need to be turned loose. >> you were vice president biden's chief of staff. you know him well. he today announced he was cancelling events or converting them to virtual campaign event the in choy. >> he's going to give us that speech about the coronavirus, and when senator sanders canceled some of hi rallies in
ohio, the trump administration actually went out and saw him. we just got word a moment ago, quote, out of an abundance of caution from the coronavirus outbreak, the president has decided to cancel his up coming events in colorado and nevada. is it wise for everybody to cancel everything? for everybody to cancel large events that might have large numbers of people on this. >> i think these very large events should be postponed for now. >> especially since they're large crowds. there's always risk in our society and in the presidential campaign, tlgs a lot of and president trump to reach voters, to communicate with voters that
don't vov. we know where the testings of the disease here. some caution here is a dodge. we'll see you again tomorrow. time for "the last word" with lawrence o'donnell. good evening, lawrence. i invite people to compare what they learn from ron in your last 45 minutes of discussion to what they've been hearing from trump administration officials, not the medical professionals but the actual white house staff because that's what ron was in the obama white house. he was in a position without medical expertise but with expertise about how to make government work, how to make arms of the government work together in a crisis like this and of course he did pick up a great deal of expertise about this kind of situation and about the medical elements of this situation.