♪ ♪ ♪ ♪ >> 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.

♪ ♪ ♪ ♪