Transcripts For CNNW New Day 20141015

Exposures. So are they equipped . Do they feel equipped to deal with the second case now . You know in the beginning, before this happened, over the summer, the cdc was saying look, any hospital can handle an ebola patient. Weve sent out emails and guidelines and given webinars. I was speaking with an official who said in retrospect we should have transferred Thomas Eric Duncan to either emory or nebraska, two facilities especially trained to deal with these kinds of biohazards. There was too much confidence in every hospital in america, that every hospital would be able to handle an ebola patient. When clearly weve seen when they took care of an ebola patient, two more people got sick. You dont get to choose where you have ebola case, so you do need to be prepared. Lets get some perspective on what this means for this one hospital and what it means for the threat Going Forward in general. We have dr. Joseph mccormick, few know more about ebola than he does. He helped investigate the first ebola epidemic in central africa. He is a professor and regional dean at the university of texas school of Public Health. Thank you very much for being with us this morning. The big point is that when you hear a second nurse who was treating obviously the man who died, mr. Duncan, are you shocked to hear this . Not shocked at all. Particularly after we had the first one. I think the first one was a bit more of a surprise than the second. I think that started to make us examine the actual protocols that were being used more thoroughly. When i see what the procedures, even that dr. Gupta showed us, im saying to myself, whoa, this is not to me, the kind of protocol that should be used. The probably the biggest danger is, when you are taking off your gear. When, after youve seen the patient you may be contaminated. Thats the biggest issue. From what i saw, there needs to be some, some changes in that protocol. But there was no protocol. We heard from the very beginning that when, when duncan was seen, all the way through the handling of specimens. Do you think this is about whats going on in this specific hospital . Or is this is a window into the reality of how difficult it is to deal with ebola. Can you deal with ebola in a hospital like the Presbyterian Hospital. But you have to have the protocols. Whether youre in the hospital in the middle of sierra leone or a hospital in dallas, you have to have the protocols in place. You have to get buyin by all of the team. You have to have a trained team, its not that difficult. But it has to be done. And if youre saying well were so good technically were not worried about it, thats the kind of complacency that i think Elizabeth Cohen is talking about. We want to bring in dr. Alexander van tulleken. Thank you so much for joining us. We learned that the patient, mr. Duncan, who died, h70 health cae workers had come into contact with him. Two of them are sick. Talk about the exponential quality of this. To all the eke that theyve come into contact with for the past 48 hours or week now have to be checked . I think we have to approach this as if thats a possibility. Personally, i think its extremely unlikely. What weve seen is a lot of talk about precautionary principles, take as much care as we can. It hasnt worked. I would look at the rest of the 70 people and their contacts, as being a much higher risk than previously we would have done. In hindsight, we do have a sensitive blood test to look for the virus in the blood. Why we werent getting serial blood measurements on this. Just to improve our knowledge. You told about this, i was completely shocked. Weve been telling everybody and it is true, you have a 21day window here, thats very confounding to when youre exposed to when you can give it to somebody else. During that 21 days to follow up, dr. Mccormick, you can test on day one of the 21day period and know whether or not i have the virus, true . Not necessarily on day one. Which day . Well it depends on how much virus you got in the first place. This gets into the weeds of the science. But if you get a big dose like mr. Duncan probably did, then youre going to see the virus within three or four days. Its not foolproof. You cant test all 70 of these people right now that alisyn points out and know who to worry about and who dont . Other tests that can be used. One of the things we know is that the first thing that goes with severe disease, particularly severe disease is a group of white calls called the lymphocytes go right out the bottom. That happens pretty early. Arent they testing them, dr. Van tulleken . As far as we can see, nina pham was under passive surveillance. Why . Why is exactly right. Weve started to believe our own dogma about ebola and how difficult it is to catch. Weve heard a mantra from the cdc saying its difficult to catch. In many ways it is. Its a nuanced message. One of the things thats very instructive. I go back to the fact this is not that easily transmitted. Look at the family members. Look at the contacts. They were under circumstances that nobody else was. Thats typically what we see in the epidemics. The transmission rate is about 10 . Great point. They dont appear to have any symptoms. They havent spiked a fever. Whats happening in the hospital . Is it just that there are more bodily fluids being exchanged . We dont know what happened in the family. But clearly theres more contact with body fluids, but my point is, that the protocols themselves. They clearly didnt get those right. And thats whats happening in the hospital. We have dr. Sanjay gupta on the phone. Did you this great demonstration that im sure the doctors here saw and all of us did. How difficult it can be to take off the equipment. And this idea of we need a right protocol in place to make this safe is that making a little too simple in terms of how difficult this actually is to do . With 100 certainty . Well, with 100 certainty, obviously adds a very high bar. But i think it could be a lot better than it is now. And that you know, there have been examples you know throughout the history of, people have been taking care of patients with ebola since 1976, you have really low, if any transmission from patients to Health Care Workers. I give the example of we know there have been transmissions this year, but up until this year, there had not been transmission of patients to health care providers. It can be done in part it involves proper protocols. I want to point out when i did that demonstration to show that the way i did that was to follow the cdc protocols exactly as they were outlined. And handed out to hospitals all over the country. I wanted to show that exact protocol. We do know in emory and nebraska for example and alisyn, i think you were speaking to the nurse from nebraska yesterday, they use a protocol thats above and beyond that. And those are the places that are designated centers, that are known to be able to do this. They have a different protocol than the cdc. Think that tells us something. When you watched sanjays demonstration there. Whats the problem . The first problem for me is youve got contaminated hands. What we did in sierra leone and surely many other people, and i suspect Doctors Without Borders does. You wash your hands, before you take anything off. You take off your gloves no, no, no, you wash your gloves, you put them in bleach. That kills the virus on contact. Then you take off your gown, and all the other paraphernalia. Because then youve got cleaner gloves. Youve got gloves that are clean. Why isnt the cdc recommending that. Then you wash them again. That, i couldnt tell you. To that point, dr. Mccormick, we did that exact thing there would be buckets of this bleachlike substance, you would come out. You would just soak your hands in there and then you would start disrobing. You had somebody helping you to disrobe, a sort of buddy. If there was contamination on the front of the gown, they were literally, they had these Spray Bottles and they would spray the gown before we started taking it off. Its not that sophisticated. We were doing similar things, sanjay, with katrina. Because we didnt know what was in the water. Its no not that you have to create new science to stay safe. We have the second case, this is scary. But for perspective. People are tuning in, this is another case, this is panic, its going to happen, everyones going to get it. Does this mean anything like that to you . Nothing at all. Were not going to get it. I said this last night. Were not going to have an epidemic or a pandemic in the United States. How can you be so sure . We know how to control this. If we have to send everybody to nebraska or atlanta, then thats what well do. And we know how to screen for it. And we know how to control this. And we dont have anything like the level that were seeing for example in west africa. Dr. Van tulleken, we told that nebraska only has ten beds. We cant necessarily send everybody, much as we might want to. Should the new patient that was diagnosed this morning, go to nebraska for treatment . I think they need a detailed evaluation of whos looking after him in this place. It doesnt need to be in a different building. But the quality of the team needs to be very different and when we talk about why the protocols are different from the World Health Organization protocols, the cdc logic is the w. H. O. Protocol is too difficult to follow. What that speaks to is a sort of laziness of how hard it is to train people. Its not hard to train people. And i think professor mccormick is exactly right. We shouldnt be worried about an ebola epidemic. But we should be worried about the affect on peoples lives. Were not going 0 get ebola but were going to get serious effects in this country. Youre worried that doctors and nurses will start refusing to treat people because theyre worried. Weve seen it in other epidemics, we seen big, big concerns. And weve heard nurses saying we dont feel protected. That should be terrifying for all of us. The nurses are complaining. You have to give them special attention. Because they really are the first line responders on this. Lets play some more of the sound of what their concerns are. Here it is. Lab specimens from mr. Duncan were sent through the hospital tube system. Without being specifically sealed and handdelivered. The results is that the entire tube system, which all the Lab Specimens are sent, was potentially contaminated. There was no advanced preparedness on what to do with the patient. There was no protocol. There was no system. The nurses were asked to call the Infectious Disease department. The Infectious Disease department did not have clear policies to provide either. So that was the copresident of the National Nurses united union. Speaking on behalf of the dallas nurses. Sanjay, hindsight is always 20 20, you have this anonymous official which is bootstrapping what the nurses union said. If we know now what we knew then, we should have sent duncan to nebraska or emory, somewhere that knows what theyre doing. Can you make that type of judgment at this point that well only have certain places that know how to do this right or does everywhere have to know how to get it right. With regard to these claims, you know, if this is true, this is pretty concerning. And its not so much even a hindsight issue, chris, you remember for months, theyve been talking about preparation, theyve been talking about the fact at the cdc level that we, anticipate a patient will come to the United States with ebola. So and theyve been, they said that theyve been going for laying out protocols for hospitals primary care doctors, Emergency Rooms to follow. The problem from a pragmatic standpoint is a patient shows up wherever in the United States. Theyre not going to show up necessarily in one of these cities, in atlanta or nebraska. And what is, what happens at that point . Patient goes to the hospital, they go check in at the emergency room desk. They come in contact with people. They come in contact with health care providers, they may or may not get put into isolation. Theyre going to have blood drawn. Then theyre going to be transported. The idea is to transport them to one of these places, they go by ambulance, by plane, arrive at another hospital. Think about how many more people now start to get potentially affected by this patient who is sick, apparently, thats why theyre going to the hospital and could potentially be infectious, it seems that yes, i understand the momentum for these designated centers, but the idea that weve waved the white flag and say you know what, we cant do with the Doctors Without Borders were able to do in the tent hospitals in the middle of remote africa. We cant do that at big hospitals in the United States, is baffling to me. Its disappointing to me. But maybe thats where we ought to be. I still think the idea of a Doctors Without Borders team or somebody like them going to these hospitals may be the better way to do it. But maybe thats just, were just not there yet. Is that the answer, dr. Van tulleken . Let me repeat some of the other things the nurses unions officials were saying. No advanced planning, their necks were exposed. Sanjays point that a single medical charity is has shouldered the burden of dealing with this entire epidemic, basically and that should be absolutely terrifying. Theyre doing a better job, were not talking about some tiny little rural hospital in america, were talking about a big significant hospital in a major american city. What were seeing here is a massive failure on a much larger scale, which is if we had reacted to this in africa where we needed to several months ago then we wouldnt be dealing with what were dealing with now. I would like to add something more. Weve had the vaccines that are currently now that everybody is running around for ten years. Ten years. Theyve been out there for ten years. Vaccines against ebola for ten years. Experimental vaccines that worked in nonhuman primates. They never went any further than that, because our system says if you cant pay, you dont play. That means if youre poor, were not going do spend the money as a Pharmaceutical Company or whatever, to develop vaccines. So now were going to pay probably billions of dollars to try to deal with this. Absolute catastrophe in west africa. When probably 25 or 50 million would have developed them through at least phase 1 and phase 2. Does that go through treatments as well . Absolutely. How close are we to a vaccine . We have one vaccine, both vaccines one developed at nih, one developed at the military, protect nonhuman primates. Now they have to put them through phase 1, phase 2. I think you heard dr. Fauci talk about that. What do you need more, a vaccine or a treatment . Yes. You need them both . You do. What you would do is use the old smallpox protocol and vaccinate all the contacts right away. That would get them on the road to an immune response that would certainly blunt their infection, if not stop it. So thats the one thing you would do. And then obviously you need the treatment so that you dont have the death rate that we have. Gentlemen, thank you, thanks so much for being here. We will be talking to you throughout the show there is other news, so lets get to michaela and the rest of the headlines. We will follow up with our top story as soon as i get you through the headlines right now. Want to let you know what else is going on. The Supreme Court paving the way for dozens of abortion clinics in texas to reopen immediately. The justices ordered the state not to enforce a law requiring clinics to have hospitals level standards. Opponents of the law says the guidelines were restrictive to womens health. More appeals are suspected, and the case could end up before the justices. Military leaders from north and south korea healed held their highest level talks in seven years. Meeting comes amid renewed tensions and shooting incidents off the waters of koreas. The spokesman suggested the meeting was a goodwill gesture on both sides, no future meetings are set at this point. 17 american soldiers were exposed to nerve or mustard gas after the invasion of iraq. Thats according to the New York Times. Which also says the u. S. Government withheld that information from troops and military doctors. The report suggests the government secrecy prevented soldiers from receiving proper medical care and official recognition of their illnesses. To sports, the Kansas City Royals now just one win from the world series, beating the orioles to take a 30 lead in the American League championship series. Royals still havent lost in the postseason, 70 now. They can secure their ticket to the series with a win in game four. The nlcs, the giants beat the cards to go up two games to one in their series, game four tonight in that beautiful city by the bay. You know who im cheering for. Its shaping up to be a good series, great teams this year. So were continuing to follow the breaking news that we have for you this morning. A Second Health care worker is infected with ebola in dallas. In the hospital staff, he was on the hospital staff and were wondering, are they spreading ebola by somehow handling the gear wrong . Or going through protocol incorrectly . Were going to talk to someone who is helping to implement new training, thats ahead. Ned on mt it could hurt your teeth. He told me to use pronamel. Its going to help protect the enamel in your teeth. It allows me to continue to drink my coffee, and it was a real easy switch to make. You know how fast you were going . About 55. Where you headed at such an appropriate speed . Across the country to enhance the nations most reliable 4g lte network. Hows it working for ya . Better than ever. Howd you do it . Added cell sites. Increased capacity. And your point is. So you can download music, games, and directions for the road when you need them. Whos this guy . Oh thats charlie. Hey could you put some pepper spray on my buritto . Its severely underseasonsed. He always like this . Just want a little spice, you know . Just a little spice. At t. The nations most reliable 4g lte network when i had my first migraine, i was lucky. That sounds crazy, i know. But my mom got migraines, so she knew this would help. Excedrin migraine starts to relieve my pain in 30 minutes. Plus, sensitivity to light and sound, even nausea. Excedrin migraine works. Were following breaking news this morning, a Second Health care provider at a texas hospital who now has ebola. They are now in isolation. Were trying to figure out whats going on with the situation wooxt he have medical correspondent Elizabeth Cohen on scene. Elizabeth, let me come to you. Youve heard the information were reporting. What other details do we understand . We understand that the Second Health care worker has now been diagnosed with ebola. Cdc director tom friedan said this was a strong possibility. There was a breach in protocol at this hospital. It wasnt the nurses fault. Nina pham, the one who is sick now. Its a problem with the system. Theres a problem with the system. The big question specifically for the hospital are they doing what they need to be doing the right way to stop the cases from spreading . We want to bring in a few guests, joining our conversation in studio, dr. William fisher. Helping to train people treating ebola overseas. Dr. Fisher is the associate Program Director for research at the unc school of Medicines Division of pulmonary diseases and Critical Care and we have in studio, dr. Van tulleken and dr. Mccormick. Dr. Fisher, i want to speak with you. We understand youre going to be part of setting some new guidelines. In terms of the treatment and the protocol that weve been talking about nurses and Health Care Workers essentially begging for. I want to talk to you about one of the things you say is really key. Ive read some of your writing. You said the key is standardizing the protocol. That the standards that are there, are not followed. And theres no clearcut protocol really. Lets start with that. Well i think to be honest, think theres been so much focus on the personal protective equipment. So the actual clothes that people wear and not enough focus on the processes that go along with wearing those clothes. Specifically how do you take them off safely. Weve watched dr. Sanjay gupta do that and he said it was very difficult. Youve talked about the fact there needs to be a buddy system. Its one of the systems thats worked very effectively in west africa. Why is it not being done here in america . One of the problems is theres no consensus to approach to how to take off these personal protective equipment across medical institutions in the country. One of the major problems is that the cdc has come out with guidelines, but everybody is kind of augmenting those guidelines. Any time you change the personal protective equipment, you have to change the process. On how you take it off. One comment about the buddy system. I think the buddy system is fine for entering an ebola treatment area. But i dont think its sufficient for exiting. What do you think is sufficient . Absolutely. What i think you need is somebody who has not been inside with you. You need somebody whose sole purpose is to guide you, get you out in a systematic, ritualized, instructed manner in how to get out of those clothes. Can you imagine its physically exhausting, as well as emotionally exhausting to care for somebody who is critically ill. To rely on someone who is physically and emotionally exhausted to guide you safely utility of your clothes, i think is a mistake. We need to have a person who is literally there and their sole purpose is to instruct you on how to take off the protective gear. I agree with this. I think the biggest risk is taking off the garments. And the process we talked about that a little bit earlier. We get what the problem is quiet are they doing it right in texas . Texas winds up being ground zero in the United States, by dint of having the cases, were getting a hyperanalysis of the hospital and the protocol. It happens to be a very good hospital. Its not looking good right now. What is the reality to you . Do they not know what to do . Are they not doing what they need to do the right way . Or is this about how difficult it is to deal with this . I think it may be the two, the earlier two. They dont know how to do it. Theyre doing probably what they were told, maybe. But it clearly is inadequate. I mean the evidence speaks for itself. Dr. Van tulleken, it sounds like the cdc guidelines are inadequate. What dr. Fisher is saying they dont go far enough and thats why all the other hospitals that are doing it effectively, like nebraska are, augmenting the cdc guidelines. I think there are two specific problems, the guidelines arent as good as the guidelines that are being used in west africa. This dont afford us much protection. But the second thing is the guidelines are ambiguous, theyre hard to use, what there arent guidelines is how to train people. The guidelines assume that the back of your body is not contaminated. If you have more than one Health Care Worker moving around a room. If you brush against a wall or a table that is already contaminated. So the then tyour back is not clean. You rely on the drill team moving around a certain way, and you rely on the patient not fitting. You have a name problem at the point of attack what you do to keep yourself clean. Then you have this problem that seems to be more daunting for us here in the u. S. Which is, well then how do you anticipate who might have this, and how big a circle of humanity we need to draw around them. And that takes us back to this blood test that you guys were talking about earlier. Dr. Mccormick. We dont have to wait 21 days every time. And have people in quarantine, right . No. What could we do and why arent we doing it in. There are three things we can do in terms of screening. They come up at different times. One is the blood test for the virus itself. And that takes depending on the dose of virus, the initial dose, that takes some time. And it may take, the average incubation period is 6. 3 days. So certainly by that time you would expect to see some virus. And to me, they should be screening for that. Secondly, we grow a group of white cells, called lymphocytes, the ones that make antibody, are wiped out by this virus. One of the early signs and thirdly, we know a Certain Group of molecules called cytokines go up or down, depending on which ones you look at. All or some of those could be used to help screen and profile someone to see whether in fact they appear to be developing the disease. Dr. Fisher, i want to bring you back into the conversation. I think its important to focus on the fact that youre part of the group that will be looking at the new guidelines. In terms of working out the guidelines, one of the important aspects of this is not only setting the protocol, but then making sure that it is fully, its fully expressed to all medical professionals around the United States. Thats one of the things were hearing from the nurses union, theyre saying we are not protected, we dont have the information and we dont even have the proper equipment. So in terms of that, is the cdc doing enough to lead this fight . So i should clarify to say that i havent been invited to review the newest protocols yet. What i would say is that the cdc is doing actually a remarkable job, i can tell you they are working 24 hours a day, seven days a week. And they are doing incredible work. But i think there are things we can do better. First, i think weve got to shift the focus from blame to action. I think we cant, cant sit around and talk about whos to blame and where and what went wrong. We have to focus on how to fix the problem. One of the ways we fix the problem is focus on process and equipment and then send it out to everybody who is going to be involved. So what i mean by that is saying one set of equipment to wear. One set of personal protective equipment. Standardized. Exactly. Standardize the process, every time you change the equipment, you have to change the process. And absolutely. Were going to have to train everybody. Because you dont get to decide who comes to your door at your hospital door. We have to be prepared for anyone to show up. Very good point. Not trying to blame. But trying to figure out where the points of weakness are. Dr. Fischer to make sure. Because the fact is there are two Health Care Workers right now who are critically ill and we dont know how theyre going to do. Hopefully theyll get the right treatment. Want to say a big thank you to dr. Fischer for joining us and dr. Van tulleken and dr. Mccormick. What weve seen here fairly clearly is that the cdc while working very hard, is working very hard at message is yes, were good, we understand now. And sometimes it gives you a sense of false confidence and you have to be very selfcritical about a situation like this remember how it started with mr. Duncan walking into this hospital, saying he had been in west africa, saying he didnt feel good, and getting sent home. And theres a difference between working hard and working smart and so we need to figure out how the cdc can improve Going Forward. Theres clearly been some gaps. Were at that phase and well be able to figure out how to do it better the next time and unfortunately it looks like there will be a next time. Were going to have more on this. Talk to congressman Pete Sessions, he represents the district with texas Presbyterian Hospital. Well get his take about what theyre going to do there to help the situation Going Forward. His room is ready,you alert thed ya know what salesman alan ames becomes . I think the numbers speak for themselves. Im sold a selling machine ready for you alert, only at lq. Com. Only abreva can heal it in as few as two and a half days when used at the first sign. It penetrates deep and starts to work immediately to block the virus and protect healthy cells. Dont tough it out, knock it out, fast. Abreva. When diet and exercise arent enough, adding crestor lowers bad cholesterol up to 55 . Yeah crestor is not for people with Liver Disease or women who are nursing, pregnant, or may become pregnant. 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Well, my take is, chris, were first of all, stunning news this morning, as people wake up across america and in dallas. We have a sad sense of reality. The reality is, that we really dont understand enough about this ebola. I heard the cdc gentleman who was on a few minutes ago. And i think he very carefully described some of the complexities of this ebola virus. The facts of the case are, when this person came to the dallas and to the hospital, this worker actually was probably unprepared to understand exactly the ramifications of this terrible thing. And what we need to do is to isolate people i, i am a member of congress, i have no medical degree. But was obvious to me from the beginning that based upon what ive heard about this ebola. That we should have isolated this person and everyone early on, taken them to a different location where it can be actually treated and isolated in a way, if that is nebraska, then do that. But instead, what has happened over the last two weeks we have seen this administration in the cdc downplay its dramatic effects. There are still 13,000 people with visas from africa, west africa, expected to come to the United States. As we speak. I think we should take stronger action to protect the United States of america, and once again, i am as a member of congress, im asking people to become understanding about this this terrible, terrible disease. Not just in the United States, but now a second case. We do not have the handle we need yet. Congressman, youre saying we should stop all flights, we should close the border . Is that the answer what youre calling on the administration to do . What im calling on the administration to do is we have some 4,000 medical, as i understand it, medical personnel and or military people. Some could be positioned at the airport. We should allow u. S. Citizens, i am not saying we should not allow u. S. Citizens. Even those who may be affected. Weve got to come up with a tools to better identify this and weve not stopped anything from that perspective. Oh, sure, we have people that will look at them when they come to the United States. Well, thats how things get transmitted in airplanes and other areas. Talking about realistic ideas and things to do. Not things that appear to be disingenuous to another country. This is a big problem. And i dont think people are up to the task. What are those realistic ideas . Are you saying we should stop all flights from west africa . What specifically are you calling for . Well commercial flights, certainly. When we say these things, we have an obligation to american citizens. What im saying to you, alisyn is we dont have a handle on how to even look at this for six days. And those tests, as youve heard, are not even available. We dont even have the protective garb down that is necessary to protect the workers. Why would we keep infecting ourselves . Youre making a couple of different points, you do have the, the problem of whats going on in africa. And thats a debate thats going to be had about what restrictions there should be. However, there is zero chance that nobody with ebola winds up in this country. So now lets get to the specific problem as aside to who did what wrong and what the larger policy issue is the hospital in your district is not getting it right. Weve seen that consistently from the beginning with mr. Duncan until now, with these two nurses. They could be doing blood tests, they could be doing other things. There could be a different sense of urgency. What are you going to do to get this hospital more in line with where it needs to be . Because the answer cant be, to ship everyone off who gets it to a different hospital. You have a real hospital there, its a huge medical center, were showing it on the screen right now. You have to be able to do better. What can you do . Well lets suppose that everything, chris, you said is true. You had heard the position on who i suppose is an epidemiologist, who talked about the new procedures, theyre not even sure how it manifested itself. You look at physicians without borders, theyre an organization that is front line in africa today. They hose themselves completely down every single time they have any contact. With chlorine. They do things that i do not think are in the procedures that are done today. Im not, i couldnt tell you one of the procedures, what im saying is, it appears that we have different types of circumstances. I think the cdc needs to understand theyve got to have the protective garb that works well. And the physician who was on ahead of time says we dont have those in place. Before we go once again saying what somebody is or is not doing right or well. We need to look at what is the standard of care and the procedures. And i dont think that theyre as up to date. I think were learning things today. Congressman, let me just tell you what the nurses at texas presbyterian are saying, theyre saying that mr. Duncan was left if an open area of the emergency room for hours. When he first came in. They say that they did not have proper protective gear. And they faced constantly changing protocols. They were given medical tape when they were asked to protect their necks, that was porous and was able to be vulnerable. They had flimsy garments. Are you confident that this morning, the texas Presbyterian Hospital where the second case is now being treated is equipped to deal with this patient . Or should he be transferred out of state . Well look, i think thats, thats not, first of all, thats not my call. Heres what i would say to you. Texas Presbyterian Hospital is reeling from this. And they understand the gravity of this. At the original time that this happened, i dont think they were prepared from my perspective, from what i hear. I dont know that any hospital is until we actually come where we are today in the reality is, were now living and dealing with this. And so look, im with you. Am i into this issue . Is the hospital in regular contact with me . Are the physicians from there in regular contact with me . Am i trying to work with them . Yes. Is the cdc working . Yes. But were behind the curve. Youre aware of the scope of the problem as it stands right now. You know what needs to be done. The protocol and how people stay safe fighting this in places far less sophisticated in the United States are well known. So we know what we can do. The question is, will we get it done . And thats why were coming to you as one of the leaders who is in charge of making sure policy goes in the right direction. So congressman sessions, thank you for joining us, we know you have a busy day, well check back in with you about the situation. Thank you very much and the thank you for the way youre handling this. This community is rocked and were trying to work through this and your effective use of having professionals on to speak about this is most important. And i encourage you, chris, to please continue having people who can speak reason and confidence about how we can effectively fight this. And i think my side is the policy and ill continue with the cdc in this administration on that. All right. Congressman, understood. Lets get you over to michaela. We want to take a look at weather. Were going to turn to chad myers, our meteorologist, we know weve all been enjoying fairly nice autumn. You say in the northeast that might start to change . Youll get a little bit wet. Long time no see for you to me. Rain showers from dubois to charlottesville. The story for the rest of the day and rain into new york. It feels tropical in new york. Theres a plume of tropical moisture. Walk outside, the relative humidity is 100 , that will be fuel to the storms youll see the next couple of days. Even d. C. And baltimore under flash flood watches for all the rain that could come down. Almost four inches of rain possible today. 69 right now in new york city. Probably headed up to around 75. Were watching gonzalo, a category 3, soon to be category 4 hurricane that may make a run at bermuda over the weekend. And one more thing anna, making a run at the big island and all of the entire Hawaiian Island chain. Thats friday night. Heres saturday morning. Thats a category 1, 90mileperhour storm heading to hawaii, better watch out. Ailsen . Chad, thanks so much. We will watch out. More coming up on the breaking developments in dallas. We have breaking news, another case of ebola has been diagnosed there. The cdc now says more should have been done after it was determined that Thomas Eric Duncan had ebola. Well have more on what the cdc is now doing moving forward. train horn vo wherever our trains go, the economy comes to life. Norfolk southern. One line, infinite possibilities. And youll see just how much it has to offer, especially if youre thinking of moving an old 401 k to a fidelity ira. It gives you a wide range of investment options. And the free help you need to make sure your investments fit your goals and what youre really investing for. Tap into the full power of your fidelity green line. Call today and well make it easy to move that old 401 k to a fidelity rollover ira. You need to see this. Show em the curve. Do you know what this means . The greater the curvature, the bigger the difference. [scifi tractor beam sound]. Sucked me right in. Its beautiful. Gotta admit one thing. Cant beat the view. Introducing the worlds first curved Ultra High Definition Television from samsung. A Second Health care worker diagnosed with ebola after helping treat Thomas Duncan. Leading to fresh criticism of the cdc for not acting fast enough after the Liberian National first reported his symptoms. Lets bring in dr. Sanjay gupta from the cnn center in atlanta. We just had congressman Pete Sessions from texas on and he seemed to be suggesting that any patient who shows up now with ebola or with symptoms should go to a Specialized Hospital like nebraska or emory. Because theyre really the only ones equipped to deal with it. What are your thoughts . Well you know, i would be disappointed if that were the case. I see that there is growing momentum towards that. But i do want to clarify a couple of things. On one side, were talking about this in the context of preventing additional cases. Secondary cases and the second part of it is treatment. So we know theres no specific treatment for ebola. We know nurse pham for example who is in the hospital now got a blood transfusion. Which is the same thing that she would have probably gotten at emory or nebraska, wherever she is its really the first part of the question, i think alisyn. How well can you prevent secondary infections. My concern and my point is this patients could show up anywhere in the United States. Theyre not going to necessarily show up in georgia or nebraska. Go to the hospital, they come in contact with someone in the emergency room and health care providers, theyre going to come in contact with lots of people there. Regardless of whether these designated centers are set up. So the designated centers arent going to do anything to prevent people from still going to their local hospitals Emergency Rooms. Then the question really is the treatment better at these places . Perhaps, we dont have a specific treatment for ebola. Not something thats been, thats a gold standard. So the treatments could really be given anywhere. I get the concern. But i do wonder if thats the best course of action. To just set up a couple of places and send everyone there. I dont know that we can do that. As weve learned in texas, the protocol either wasnt followed or it wasnt understood. But there was some sort of breakdown. So starting today, is there some sort of effort at hospitals across the country, to have a consistent and effective protocol . Is someone teaching nurses today how to do this . They say that they are. And they say that they did as well. Theres two problems. One is that not all the hospitals did get the training, up to 75 , 76 of nurses said they didnt feel comfortable. And two is the trainingself doesnt seem to be in line with what we know has worked with groups like Doctors Without Borders in central and western africa. I showed the training, i did it exactly by cdc guidelines and there was still skin showing. Which we know could be a potential source of contamination. So the training has to get better. But what were training as well has to be very clear. Your demonstration was really compelling. Were going to show all of it later in the program. Dr. Sanjay, thank you so much. Were continuing to follow the breaking news. How will the u. S. Respond to the later ebola diagnosis. Well speak with one of the leaders of the u. S. Response, next. Hey so im looking at my bill, and my fico® Credit Scores on here. We give you your fico® score each month for free awesomesauce wow the only person i know that says that is. Lisa . Julie . at discover, we treat you like youd treat you. Get the it card and see your fico® credit score. Is we begin with breaking news, another texas Health Care Worker testing positive for ebola, raising fears of a possible outbreak. The worker was isolated with a fever last night after working with the team that cared for the late Liberian National, Thomas Eric Duncan. Nurses at texas Presbyterian Hospital are going public with their own claims that this is no surprise. There is a lack of ebola protocols within their embattled facility. They had a list of grievances that they say will lead to exposure of people trying to save lives, cnns coverage of the crisis begins this morning with senior medical correspondent Elizabeth Cohen live from dallas. Elizabeth, this is not new. Weve been hearing from Health Care Workers, specifically the nurses from the beginning, the question is, not whether or not theyre telling the truth. But whats being done about it. Right. Exactly, chris. And certainly this second infection with ebola among a Health Care Worker, raises the question is this hospital capable of safely taking care of ebola patients in our other hospitals in the United States, safely capable of doing so. Breaking this morning only four days after Critical Care nurse nina pham was found to be infected with ebola, a Second Health care worker has been diagnosed with the deadly disease, the hospital staffer, at Texas Health Presbyterian, is one of 76 Health Care Workers who provided care for the nowdeceased ebola patient, Thomas Duncan. According to the hospital, the staffer was immediately isolated after an initial report of a fever tuesday. The cdc says theyve interviewed the patient to identify any contacts or potential exposures in the community. Our nurses are not protected, theyre not prepared to handle ebola. Another infection on the heels of shocking new allegations from unnamed nurses at the hospital who say there were no protocols to deal with duncan. On his return visit to the hospital, mr. Duncan was left for several hours, not in isolation. In an area where other patients were present. All this, released by National Nurses union. The union wouldnt say how many nurses came forward. Nor would they identify them. The nurses say protective gear they wore left their necks exposed. The nurses raised questions and concerns about the fact that the skin on their neck was exposed. They were told to use medical tape wound around their neck, that is not impermeable. The hospital did not address the allegations drktly but said in a statement patient and employee safety is our greatest priority. Were not waiting for the results of our investigation, were immediately changing any procedure that we think can be improved to increase the safety of those caring for her. But an official close to the situation tells cnn that in hindsight, duncan should have been transferred to emory or nebraska, hospitals that are more than ready to treat ebola. Remarkably pham, the first person to contract ebola within the u. S. Says shes doing well and feels blessed to be cared for by the best team of doctors and nurses in the world. I know for a fact nina is somebody who never shies away from safety. We have an entire department on Infection Prevention and Infection Control in the hospital. Were briefed almost monthly on Infection Control. I want to read exactly what that official told me. The official said if we knew then what we know now about this hospitals ability to safely care for these patients, then we would have transferred him to emory or nebraska. Meaning Thomas Eric Duncan, the original patient. Its important to note, this hospital has treated one ebola patient, two Health Care Workers got sick. Emory and nebraska collectively treated five patients, no Health Care Workers got sick. Alisyn, chris . Obviously the important question is going to be why is that . Is there something thats being done differently in or being done bet centre we have to learn Going Forward. Alisyn for more discussion on this. Were going to talk all about that, chris. Joining us now is dr. Anthony fauci, director of Infectious Diseases at the National Institutes of health and cnns chief medical correspondent, dr. Sanjay gupta. Dr. Fauci, when you woke up and heard our breaking news that theres another patient who has been diagnosed with ebola in texas, what did you think in. Well, its extremely disappointing and sad that this individual got infected. It didnt surprise me, because it was very clear that the conditions that led to the infection of nina pham clearly were the conditions in which this person was exposed. So i was not surprised. I was saddened and disturbed. So clearly there was something that went on in that setting, that did not totally protect those Health Care Workers. And thats something that has got to be changed and thats the reason why the cdc has sent their team down there, to try and find out what went wrong and to make sure that doesnt ever happen again. And that hospital or any place else. Dr. Fauci, it sounds like there were many things that went wrong in texas. This morning, the thursdays are going public with the conditions. Let me read to you their list of things that worried them. Number one, they say that Thomas Duncan was left for hours in an exposed area before being moved into isolation. Number two, they say that patients who were exposed to duncan were only kept in isolation for a day before then being moved to areas around other patients. Number three, the nurses treating duncan were caring for other patients at the same time. Number four, preparation for ebola. They say at their hospital, texas presbyterian, amounted to little more than quote an optional seminar for staff. Number five, in the face of constantly shifting guidelines, nurses were allowed to follow whichever guidelines they chose. Thats, this is an incredible disclosure from the nurses. What will happen today at hospitals Going Forward as a result of this . Well first of all, i have no reason to not believe what those nurses are saying at all. If thats true, thats clearly not acceptable. So right now, as youve heard, what the cdc is doing, they will deploy top teams to any hospital that has an ebola patient. Number one, number two. Instead of there being passive training, go to a website, heres a piece of paper, to actually have drills, where you have people who are experienced in this, practicing with individuals in hospitals, about showing them what to do. And thats exactly what you heard from the cdc. That theyre ratcheting up in a much more proactive way as opposed to passive training. Dr. Fuchi, how could this have happened . How could these conditions have been in place when Thomas Duncan showed up . I cant explain it, were going to have to go to the hospital and find out. Which the cdc is there on site trying to find out what went wrong. I think Everyone Needs to realize you cant deny it something went wrong in that hospital. Those two people should not have gotten infected. Sanjay, we know that Thomas Duncan, they believe yesterday, it came out, that he was in contact with 70 separate people. Who as of yesterday, were under observation. Two of those Health Care Workers now have tested positive. Do you think there will be others . Most likely, i mean you know, its hard to say. You dont want to say that. Because you hope it doesnt happen. But look, we dont entirely, were not entirely sure why these two Health Care Workers became infected. So until you can really pinpoint that down, you know i think its going to be challenging. I know you just asked dr. Fauci the question what happened at this hospital. I hope that the hospital comes forward and says, if they can figure out what happened. Not because you know, they want to beat up on themselves, but because i think theres probably a lot to be learned here for other hospitals, something really did not work. I made this point before, alisyn. It can work, weve seen people really stop transmission in really tough spots around the world. Central and west africa. In the past. I mean you know, not having transmission from Health Care Workers, from the patients. And i think the fact that you have this wonderful hospital, the hospital that has lots of resources and now two people have gotten infected from one patient . Its crazy. If i could ask a question as well, alisyn, just pragmatically, dr. Fauci, i know one of the vaccine trials, something youve talked about. Theres obviously a lot of interest and the idea that you could start to possibly protect Health Care Workers who are understandably frightened. Is there any consideration to fasttracking a vaccine of some sort . I know that theres one at the nih. Are there other things that could help more immediately . Dr. Fauci . Well, first of all, sanjay, good question. We are fasttracking it really quite fast. Right now its in the phase 1 trial. We have all 20 of our volunteer there is. We want to clear them for safety and then were going to go out into an expanded trial that will be involving a larger, larger number of people. Including in west africa, specifically in west africa. There will be people involved in the trial that will have access to the vaccine. Its going about as fast as any vaccine trial that ive ever been involved with over the last few decades. Dr. Fauci, there are more things coming out from the nurses. And i dont mean to harp on this. But i just want to read some more. They just came out this morning and this one is particularly eyebrowraising. Nurses were forced to use medical tape to secure openings in their flimsy garments. Worried that their heads and necks were exposed as they cared for the patient with explosive diarrhea and projectile vomiting. Why were they just using medical tape to protect themselves . I cannot explain why they were doing that. If theyre claiming that thats happened, i believe them certainly. I have no reason not to believe them. But if in fact that happened, that is not acceptable. That that happened. Thats not acceptable. That would put them at risk. A, to have exposure of skin. And b, for a tape, when you pull the tape off, you erode, you could inflame the skin. That is not a good idea. Dr. Fauci, we really appreciate you coming on. We always appreciate hearing from you. We know youre busy, were going to et let you go to attend to the breaking news. Sanjay, i want to continue with you. When you hear this list of complaints from the nurses, how confident are you that there are not other hospitals around the country, this morning, that are equally illprepared . Well let me address the last point you brought up with regard to the medical tape. The scenario is this, we showed essentially what the protective garb as outlined by the cdc would look like. You know putting it on, taking it off. This is the guidance that the centers for Disease Control has been providing to hospitals. And you know, a couple of days ago we showed that in fact the neck was exposed. And so you know, if you can imagine youre told these things about ebola. You hear that the bodily fluids could potentially cause an infection and your neck is exposed. Theyre told to put this medical tape on. You know to answer your question in some ways, its not even so much that the guidance wasnt there, its that the guidance is not good guidance. It doesnt seem to fit with what we know about the science of ebola. If it can pass through any place in the skin where you may have a break, even a break that you dont recognize for example on your neck, then you got, you go the to protect the skin. It sounds very simple, but it just didnt seem to happen here. Even if they had followed it to a tee. So again, this morning, is there some sort of massive nationwide Training Session that hospitals, Health Care Workers and nurses are sitting in . Well i dont know. I know theyve been doing these large sort of remote Training Sessions. I think theres people who are going to hospitals like the one in dallas, and providing training. I dont know if theyre going to all hospitals. I can tell you when i was at the cdc a few months ago in their kmond and control center, they were talking about the fact they were doing these large calls with e. R. S, primary care docs, frontline doctors all over the country and going through the guidance. So some of that information may have gotten out there. But the problem again is that surprisingly, and i think you know, given how much time theyve had here, surprisingly its not good guidance, it doesnt seem. Even if you got the guidance out there, its got to be good guidance. And thats the part thats particularly, worrisome to me. Its not that challenging. Were not talking about some new experimental vaccine or experimental medication. Were talking about covering your skin. Covering your skin, ba us thats how you get ebola. If youre a Health Care Worker, taking care of a sick patient, thats the time theyre most infectious, thats why Health Care Workers do get sick cover your skin. Why that didnt happen is very concerning. We can see the confusion. Sanjay, thanks so much for explaining all this. We will check back in with you, but meanwhile, lets go over to chris. I think sanjays frustration is well warranted in this situation, because it is something that is not complicated to do. Sanjay himself has brought you stories about it being done effectively in the middle of nowhere in west africa where its done in tents, let alone in a topnotch facility like texas presbyterian that takes us to accountability. There are a lot of different people involved. A lot of different agencies and alphabet soup ak ro acronyms, l to jake tapper talking to someone in charge down there in texas about how they perceive how theyve done so far. I can tell you from hearing that, they did a terrific job of caring for mr. Duncan. And protecting their employees. What youve said just isnt true. They didnt do a great job. A great job is when you treat an ebola patient and he survives, not you turn him away from the hospital and then he actually gets worse and then he comes back and then you treat him and then he dies. And no one else on staff gets ebola. All right. Now it seems painfully simple. Jake tapper talking to the former president of the dallas medical association. This comes down, lets bring back in Alexander Van tulleken, a doctor obviously and dr. Joseph mccormick. Good to have both of you here. Accountability matters in a situation like this its not about a blame game. But its about whos in charge, whos doing the right thingsments because this is not indepth science were talking about. What do you see with the experience youve had, dr. Mccormick in dealing with ebola outbreaks and what it takes to get it right. What do you think is going on here . I think there was a certain level of confidence that was probably misplaced. The cdc has been there, i dont know what theyve been doing. But theyve been there. Clearly theyve been in contact with the hospital. And yet, all of the litany of things that weve just heard were not done. Because the nih and the cdc both say they, they, they, but dr. Van tulleken, they are they, right . Theyre in charge, theyre there in the hospital, they could be changing protocols like that, they know what to do. When you hear Anthony Fauci saying this shouldnt have happened. The necks br exposed. You follow the protocol exactly and yet can you still get infected. So the sense i have is that weve been playing catchup with every single aspect of this. And even when we had an infected nurse, we didnt take those other 70 people who were in the same situation as her, isolate them, start doing serial blood tests the start quarantining them. Monitoring them. So we still have the sense of well, were working on protocols, there are people literally right now as we speak, in that room, having to follow some kind of protocol. We were just discussing, what are they doing . Do they now have this is something that will be an insight for people watching. When youre running a hospital and Something Like this happens and you have monsters falling on your head, with big federal agencies, it causes paralysis by analysis, so many people telling you what to do, you do nothing. Do you think with all the obvious things that are are being missed here, we may be dealing with that as well. We may well be. I think we should have started to ask ourselves a lot more questions, after the very first of this episode when mr. Duncan came back. That should have raised red flags right there. And somebody should have been asking questions about, okay, if you blew this one, what are you going to do next . And we, im not sure that happened. And it mae well be that simply theyre overwhelmed with the enormity of this, the press coverage, im sure theyre getting hundreds of phone calls. Look, way down in south texas, 500 miles away, we were getting phone calls about my cousin says theres a case over in Valley Baptist Health center. This, people have unrealistic, but there are fears, i suspect more of this is going on in dallas. That may be adding to the whole paralysis of unable to change. And then we heard dr. Haley say oh, everything is fine and they did a great job. Dr. Haley is an old friend, but i miss disagree with him. Thats not a great job . Not a great job, no. Well get back to breaking news. Defeating isis will be a tall order, president obama acknowledging that while meeting with Coalition Military leaders. He says the two dozen countries are united behind this longterm campaign. Isis advances, continue in syria and iraq, despite relentless air strikes. Militant fighters are poised to launch an attack on a major air base in western iraq. New details emerging now about the accused gunman who killed one american and injured another at a gas station in saudi arabia. The Saudi Embassy says the shooter is a 24yearold dual u. S. And saudi citizen who worked with the victims until he was recently fired for drug issues. The two workers, two victims worked as defense contractors. The shooter was injured in the shootout with security forces. Overnight, violence erupting once again in hong kong. Police fired pepper spray into a massive crowd of demonstrators who are trying to take over a major road outside government headquarters. At least 45 people were hauled away in handcuffs, meantime, officials in the country launching an investigation into a video allegedly showing a pro democracy demonstrator being beaten by plainclothes officers. Another big recall to tell but this morning, this time toyota recalling nearly 1. 7 million vehicles worldwide, including more than 400,000 here in the u. S. These recalls address brake problems and fuel line problems. They could possibly cause fires. Toyota says it is not aware of any crashes, injuries nor deaths as a result of those defects. But we wanted to pass that along to you. Chris, alisyn . Thanks so much. How can screening at airports stop ebola from entering the u. S. . Temperature checks can help. But Thomas Eric Duncan would have gotten cleared anyway. Well discuss what other steps can be taken. His room at laquinta. Com, he gets a ready for you alert the second his room is ready. So he knows exactly when he can check in and power up before his big meeting. 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Quitting smoking this time was different because i talked to my doctor and i. I got a prescription for chantix. Along with support, Chantix Varenicline is proven to help people quit smoking. It was important to me that chantix was a nonnicotine pill. The fact that it reduced the urge to smoke helped me get that confidence that i could do it. Some people had changes in behavior, thinking or mood, hostility, agitation, depressed mood and suicidal thoughts or actions while taking or after stopping chantix. If you notice any of these, stop chantix and call your doctor right away. Tell your doctor about any history of Mental Health problems, which could get worse while taking chantix. Dont take chantix if youve had a serious allergic or skin reaction to it. If you develop these, stop chantix and see your doctor right away as some can be lifethreatening. Tell your doctor if you have a history of heart or blood vessel problems, or if you develop new or worse symptoms. Get medical help right away if you have symptoms of a heart attack or stroke. Use caution when driving or operating machinery. Common side effects include nausea, trouble sleeping and unusual dreams. I am very proud. I love myself as a nonsmoker. Ask your doctor if chantix is right for you. He flew into the u. S. And did not show signs of ebola until after he landed. We know when he told the hospital of where he had been, they didnt react. However, lets deal with the air travel. Precautions are now in place at airports that likely would not have stopped mr. Duncan from entering the u. S. Ultimately ending up in dallas. What are the new precautions . Can they be effective . Does the u. S. Need to consider something more severe . Lets bring in miles obrien, cnn aviation analyst. Lets start with the extreme. We just had congressman sessions, the hospital in dallas is in his district, so hes relevant here. He says 4,000 people with passports are out there. We cant control the travel. Just isolate. Isolate for now. That gets a lot of pushback. Your take in. I dont think its possible. Were all on the same planet here and isolating this kind of thing is not going to happen. Stopping flights . Well you know, think of the humanitarian consequences of that. These are poor nations that are relying on the airlift capability. Allow humanitarian aid, but no other travel, do you think we can do it . I dont think its possible and i think the consequences of that are so great and so draconian, that i think it is better to approach it the way it is being approached now. Lets bear in mind is not another traveler that has caused the spread. Were talking about Health Care Workers who may or may not have been using proper procedures who came in contact with one person who got in before what were talking about was in place. He was traveling, asymptomatic, this was before the level of screening and the questionnaires, we have to rely on people having candor about where theyve been and who they were in contact with. Lets hope that people will do that we cant assume that to be the case. Think with proper procedures, taking the temperatures at various steps along the way on the trip and hoping that people are at least candid about who theyve been in contact with this can be nipped without doing the measure of shutting down these countries who are in desperate need of help right now. How are the screenings going . Ive been looking at it, i find it kind of surprising that in paris and in brussels they havent started screening. Most of the direct flights are going through those places. Now weve got them at jfk, thats good. Heathrow has started it up right now. It would be good if that first stop along the way, and you know frankly, lets you know, defense in death is they use a nuclear power. You want to have several layers of safety along the way. If you dont catch it at brussels and paris, if you dont catch it there, youve exposed an entire plane on a transatlantic flight. I was just at Logan Airport two days ago. We flew in and there was a plane completely surrounded by crash trucks. It had come in from the middle east. There were four people on there who had fevers and they had completely cordoned it off. You say well thats an overreaction. In this context, maybe its the right thing to be doing. To presume this to be ebola. I think the system now has awakened to this youre not going to have a repeat of the duncan situation exactly as it played out. I wonder, because you know, mick and i have been wondering about this since it began. You have this 21day thing. Where you dont know right away if somebody has it you have all the different ways to get into the United States. You have influenza. You have false positives. It just seems that if youre looking at this as a way to stop it youre looking in the wrong place. So interesting what we were talking about. Is that dr. Mccormick was just on air, talking about how instructive it is, that its Health Care Workers that are getting sick. Its not the family members and so far we havent seen people on the planes getting sick. Does it seem efficient the way its being done in. I havent heard any ripple effects to this. The temperaturetaking is a very nonintrusive procedure and pretty quick. Only a few people. And theyre honing it down to a small group of people coming out of these countries. Think when you consider the grand, the layers of security we already contend with. This is just kind of the rounding era kind of stuff. I ask it because then you can make it keep happening. If its cumbercumbersome. Well get rid of it. And you look at history. What happened with sars in asia. This, they were actually able to do this in a way that didnt slow down the system and choke it. Miles, thanks so much. Were going to have more breaking news this morning, with another case of ebola at texas presbyterian. Nurses are furious about the lack of protocol. Wait until you hear the laundry list of complaints they have. Health care workers are speaking out about it. We will talk to a furious head of the nurses union about the latest developments. And Dallas Health officials are getting set to brief reporters on the latest case at the top of the hour. Well bring it to you live so you can hear from them what they say the situation is a single ember that escapes from a wildfire can travel more than a mile. That single ember can ignite and destroy your home or even your community you cant control where that ember will land only what happens when it does get fire adapted now at fireadapted. Org. Nurses are steaming mad after this latest case of ebola diagnosed in texas presbyterian. Theyre angry about had they say is a lack of protocol when Thomas Eric Duncan is being treated. Now frustrations build as nurses try to insure their own safety. Lets bring in karen higgins, copresident of the National Nurses united. Shes an intensive care nurse at Boston Medical Center and she represents the young that tries to protect nurses. Can you hear us . Yes, i can, no problem. From your perspective, now its its been two different nurses who have gotten ebola from trying to save a life. Do you believe this needed to happen . And if not, why . No, it didnt need to happen and it shouldnt have happened. Its really seriously time to have cdc take a stand with the hospitals, because what theyre being told is every hospital is ready and they can accept these patients and provide care. And in reality, what is going on is exactly what happened in dallas. Is that you know, its good, words out of your mouth, but in actual practice, what do you have, what is the equipment thats available, they need to make a stand and say you know what, no more having protocols that keep changing. They keep adjusting. Still are not protecting the Health Care Workers. They need to make a stand and say you know what, there is mandatory equipment that cdc uses, that we want, and we want to have it in our hospitals, so that if a patient shows up, that we know we are protected. Taking care of that patient. And who is they . I think its important for who is they, who do you believe is in charge there . Is this about the cdc . The people from the state . Is it about the people running the hospital . And just to be clear, the Second Health care worker who has the virus, we dont know that theyre a nurse, but so many are doing the same jobs there that the criticism goes to all of it in terms of who is being protected. Who is they . I think they is all of them. I think the cdc has to take responsibility, theyre the ones that have accepted that the hospitals keep telling them theyre ready. It is Public Health in the states that have to take responsibility. Because theyre in the states, they need to know that the hospitals are prepared. And absolutely. The hospitals. Absolutely. You know, it is were hearing from nurses across this country. No way do they feel theyre ready to take ebola patients and yet we continue to hear the hospitals repeat, repeat, yes, we are. Its shameful. To your point, the litany of complaints that the nurses in dallas have had, theyve come, theyve made them public this morning and they are eyebrow raising. Number one, Thomas Duncan was kept in a nonisolated area of the Emergency Department. We knew that, for several hours, potentially exposing many other patients. Number two, patients who may have been exposed to duncan were kept in isolation only for a day afterwards. Before being moved to other areas of the hospital. Number three, nurses treating duncan were also caring for other patients in the hospital at the same time. Number four, listen to this one, karen, preparation for ebola at the dallas Presbyterian Hospital amounted to little more than an optional seminar for staff. Number five in the face of constantly shifting guidelines, nurses were allowed to follow whichever ones they chose. How can nurses feel safe today with what they might be facing with ebola . Thats the problem. I would say to you, isnt it shameful what happened in dallas . I can guarantee you this would happen in most of the hospitals across the country, given what the nurses are saying. This is what im saying it has to stop. Its not fair, not just for nurses, for anyone in the hospital that will have contact with that patient. The prit pright precautions have taken and somebody has to take a stand and say we have to have the highest protection we possibly can. I have an icu nurse, i have no problem taking care of a patient with ebola. As long as you provide me the safest equipment and allow me to go into the room knowing i am safe youve done Everything Possible to keep me safe. Thats not happening in hospitals across the country. What are you hearing about what the nurses are saying at this hospital . You know, ways not in on the conversation that they had. But i think obviously theyre very scared. And theyre very upset. And they felt like they were basically, right from the beginning, which was really upsetting, is that the fingerpointing was at them right away. Theyre the ones that were at fault because they didnt do the right thing. They did do the right thing. They were taking care of the patient. The hospital was not doing the right thing, and that was taking care of the employees there and making sure they were safe. Karen why do you feel so confident this morning in boston . Why do i feel confident . You said you could, youre prepared for anything as long as you have the right equipment. So youre still at work and you feel as though you will be prepared for whatever you encounter. Well im hoping i would say to you, do i feel really confident . I dont feel really confident at this point. I feel like things are now due to whats happening in dallas. I would say that our facility is taking much stronger steps to provide much more Safety Equipment and much more better equipment than they had. Do i, you know, until i actually see it and actually go, make sure that were not just seeing it, that were being taught and setting out hopefully programs that we will do oneonone teaching of how to get in and out of this equipment safely and keep people from being contaminated. That is the next part. Its not just having the equipment, it is investing and makinging sure we all know how to use it safely. Im saying, you do that and i will be okay. You dont do that, and thats right, youre putting all of us in the same position you put those dallas nurses in. And that is not acceptable. And that should not happen. I understand. Thank you for explaining all that karen higgins, thanks for being with us. Best of luck, well talk to you again. Thank you, byebye. More on the breaking news straight ahead. Is the cdc doing enough to help hospitals keep workers safe . It doesnt sound like it. Should the Obama Administration be doing more . Dallas Health Officials are getting set to brief you on the latest case, were going to have reporters there. This will happen at top of the hour, well bring it to you live and you can hear from them if they think theyre getting the job done and what needs to happen. Its happening. Everywhere. People are dropping their pants for underwareness, a cause to support the over 65 Million People who may need the trusted protection of depend underwear. Show off a pair of depend and show them its no big deal. Because hey, its just a different kind of underwear. Join us. Support the cause and get a free sample of depend at underwareness. Com get 4 lines for a hundred bucks. With unlimited talk, text and now up to ten gigabytes of 4g lte data. Plus hook up the family with the Samsung Galaxy s5 for zero down i got this. [thinking] is it that time . The son picks up the check . [thinking] im still working. Hes retired. I hope hes saving. I hope he saved enough. Who matters most to you says the most about you. At massmutual were owned by our policyowners, and they matter most to us. Whether youre just starting your 401 k or you are ready for retirement, well help you get there. Lets bring in cnn political commentator and republican strategist anna navarro and cnn political commentator and editor in chief of the daily beast, john avalon. Critics of the president say he should have done more sooner. We heard from congressman pete session who is say the administration has been not proactive enough. I think that may be true but im not sure this is time for the blame game. There will be plenty of time to dissect what could have been done and should have been done earlier. I think its time to pull together as a country and our government, we need our government leaders, our congress and our administrative leaders to pull together and get a plan implemented and execute that plan. To address what is an urgent issue. If this dissbeg greintegratedis political blame game and say president obama has been playing the violin while rome is burning, we wont get anything done. We need to get the issue addressed and then we can blame each other. But the illness in dallas looks like a paper cut. It gets to the urgent question, whos in charge . Because you know that hospital in texas is now inundated with alphabet soup, nih, cdc, the white house, everybody is leaving meetings and making phone calls and come back with new instructions, who is leading . Youve got a panicked environment and no one clearly in charge. The head of the cdc, tom friedan seems to be the head of the movement. That adds to the confusion, not only communicating to the American People and on the ground more importantly. Now you have cdc admitting that this hospital wasnt really prepared in terms of protocols. This is where duncan ended up. Were dealing with the circumstance now. I appreciate the reasonable republican to my right saying we shouldnt politicize it. We know this close to an election, its get be politicized. Just because we shouldnt politicize it, doesnt mean we shouldnt act and have a plan. It does feel like we are behind the 8ball. Three weeks ago i flew to nicarag nicaragua, second poorest country in the hemisphere. What theyre doing now in the states when people come in from africa, they were doing three weeks ago. Wanting you with a noncontact thermometer and asking to you fill out a questionnaire. The United States started doing it one dead ebola patient later. Why are we so behind the 8ball on all of this . What about that claim, there should have been a point person, there should have been someone in charge. Its always interesting when republicans say we need another czar. Obviously they often claim the federal government is too big and we dont need more bureaucrats running around. Has there been an absence of somebody spearheading this or has it fallen in the lap of the cdc and thats where it belongs . I think theres an absence of a clear leader in charge and somebody who can put all the different heads of the dragon together and speaks and coordinates the Interagency Task forces, thats one of the hardest jobs you can have in government. A coordinator of all different agencies who all want to be in charge. Thats why you sometimes have agencies like the office of Emergency Management to coordinate the agencies. I think the president youre going 0 see further action on this. Theres a panic we need to cool while confronting the reality of the situation. We havent had a potential pandemic in the United States for a while. This has been brewing in west africa for months. The International Community as well as the United States didnt get on it soon enough. Now the administration has taken proactive action. Weve got troops on the way to west africa to contain this. This will take innovation and focus. Its happening so close to an election that silly season will compound this. I think thats where we should shift to. A lot of this is about the election. Talking to all the experts, thats what we do all the time here. Theres no reason to believe we have even a potential pandemic on our hands. The people getting sick are the people who are treating the sick, it not spreading the way it is in west africa. They dont believe it will. We still have to get it right. That does take us to the politicizing of this with the mid terms coming up and what do you think, ana, in terms of when we look bigbowl. The midterms are coming up, setting us up for 2016. Mitt romney, do you think hes going to wind up being the man again . I dont. I think this is such a, one of these mediafed continuing narratives. The man has said no every which way. Now his wife has said no every which way. Let me show you what his wife said. We do have a full screen of her quote. Because i think she puts a fine point on it here we go. Done period. Completely, period. Not only mitt and i are done, but the kids are done. Done. Done. Done. If you know anything about that dynamic. If anne romney says theyre done, theyre done. Can you put a fork in that, its done. Even if you dont know anne romney, thats six donees in 12 words. A lot of donees. Hes in a wonderful position right now. Everything he has said during the campaign that people laughed at has turned out to be true. Russia, the middle east. He now is the most soughtafter surrogate and fundraiser for any republican running. Everybody wants him around. Hes got the golden touch. Will he go visit, heres the big question even i like mitt romney now. I want him to come to florida. As much as he can. And that will be the key question. Were leave it hanging. Can he help jeb bush coming up . We know ana navarro. If he goes to visit him, then you know he doesnt have his eyes on the prize. Because hell be dealing directly with somebody who very well may. Ana navarro, john, thank you very much. Well give you more on the breaking news in minutes. Because officials are going to set their own News Conference. Theyll try to come out and deal directly with this in dallas, facing questions from reporters and people like you. What do they know . What dont they know . Isis advancing towards a key air because near baghdad. How immediate is the danger to the iraqi capital. We have all the news coming up. Were just as simple . Thanks to angies list, now it is. Start shopping online from a list of toprated providers. Visit angieslist. Com today. When i had my first migraine, i was lucky. That sounds crazy, i know. But my mom got migraines, so she knew this would help. Excedrin migraine starts to relieve my pain in 30 minutes. Plus, sensitivity to light and sound, even nausea. Excedrin migraine works. [ male announcer ] the rhythm of life. [ whistle blowing ] where do you hear that beat . Campbells healthy request soup lets you hear it in your heart. [ basketball bouncing ] heart healthy. [ mm. ] great taste. [ tapping ] sounds good. Campbells healthy request. 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About 110 miles northeast of baghdad in anbar province, already mostly overrun by the militants. President obamas vowing to continue air strikes against the terrorist group after meeting with Coalition Forces saying the effort to dismantle isis is a longterm campaign. We talk about it all with barbara starr, something weve been cautioned about that it is going to be a long campaign. Good morning, michaela. Longterm campaign. At that meeting yesterday with 22 International Defense chiefs, a message came out after the meeting and what the defense chiefs said is while they believe they have the strategic advantage, the big picture longterm advantage over isis right now isis has the advantage on the grouped and you see that at that airbase, youre talking about, the al assad airbase west of baghdad. The u. S. Was there in considerable presence during the war. Now isis fighters said to be surrounding that base, preparing to attack, preparing to take it. If they take the al assad airbase this will give them more weapons, more territory, more capability to launch new attacks. The u. S. Still continuing the air strikes but the question is what is happening on the ground . The real problem right now many will tell you is iraqi forces still unable to launch a counter offensive against isis, despite a dozen u. S. Advisory teams on the ground trying to help them. The iraqis just not able to get the job done. Michaela . There have been concerns about their abilities and their resources. Barbara starr, thank you so much for that. Chris . A lot of what were hearing this morning in terms of anger and frustration has been driven by nurses, the shocking allegations because of whats happening, they say, at a texas hospital, where two people are now infected with the virus. Wait until you hear what protocols, in quotes, they say were ignored by the staff or not taught properly. 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Call Liberty Mutual for a free quote today at see Car Insurance in a whole new light. Liberty mutual insurance. Captions by vitac www. Vitac. Com good morning, welcome back to new day. Chris cuomo joined by alison camerota. New fears taking hold in dallas now that a Second Health care worker has been diagnosed with ebola. The worker is in isolation this morning at texas Presbyterian Hospital. Nurses at the facility are going public with stunning claims about the lack of ebola protocols inside their facility. Wait until you hear the litany of things that went wrong, they say. Well get the latest in a News Conference from dallas in just a moment for you. Our coverage begins there with senior medical correspondent Elizabeth Cohen. What is the latest, elizabeth . Reporter alisyn, i think the numbers say a lot. This hospital in dallas, texas, presbyterian treated one patient with ebola and two workers got sick, in atlanta and in nebraska they collectively treated five patients and no workers get sick. So now people are asking questions, what happened at this hospital . Breaking this morning, only four days after Critical Care nurse nina pham was found to be infected with ebola a Second Health care worker has been diagnosed with the deadly disease. The hospital staffer at Texas Health Presbyterian is one of the 76 Health Care Workers who provided care for the now deceased ebola patient Thomas Duncan. According to the hospital the staffer was immediately isolated after initial report of a fever tuesday. The cdc have interviewed the patient to identify any contacts or potential exposures in the community. Our nurses are not protected. Theyre not prepared to handle ebola. Reporter another infection on the heels of shocking, new allegations from unnamed nurses at the hospital who say there were no protocols to deal with duncan. On his return visit to the hospital, mr. Duncan was left for several hours not in isolation, in an area where other patients were present. Reporter all this released by National Nurses union. The union wouldnt say how many nurses came forward nor would they identify them. The nurses say protective gear they wore left their necks exposed. The nurses raised questions and concerns about the fact that the skin on their neck was exposed. They were told to use medical tape wound around their neck that is not impermeable. Reporter the hospital did not address the allegations directly but in a statement said patient and employee safety is our greatest priority and we take compliance seriously. Were not waiting for the results of our investigation. Were immediately changing any procedure that we think can be improved to increase the safety of those caring for her. Reporter but an official close to the situation tells cnn in hindsight, duncan should have been transferred to emory or nebraska, hospitals that are more than ready to treat ebola. Remarkably, pham, the first person to contract ebola within the u. S. , says shes doing well and feels blessed to be cared for by the best team of doctors and nurses in the world. I know for a fact nina is somebody who never shiz away from safety. We have an entire department on Infection Prevention, Infection Control in the hospital. Were briefed almost monthly on Infection Control. These tests will be double confirmed by the cdc. Briefing reporters on the latest case of ebola and what theyre going to do to make things better. Lets listen in. Like nina pham, this is a heroic person, im sorry, i said like nina pham, this is a heroic person, a person who dedicated her life and is dedicating her life to helping others and is a servant leader. This is a person with their life before them, and a person who is dealing with this diagnosis with the grit and grit and determination that nina has dealt with the diagnosis, and like nina, the protocol to find the virus worked well in that within 90 minutes of taking her temperature. She was in isolation in the hospital, and we hope and pray that like nina, she will get on a good track. As you know, nina has moved from stable to good, and the doctor may have some information on her health when he speaks this morning. So the fight against ebola in dallas is a twofront fight. We have 48 diseased contacts we focused on in the community that were contacts with eric duncan. The good news about those 48 people is they are asymptomatic and have no fever, and we are at the tail end of their monitoring period. Sunday will mark the end of that monitoring period, and the chance of those people becoming symptomatic at this point or getting the ebola virus is extremely remote. However, at the hospital, we have a situation involving 77 people, two of which have tested positive for ebola. We are preparing contingencies for more, and that is a very real possibility. You can imagine the anxiety of the families of these 77 people. You can imagine the gut shot that this is to the family that is Presbyterian Hospital, that has done a great job of taking care of this community for many, many years. I hope this community will rally around the human beings that are suffering and worrying now, even as they go about their calling of serving others. With me today is dr. Varga, the executive Vice President , Texas Health Presbyterian, who will speak next. Mayor Mike Rawlings will speak after dr. Varga, and well take some very limited questions after that time. Were giving you the very limited information that we have at present. We are continuing to get information and will be updating you throughout the day in a variety of ways, and we have some very important work that i need to get to quick, the mayor and i need to get to at the conclusion of this, so dr. Varga . Excuse me, thank you. Good morning, my name is dr. Daniel varga, im the chief clinical officer for texas health resources. I want to thank the mayor, the judge, cdc, state Health Officials and the Dallas County Health Department for their continued partnership as we manage this unprecedented crisis. As others have said this morning, todays development while concerning and unfortunate is continued evidence that our Monitoring Program is working. Currently as judge jenkins says we continue to monitor 75 Health Care Workers in conjunction with the state. While i cannot discuss patient specifics, i can tell you this new patient was involved in the care of mr. Duncan, the original patients who passing we still mourn. Our interests at this time first and foremost is making certain both our current patients receive the care they need, that will remain our focus. The health and safety of our patients and employees remains our highest priority and we will continue to coordinate with owe ifishes at all levels to meet the challenge that ebola presents to our hospital, our community and our country. Lot is being said about what may or may not have occurred to cause some of our colleagues to contract this disease, but its clear there was an exposure somewhere, some time in their treatment of mr. Duncan. Lets be clear, were a hospital that serves this community incredibly well, and we have for nearly a half a century. Were a hospital that may have done some things different with the benefit of what we know today, but makes no mistake, no one wants to get this right more than our hospital, the first to diagnose and treat this insidious disease thats now attacked two of our own. After several weeks of great emotion and great effort our team spirit is tried and tested and the support of so many is really helping everyone to rise to continue to meet this challenge. Thank you. Good morning. Another long evening and morning for many, many people. We rallied together and we decided that we needed to move quickly, like we did sunday morning, to make sure two things happened. One, that effective cleaning was done as soon as possible, and two, neighbors and the citizens were communicated. It is no odd thing that we decided to do this at 7 00 in the morning, so when folks are getting up, they know what the facts are. It is a concerted effort, not only with the county and the state and the city, but individuals out there. This morning, chief brown, chief bright, our city manager, were all working in coordination to accomplish our goals for this morning. Dallas fire and rescue went to the 6,000 block of village bend drive, where they began phase one of decontamination of the common areas and the areas outside the apartment. Our patient lived alone and with no pets. State of texas has hired protect environmental for phase two, that inside the apartment and the cleaning of the car and the movement of the same, removing the same. That hopefully will be done early this afternoon. I personally was at the apartment complex this morning and talked to citizens as they were waking up and moving about, which leads us to the second part of our strategy, communication. We work closely with the apartment managers in creating a strategy that i think is working. Each apartment in their complex was, the door was knocked on and we talked to as many people that came to the door as possible. Same time, the apartment complex will be handing out flyers and information to apartment complexes nearby. So we cast the net a little wider. And then we had reverse 911 calls that went out at 6 15 this morning. Meanwhile, we continue to not only monitor the 48 individuals that came in contact with mr. Duncan, but we take care of louise and her family, who are still in isolation. They are asymptomatic, and they are doing well, and as you know, we moved ninas pet yesterday and are making sure that that pet is well and taken care of at the same time. I think there are two things that i harken back to this. The only way that we are going to beat this is person by person, moment by moment, detail by detail. We have those protocols in place at the city and county, working closely with the cdc, and the hospital. The second is we want to minimize rumors and maximize facts. We want to deal with facts, not fear. And i continue to believe that, while dallas is anxious about this and with this news this morning, the anxiety level goes up a level, we are not fearful. Im pleased and proud of the citizens that i talked to day in and day out, knowing that there is hope, if we take care and do what is right in these details. It may get worse before it gets better, but it will get better. With that, we will take a few questions, all right, and, but there are a lot of questions we cant answer because either we dont know or because testimony and discussion is going to take place later this week, but we will try to give it a go and give you as much information as we can. Well start on this side and take a couple questions here and move to that side. Yes, sir . Reporter this is for dr. Varga. Possible breaches like the second case might suggest some symptomatic institutional problem. I dont think we have a systematic institutional problem. The biggest challenge we have is first and foremost the care of the two patients that we have and the ongoing screening of folks in the community. Our Emergency Department has continued to have folks come in. Its a tribute to the information thats been out there in the community about folks to be aware of this symptomatology around ebola. Our agency has been handling that appropriately. I think the case of this patient here tonight again shows that the ability to intake those folks, get them into isolation and manage them has been very effective but were looking at every element of our personal protective equipment, and Infection Control inside the hospitals. We dont have an answer for this right now, but were looking at every possible angle around this. Thank you. Right down here, you raised your hand. Reporter was this person a nurse . Hearing the questions is going to be difficult right now but the answers matter so were going to keep listening in, and youll see for yourself its evident what theyre discussing. She is a woman. Over here, and then well come back. Go ahead. Are you awaiting test results on any other employees . Because obviously this one was in the wowork yesterday. Thats the states decision and ill let them speak to that. Later today there will be a discussion there will be a joint Conference Call as normal with the cdc and the state. Reporter about this case or another case . About this case. And let me, im not sure what briefing well try to give you perspective on what was just said and why. Lets bring in cnn chief medical correspondent dr. Sanjay gupta, senior senior medical correspondent Elizabeth Cohen. Distinguished professor at the university of arizona, just to reset what we were just listening to, press conference from the officials, local officials, important to note down in dallas here. It was led by judge clay jenkins. That will seem unusual. It is not in this area of texas county. Judge is given power over Disaster Preparedness and this falls under that. Thats why the judge was there, but sanjay, let me start with you. Who was not there is also notable. They said the things you expected them to say. Were doing our best, the monitor is working, the person who has this, a woman, they wouldnt say more than that, is a Health Care Worker, a brave soul doing her job. Where was the fed and where is there an understanding of how to make things better because the person mr. , dr. Varga, said no systematic problem here. Yes, i mean theres a couple of concerns. The first point about the federal sort of authority here i think it surprises people that the centers for Disease Control as much as people think they will sort of swoop in and take care of a situation like this as it occurs, that wasnt the plan initially. We now know theyre going to send teams to dallas to help oversee what is happening there, but that wont the original plan and they dont have specific authority or mandate power in dallas. They cant say you must do x, y and z. So whether that relationships going to change and some make the argument that look, this is no longer just a dallas issue. This is a National Issue that we have to have a federal oversight in some way, you know, that may happen, and i think with regard to the protocols in place, chris, i think theres two issues, just sort of trying to explain this as well as i can. Part of it is implementing the protocols the best that you can and the second part, are they good protocols. And i think both those things matter here. I dont know that these are necessarily the best protocols, because there was still so much skin exposed for example in these Health Care Workers who had direct contact with patients, and thats obviously a big problem. Elizabeth, i heard some new things i want to bounce them off you in this press conference that we didnt know before. We found out this next patient, the second patient is a woman, and they said something that i thought indicated that shes young, he said the judge said like nina, who is a young nurse, this person has their whole life before them. They continue to monitor 75 patients, i think thats awe higher number than we had originally thought. The new patient has no pets. They have canvassed the Apartment Building where this new patient lives and talked to neighbors and they will begin the process of cleaning and doing whatever they need to do in her apartment. What else did you hear, elizabeth . Also i want to touch on the first thing that you said, that this is a woman and i agree with you it sounded like shes young. This doesnt surprise me. This is actually very simple. The Health Care Workers that are most at risk are the workers who, one, spend the most time with the patient, and two, who are responsible for cleaning up. So we dont know perhaps this woman is a doctor, just if you look at gender roles in health care, it probably is a nurse so those are the ones who are the most exposed. Elizabeth, thank you very much. Lets get back into the press room, theyre taking more questions about whats going on there. Reporter the question now is, are others being monitored at the hospital, if we had patients coming down with symptoms early on, are there steps to isolate them now . That will be our last comment. This will be our last comment. We need your help on this. We have 75 people who are hospital workers and we dont want a situation where people are afraid that if they bump into an asymptomatic person who works at a hospital and has been involved in the care of mr. Duncan at the krogers that theyve been exposed to ebola, because what this case further illustrates, these two heroic womens plight illustrates is ebola comes from the body fluids of a symptomatic ebola victim, and thats how they contracted the disease, and thats how eric duncan contracted the disease. You dont contract the disease from being around asymptomatic people. They are regularly testing their temperatures. We are going to set up a place where if if people want to be away from their family, they have the opportunity to do so, or if, like nina, they live alone with their dog and they choose to be monitored there, they can do that. This is not going to be a situation where were going to put protective orders on 75 Health Care Workers. The system right now is working. They are taking their temperature regularly. If they have a slight headache, a slight fever, if they get that i chill because the breeze blows they take their temperature. If they have any temperature or any other, you know, loose stool or any other symptom, they immediately go to isolation in the hospital and they are tested. Reporter its not working. Are they workers . They are employed but not working. Thank you, guys. Thats it. Appreciate it. Lets bring in dr. Richard carmona. Thank you for joining us this morning. It is a little conspicuous who was not there. You have the cdc and nih, do you believe there say need for leadership there especially when you hear one of them say they dont have a systemic problem at this hospital. Well, thanks for the opportunity to comment, and im, like my colleagues, dr. Gupta and Elizabeth Cohen who have covered the story so well, dr. Fauci and tom frieden, at the forefront of this nationally we are all concerned there is a problem from the first case that was diagnosed after mr. Duncan died, we knew there had to be a break in policy, procedure, protocol, the type of equipment being used, and now its becoming manifest because there are many more potential exposures. So i do have some significant concerns because of the complexity of the issue and the fact is that over time, since after 9 11 we put a lot of money, the federal government, into communities to hospitals to train for all hazards, which included bio events such as this. The challenge of course is when you dont have these events for years, these are perishable skills. People forget, if youre not practicing, if youre not staying on the edge of the best science you forget and when something happens gaps occur. So its really important that they work closely with the cdc now to ensure that they have the best practices. So dr. Carmona, when you say there is a problem, do you mean theres a dallas hospital problem or there is a nationwide hospital problem here . I cant speak to a nationwide problem. As Surgeon General i was involved in a lot of the training, education, working with my colleagues at nih and cdc to ramp up after 9 11 to ensure we had the best preparedness programs in place which included bioagents. The problem is after these things happen, our memories start to fade. Our government stops to fund programs. Recertain is not as robust as it should be and so on, so theres a rippling effect that goes out and again the most important thing is if youre not training on a regular basis, if youre not being given the most recent information on a regular basis and going through scenariobased stressful training, these are perishable skills. Understood doctor. Thats where the risk comes in. Sanjay, let me get you back in here, though. Yes you have perishable skills, you have to train and spend the money. However, dr. Fried be when he was in west africa you told me he had on the whole biohazard suit. That is not what these men and women who are doing the work on the front lines in the hospital in texas have. Why not . Why dont they have the stuff that doctor frieden from the cdc had when he went into an ebola exposed environment . I think that that does sanjay, did g ahead. I think that increases the confusion a little bit around this, and whether you say that this is a double standard or you know, he was a Government Official and therefore they just were taking extra caution, you know, i think its a really important point. We see the hazmat suits. We see these full protective suits all the time, and then we hear that its only really necessary if someone has direct contact with patients, but what youre looking at is video of the head of the centers for Disease Control dr. Frieden in west africa touring an ebola facility, not taking care of patients, wearing the full protective gear. Look, again, i dont want to overstate this, maybe it was just because hes a government owe fushl, they said this is what you have to do, but what does that mean for the people who are providing direct care for patients here in the United States, they see their cdc chief not taking care of patients directly wearing all that garb and theyre not wearing the same garb here. That sort of confusion makes it i think even more challenging for people to do their jobs and have confidence. Sanjay, i have a question one of the things dallas officials reported, they touted the success with this second victim, a female, they said within 90 minutes of taking her temperature, she was in isolation. Why not within five minutes of taking her temperature. What is so complicated about getting into isolation . It should not be complicated, alisyn. It should be fairly easy. I think the most important thing at that point once theres a suspicion someone may have come in contact with ebola and have a fever the most important thing, greatly limit the people now in contact with that person and who are is there is properly protected. Whether its 90 minutes or five minutes im not sure. I think the reason they call it a success is because they found somebody early and they will get treatment or get care early and this seems to make a big difference in terms of their overall prognosis. But yes, i mean ultimately if these numbers just start to grow theyre going to have to have a system in place that very, very rapidly addresses what these patients need, and that is to isolate them so they dont get other people sick. The big concern is to make less patients, right, thats why we want to see whats going on in terms of being proactive, getting it right and Going Forward. Dr. Carmona as a former Surgeon General, can you speak to the need for leadership from the top in the press conference we just watched where there is no one on the federal level there and secondly, can you speak to what we keep hearing from experts that you dont have to wait 21 days. You could do blood tests much soon ear long to find out if someone exposed has picked up the virus. Well, all of those are important points, but as sanjay has been outlining, this is confusing because mixed messages seemingly are emanating from the local level to the federal lel so people are confused. Theyre concerned. My heart goes out to this young nurse who has become ill, and one of the things i know because being a rentalstered nurse as well as a physician is that your nurses are often the best barometer of the activity, the operations, and the quality of care thats being produced in any organization, because youre at the bedside 7 24, so these allegations are quite disturbing of using tape to cover a neck that could be permeable and trying to kind of jimmyrig a system apparently that really wasnt meant to be used that way which exposes some of the challenges. I think we should listen carefully to what the nurses are telling us. We need to have the cdc team in there which is what i said, dr. Frieden said, dr. Gupta said early on where there was an apparent break and need to find out where the wreak was and we need to look at our protocols, some several years old to make sure they reflect the best science today. Would all of this be streamlined if we had a Surgeon General in place today . I think it would help. Some fight feel its bias. The Surgeon General is the doctor of the nation, a trusting, authoritative, authentic person that the public relies on for information whether it be smoking, obesity, terrorism, weapons of mass destruction, issues that i dealt with when i was Surgeon General but you are the chief communicator, the chief Health Officer so i think it is important that we have appropriately vetted senior Public Health official who has earned and merits the title of Surgeon General to address these issues and coordinate all of those activities so that one person is speaking to the American Public and allaying their fears and educating them at the same time. We must inform but we have to be careful not to enflame the public. Right now as youre speaking, dr. Carmona, were split screen and showing the people at home this is footage of officers and Emergency Responders in the area where this Second Health care worker, this young woman lives. Obviously they have to canvas the area to clean where she was and inform neighbors and that goes to what dr. Carmona, sanjay, was just talking about, which is enflaming the situation. This is difficult. You want to show urgency. You want to show that youre in control and that you have a serious problem, but you also want to show people that you are in control. It seems that second part is getting more difficult to communicate. Is that just cynicism or is that just a function of the facts on the ground . No, i think youre absolutely right and i think that same sort of balance we saw even in west africa, youve got to have a very strong front. Those officers now going to that Apartment Building you can imagine what the people in the other apartments are starting to think. Thats just going to create fear. Is there a way around that . I dont know. They have to do their jobs here, but its obviously going to make other people worried. In west africa they were careful because they knew if they went to someones house to see who their contacts may have been, those people would be stigmatized and ostracized, wouldnt be able to function within the community, the society anymore. Were not at that level here in the states obviously but this has to be, this is basic sort of Contact Tracing and this is basic work that needs to be done to protect them while hopefully not scaring them too much simultaneously. Sanjay, as far as we know at the moment according to the press conference, all thats happened is she spiked a temperature, this next victim, and she is in isolation so at her apartment, what has to happen with her linens and her belongings . Im glad you brought up that, alisyn. Its a good point and it bears repeating, she should not have been contagious or infectious. She should not have been spilling the virus into, you know, into the community on to other people, so she shouldnt really be a threat. I think what will happen there is this term that weve been hearing a lot over the past month, abundance of caution, theyll probably remove the things that she had direct contact with in her apartment and if it were a hospital that stuff would be destroyed, burned, incinerated, thats what may happen here as well. Sanjay, thanks so much for the information. Its been great to have you throughout the whole program. Hopefully well get some information about the use of this blood test on this Health Care Worker, and miss pham. Now we know they can test and not wait the 21 days hopefully theyre getting more advanced in detection for the other 70 plus people theyre monitoring. Thats right. Well take a break and we will continue to follow the breaking news and new details just coming in from dallas, specifically did officials calm ebola concerns or just add fuel to the fire in the presser they just held . Well break it down with the latest developments. 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Officials in dallas just briefing us on the newest case of epaola, acknowledging it could get worse before it gets better but they believe it will get better. How long could that take and are they prepared to do it, to make things better . Back to senior medical correspondent dr. Elizabeth cohen to recap what we just heard from officials. Reporter hi, chris. There were several interesting things in the press conference, one is that an official said i dont think we meaning Presbyterian Hospital have a systematic problem in the hospital. Many people would beg to differ. This hospital took care of one ebola patient and two Health Care Workers got sick. Emory and the university of nebraska took care collectively of five ebola patients and no Health Care Workers got sick. You wonder when will this hospital take responsibility and say we need to, we are going to figure out what went wrong because clearly something went wrong. The question is elizabeth, do you wait for that or do you step in and by you, meaning the federal government here, the cdc who is supposed to be in charge and do it for them. The cdc announced new measures to take in dallas. They didnt have anyone at the press conference but what are the measures . Reporter the measures are theres a multitude of them and they are all aimed at making this hospital a safer place to treat ebola patients, so sending in Doctors Without Borders teams, of course they have more experience than anyone treating ebola patients, improving processes and procedures for safety, put a site manager in place, that person would just be concerned about making sure that it was safe for workers, im sort of shocked that wasnt done originally. Establish a cdc response team, that team is already here and i believe more are coming and increase training opportunities. I think what this adds up to and what experts are telling me it adds up to is that there was overconfidence in this hospital. When the cdc came here, they werent keeping track of Health Care Workers, two of whom have become sick. They feel they wear protective gear and work at the hospital they didnt monitor the folks. They now know that was not the right way to go. Elizabeth, thanks for the information. Lets bring in cnn medical analyst dr. Alexander van tellekin. The Health Officials said something things, they continue to monitor 57 people now, a little bit higher than what we thought who originally had contact with the patient Thomas Duncan. One of the things they said, 48 people who had contact with him are about to reach the end of the window. This sunday marks the end of the window they believe during which they could have contracted the disease. That means 21 days have passed and theyre in the clear permanently . As far as we know that seems to be right. The average incubation period as the professor was saying is 6. 3 days so it seems like 21 days out we are really in the clear. This is a probability issue. Once you get past the mean incu incubation period it drops. Cant you do more with the blood test . I think so. There are a number of different blood tests you could use to get a good idea if someone is circulating virus, is someone dropping the key white count thats indicative of disease, are they changing these key molecules that occur also with disease relatively early on. We could do a lot of those things and we should be. Certainly for those people who seem to be the very highest risk of potential infection. It was interesting to hear them talk about the fact there are these 77 point of contacts but two patients that are sickened, that we know are both nurses now. You were talking that its interesting to learn that its the Health Care Workers, not been these other points of contact. Everybody seems to think were obsessing about the hospital in dallas but its important, dr. Mccormick we look at the hospital so hospitals can plan for the eventuality of a case coming to their e. Ae. R. If this is not a learning experience for every hospital in the country they must be asleep. Call to action. This has to be a learning experience and unfortunately learning about, you know, what went wrong. I think what wed really like to have seen in the press conference is more details. We hear of people being monitored. They should have daily blood tests of the kinds were talking about, all the people should probably be isolated, are they still at work . They definitely shouldnt be at work. Panic is a function of the unknown and mixed messaging and a lack of leadership and again no disrespect to the county judge and i understand that he has broader powers in texas than you might assume but to not have a member of the cdc there who is supposed to be handing everything down to these people breeds a lack of confidence. Youve worked with the cdc doctor, do you think theres a role that needs to be filled . There is a role and i think that traditional cdc relationship is now proving to be i think somewhat of a liability in the sense that cdc cannot come in and say you will do x, y and z. They dont have the Legal Authority for that so its always been you invite us, well come and help, tell us what you need and well help you. In this kind of circumstance and any kind of epidemic weve got to have a different arrangement. A clear czar. We were talking about this behind the set is the need for someone to be leading sort of the call for action, the protocols, setting the guidelines, like an ebola czar for lack of a better word. What we have here its very difficult when you criticize leadership you point the finger at individual people. We have a system that is very, very hard to lead. Its a diverse range of agencies responsible. The idea of a czar would be to centralize that responsibility and where the buck stops, this is about enforcing a relatively simple set of things, about making a relatively simple set of decisions and make sure that you have a system in place to make sure people adhere to those rules. The ebola czar does not have to be the worlds most infectious expert, you can look at the airline industry, very good at safety protocols and making sure theyre yoorlly adhered to. Doctors van tull ken and mccormick thank you, great to have you on set. Lets get to those now, isis advancing continuing in syria in iraq. Militant fighters are poised to lunch an attack on a major airbase in western iraq. President obama acknowledging defeating isis will not happen easily. He says the nearly two dozen nations are united behind this longterm campaign. Another round of violence erupting in hong kong. Police fired pepper spray into a crowd of demonstrators trying to take other a major road outside government headquarters. About 45 people were arrested. In the meantime officials are launching an investigation into this video allegedly showing a prodemocracy demonstrator being beaten by plain clothed officers. At least 17 american soldiers were exposed to nerve or mustard gas after the invasion of iraq according to the New York Times which in their report says the u. S. Government withheld that information from troops and from military doctors. The report suggests the governments secrecy prevented soldiers from receiving proper medical care and official recognition of their illnesses. You know there will be repercussions of that. A major recall in toyota, more than 1. 5 million vehicles from around the globe, both toyota and lexus are being recalled over brake problems and a fuel leak issue that could start a fire. More than 400,000 vehicles in the United States are part of that recall. The company says it has not heard of any crashes or injuries or deaths as a result of the problem. Can i talk baseball . Please. Kansas city royals one win away from the world series, they beat the orioles to take a 30 lead in the American Championship league series. The royals have not lost in the post season, winning all eight games. They can finish things off tomorrow in baltimore or today rather, game four in baltimore today. How about those giants . Just sayin, thats all im saying. Exciting, thanks, michaela. Youre welcome. 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Like nina pham, this is a heroic person, a person who dedicated her life and is dedicating her life to helping others and is a servant leader. Welcome back to new day. That was Dallas County judge jenkins, just moments ago speaking about the Second Health care worker infected in dallas with ebola. Officials already have begun the daunting task of what is called Contact Tracing locating any people who have come in contact with that Health Care Worker. How many people could be in jeopardy and how can officials find any impacted before the disease spreads further . Joined by dr. Alexander van tulleken. Set up three scenarios, the first one a patient that tests positive for ebola shows up sick and has the symptoms. Comes to the hospital, is tested, then the work begins not only on his medical treatment but on tracing every person theyve come through contact with. Yes, so if if we mention this red figure represents someone who has been in contact with for instance someone like Thomas Eric Duncan. They develop symptoms and so they are now positive for ebola. We need to Contact Trace every person. We need everybody. The first thing to do, since you developed symptoms and became contagious, you can infect other people where have you been and what have you done . The average incubation period is six days. After that, once youre symptomatic before you go to hospital might be a few days. If you asked me what ive been doing the last three days its difficult to remember. Any errands you have done, any stop you made at an atm, et cetera, these are all things that they have to Pay Attention to. What we use is the threefoot rule, seems to be that you cant be three foot is arms length. Theres a big difference between arms length and arms length if youre interacting with someone at a Cash Register youre closer than three feet. All of the people have to be contacted and the question is what do you do with them then. You need to make sure that you can stay in touch with them. They need information theyve been exposed and they need information about who to contact if they develop symptoms and what symptoms develop. Youre relying on human ability, memory. Yes. Honesty. And it isnt being nefarious, you just might not remember. Exactly an the other thing is its hard not to miss anyone. So youve got to be a real detective here. Youre going to be using email, telephone, facebook, personal information, you may have to go, gas station, you got to go back to the gas station see who was on that at that time, who served them, which register. Very hard to do so a detailed questionnaire is where we start. Its really key and somebody like we know know ta pham she knew right away this is a concern because ive been around ebola patients and quickly went to, let me swipe this to the next scenario, went to the hospital and was isolated. Second scenario, a. One of the network of contacts that for example duncan or nina pham, the nurse would have come in contact with, then what . The ideal is you get someone who displays no symptoms for 21 days. Looking fine. We can stop monitoring you and thats okay. What weve seen is that isnt good enough anymore. We used to say all right well watch you for 21 days. Now that weve got these two Health Care Workers infected we have to say this is america. We should be doing serial blood tests on them and they should be at home. They dont have to be in a hospital room positive pressure or anything like that. Just alone in their home. Somewhere where theyre not out in contact with lots of people. You limit that as much as possible. The first red flag is the fever . The first red flag is fever or feeling unwell. This is a virus that presents your body only has a few ways of getting ill and a fever is usually an early manifest indication of you are your immune system getting going. You may not notice it but maybe out in the cold, a variety of unwell symptoms. The key is the 21 days. Thats the outside that were looking at. Yes. Weve been cautious we dont want to overpanic people. We want to have urgency when we talk about this. The question mark is, what if we miss someone . What if, in those contacts theres somebody who came within the three feet of a sick patient with symptoms, what if we missed one of those points of contacts . Thats the kesh. The only way of addressing that is doing what were doing now which is talking about it in the press, in the media, make sure the public are generally informed. If you are in the region, and this is the really difficult bit is we say at the moment if youre in the region where theres been someone with ebola, should you worry and how should you seek care . At the moment we say contact your health care provider. Thats tricky thing to do. Go to the hospital you potentially expose more people. We do not have an ebola hotline where you can say i worked at the gas station, i think ive seen that guy who is sick come in, we dont have any symptoms in place. This is one of the criticisms weve offered of the cdc. At the moment its reasonable to say if youre concerned you have symptoms, speak to your health care provider. Ill shake your hand and come in within three feet of you. Thank you so much for that dr. Van tuleken. Alisyn to you. Thanks so much, mikial. More details on the breaking news coming up. Plus she should be worried about high school and hanging out with her friends. Instead, wait until you meet this extraordinary 15yearold, deciding to spend her time making other kids lives better and guess what . You can help her do it. Its the good stuff. We need it. coffee being poured into a cup. save your coffee from the artificial stuff. Switch to truvia. Great tasting, zerocalorie sweetness from the stevia leaf. Searching with devotion for a snack that isnt lame but this. Takes my breath away when salesman alan ames books his room at laquinta. Com, he gets a ready for you alert the second his room is ready. So he knows exactly when he can check in and power up before his big meeting. And when alan gets all powered up, ya know what happens . I think the numbers speak for themselves. Im sold hes a selling machine put it there. And there, and there, and there. La quinta inns suites is ready for you, so youll be ready for business. The ready for you alert, only a laquinta. Com la quinta note im so fancy you already know thats my song. Well be back tomorrow with Christine Romans and her discovery she is a viking princess with the root series. See if it im telling the truth. Todays edition of the good stuff an extraordinary young woman, 15yearold leanne joyce spent time in the hospital when she was younger for congenital heart problem, that is the bad stuff but the challenge is how we deal with the trouble that comes our way. This kid shows us all how to be. She created positive impact for kids, a charity that helps hospitalize kids with everything from get well cards to exboxs ad ipads, whatever they need to keep up their spirits. I want kids to feel normal as they can. I know what its like and its not fun. Remember she is ohm 15. So far, get this, leighanne raised 30,000. She has helped kids in all 50 states. Thats impressive. Goal, 100,000 bucks by the time she graduates high school. Up for a 10,000 grant from kind causes. Looking at your coffee at home, i want to help, you can. Visit them online, and help right there. Thats amazing. Great story. Teenagers, see, they can make things happen. Sometimes. There is hope. As we heard from the mayor down in dallas, things are bad now but hopefully they will get better. She is proof we can all do better and she certainly is. There is a lot of news. Right to the newsroom with ana cabrera in for Carol Costello. A busy morning as you know. We have breaking news to lets get right to. Captions by vitac www. Vitac. Com hello again, im ana cabrera in for Carol Costello thank you for joining me. Texas Health Officials say another case of ebola has been diagnosed here in the u. S. And this later victim is a Second Health care worker, a woman who helped treat Thomas Eric Duncan and this mornings news triggers even more alarms. It means even more people could have been exposed to this highly Infectious Disease and will now need to be identified and monitors. This really just underscores the critical but very dangerous mistakes that were made, how did