Him to. Nt so its a fault issue. I understand it had political resonance in the primary. Now when it comes down to a general election, the issue is, do you want somebody you know vote, whoe going to has voted many times and time again in support of the majority that the vast kansas people hold . Or do you want somebody who obamacare, for greater gun control . I just think theres a clear, here. Difference somebody that we know versus somebody that would be a significant risk, and the risk in the direction of things that most kansas people would find aboutable. Moran on senator jerry newsmakers. Now, a discussion on the u. S. Ebola epidemic, both at home and abroad. From todays washington is about an hour. Were joined now by dr. Gavin macgregorskinner. Infectious disease expert with the elizabeth r. Griffin foundation. Doctor, i also just want to note some of your other history, because i think its very interesting. You recently returned from nigeria, where you were treating withnts on the ground ebola. Previously you had worked in preventing and controlling pandemic influenza outbreaks. You also worked in helping 2004nt disease after the tsunami. You have an extensive background here in dealing with these outbreaks. So id like to get your thoughts, off the bat, about latest headlines weve heard out of the ebola. Utbreak the glass officials have narrowed down to ten the list of who might be infected with ebola. We see the death toll worldwide is now over 3300. Epidemic ining this the right way . Thats a really good question. U. S. Healthin the care system wonderful trained andth care staff, both paid voluntary. Not just including doctors and the auxiliary staff, administration staff. What we really have at the is a type of approach to controlling ebola. The cdc in the center. And then we have all the health it be thems, whether hospitals, the Urgent Health care, the travel clinics, throughout the country. We havent created a functional network. And thats what we need to create. Need to be able to share experiences. Had emory hospital in atlanta. Theyve treated patients successfully. Theyre champions at the moment. They should be telling us the challenges they face. We know, its not easy treating ebola patients. Stressful, intense. It requires Good Management and good implementation. Withvery day, youre faced new challenges. We arent hearing the challenges at emory. Hearing the challenges at nebraska. They arent teaching texas patient. Tomorrow, this is going to happen, and this is what we did consider itneed to now. Were not sharing experiences. Youre saying theres a lack of communication with the hospitals dealing with this disease . There is a need for better communication. There is a need for teamwork. And we arent working as a team. State, i teach Public Health prepareness, and the answers, all the time, to all my students i teach graduate students. Theyre in their 40s, 50s. Theyve had many years of experience. Telling them you dont work as individuals. Here in the u. S. , we have a wonderful democracy, where we promote individual thought, creativity, innovation. But when it comes down to disasterrings and emergencies and disasters and emergencies and highly Infectious Diseased, get all the team together. And we havent got the whole team together. Seems like part of the issue education. I think theres a lot of confusion, perhaps misperception exactly how ebola is spread. Can you break it down for us how this disease travels from one to another . What should we be concerned about . Its important, because weve heard the cdc director, dr. Tom weve heard from dr. Anthony fauci. Theyve said its really hard to get this disease. Its true. Having dealt personally with ebola patients, how do i feel . Im scared. Ive got to be honest. The people in my team are scared. Toall Work Together to try give each other confidence. What we do know, if we put on proper protection, the suits, the gloves, the shields, thatace shields, we know the virus is in the bodily fluids. We need to really define what talkmeans, because we about bodily fluids and i have my two children going, dad, bodily fluid . We could have it in saliva. Of virus ines lots blood. We know that people that have ebola, they vomit. They are sick. So theres virus in the vomit. A person who a patient that has ebola has to go to the toilet. When they go to the toilet, there is vomit. Feces, when, in the they have diarrhea, theres virus in the diarrhea. Get as they get worse and worse and worse, theres more virus and we start to see sweat. Us in the the other really important thing that we havent talked about is semen. In the semen. Irus and theres virus in breast milk. And we havent talked about that. And so, at the early stages of the disease, when people are treatingck and were them, we have virus in all these bodily fluids. The fluids weve just described. You have to touch those bodily fluids. Doesnt float in the air. Them. Uch then it has to get into your body. Doesnt go through the skin. Have to put your hands in your mouth, your nose, your eyes. Fun things at home in my family. How many times do you touch your face in a day . Its a lot and people are out here, in universities and academics, studies. How many times do we touch our face . Its a lot, a lot throughout the day. With nurses and doctors and physicians and other specialists in the hospitals, touch your face so when i do training in a them, theand i teach hospital Infection Control precautions, dont raise your hands above your shoulders. Thats really hard to do. So how much of the virus get infected . To i mean, just i mean, if you you said just touching perhaps touching the bodily fluids of someone else could be enough . At whenlook youve got ebola and we look at, again, the blood in your body, blood sample, theres billions of virus in there. Vomits,eone with ebola theres billions of ebola virus ground. Someone has diarrhea and the sheets are covered, theres billions of virus. Need . Ch do we probably one. Not very much at all. When youre working with ebola 100 , you have to get it correct every time. How long does a virus stay theve once its outside of body . It really depends on the surface that its on. To emphasize right now, its not days. Dies. S virus it is killed on dry surfaces. On to a surface and it may only last up to 30 minutes. Other porous to surfaces and last one to two hours. Period, we really believe from the evidence, the evidence that we have, the research and the samples weve hospitals, that over a 24hour period, if its outside dead. Dy, the virus is and its not contagious. And therefore, it cant be transmitted. So its not days. Its more like hours. Thoughtst to hear your on this outbreak to outbreak response to it. And you can call us on the telephone. Find us on social media, on facebook at facebook. Com cspan or send us an email. Earlier this week, the director National Institutes of collins,francis cloil was here on the washington journal to talk about her work developing a vaccine for ebola. The vaccines are moving forward at an unprecedented rate. This is an effort we started 13 years ago, anticipating there a vaccine,need for because ebola has been around since 1976, albeit in small outbreaks. The fifthgeneration ebola vaccine. It looks very good in the animal models where it seems to be completely protective. Dont knowrse, you until you try this out on human patients, whether its going to be safe and whether it will work. We did start just three weeks ago, whats called a phase 1 vaccine. This 20 individuals have now been injected with that. The are volunteers here at n. I. H. Clinical center. So far, all is going well. No red flags to indicate theres problem with the vaccine. But it will take now a couple of months to see whether those individuals mount an immune response that you would think against protective acquiring the disease. Once we have those data, if they tok promising, then we need move quickly to get this into what youd call a phase 2 trial in west africa, in individuals, who are at risk. All of that is very complicated ina circumstance where, liberia and sierra leone and guinea, theres a great deal of massage as can you can imagine, on the Health Care System. But were determined to figure out a way to do this. Then,ts the timeline, doctor . What are you going at . Well, it will be november the evidencee about whether the vaccine is looking promising in this phase 1 trial. Good, then shortly after that and there are meetings going on exactly about how to do the design we would try to set up this more africave trial in west that would determine whether the vaccine is effective or not. Dr. Francis collins from the National Institutes of about theking agencys work in developing a vaccine for ebola. Dr. Macgregorskinner, what is your take on how close we are to actually finding a cure and prevention . Im not directly involved in the Vaccine Research. We know thats a billion, billion dollar industry out there. And its out there for diseases that are really common. So you have to take this from a business perspective. Are those pharmaceutical companies, those Vaccine Research companies, as well as government, are they in the bids business toy the make money or to save lives . Weve heard this is a fifthgeneration vaccine. Through ive been involved in vaccine trials andinfluenza, for bird flu for pandemic influenza, and some of those vaccines looked failed. G, others so at the moment, we the treatment, the drugs we have, ehave,cines with were we have, were really at the modeling stage. All thet started trials that we need to do. And a real important thing about u. S. Health care system is we practice evidencebased medicine. Make guesses. We dont risk peoples lives with the unknown. Empiricalave the evidence, the data, that our experts have analyzed, weve got werecareful about what saying about the future for a vaccine. Vaccine, we may not have another Ebola Outbreak for years. So where do people regroup the cost . Is this whats needed . We will turn now to your phone calls. Paul, fromrt with florida. Om ahead. O ive done serious work in statistics myself and i think underestimating the true danger to the public. Number 1re to take the times,ble it 307 30 youd have some idea of how quickly one becomes millions. And any doubling in this system spread like could wildfire. Thats i think thats the held truth thats being back. Very good question, paul. My i was talking to daughter is in the middle school. We were talking about this. She said, dad, would you like me 1 million or pay you a penny that doubles every day for 30 days . And its just like we were talking in the context of ebola. We do know we do have the resources. We do have the tools in the toolbox here. What we need to do is improve the communication, the awareness. Were very careful in this tontry, and this is working our detriment at the moment, that we need to identify where the hospitals that are ready and the hospitals arent ready, where the Health Clinics that may be getting ebola and contact. Ey so, again, theres two ways that we really two activities we here. O focus on its Early Detection and then its that contact tracing. The Early Detection correct and we get the resources out for contact tracing, we know from previous experiences with going to beatre this disease. Next up, robin on the democratic line. Robin, youre on the air with dr. Macgregorskinner. Thank you for taking my call. I am very worried about what is going on here with this ebola. Youre on the air. Okay. About whatm worried happens what happened already with the case in texas. I dont think were ready for this. The hospitals dropped the ball. And what if this happens in other hospitals . And theyre lying coming over liberia. Africa and thats a really good question, robin. Share similar concerns. I think we have to be very careful within the u. S. Health and all the different processes we have. Then tell you, difference i teach Emergency Management. We teach a whole Community Approach. Its really important when we have a disaster, an emergency, whether it be a Natural Disaster like a hurricane, a tornado, or a highly Infectious Disease like ebola, we need everyone in the community to be involved. We need them to be equal shareholders. Whats important here now is at, again,d to look the tools and the toolbox, and we can improve our communication. I dont expect every nurse, every physician, every hospital country to be an agreat student when it comes to geography. They dont need to know where liberia or guinea or sierra leone is. In, say,we need to put hospital electric Electronic Medical records we heard from the people in dallas we think it was a failure in our Electronic Medical record system. I know if you put in any of those west african countries, the screen flash red and it means tell someone. What happened to oldfashioned communication between nurses and doctors . Dont blame that nurse dont put her on the fire a nurse in an Emergency Department. She has a thousand things going on in her head. Activities. Ousand shes really busy. Shes stressed every day. Weve been there. Lets facilitate the system. Where is the signs up at the front of the hospital, saying if recently traveled, call this number or dont come into come toital and well you. We havent done that yet. So there has been, to that point, some talk about exactly where do we start to catch potential infections or potential folks who may be contagious . In the financial times, there today that says they ban flights to ebola hot spots. Calling for action as infected man is held under armed guard. Who are joining this push are bobby jindal, the governor of louisiana, calling on the country to shut down flights withcountries afflicted ebola. Also, one said a ban on flights considered. And ted cruz attacked the white houses unclear approach and called for airports to take every precaution. Meanwhile, you have u. S. Senator John Connor John cornin to u. S. Customs and Border Protection commissioner to request Additional Information on the screening process for incoming passengers the confirmedter case of ebola in dallas. What are we doing in terms of screening, and is it enough . Ive just recently come back from nigeria. I was in nigeria, i went through two airports in nigeria. Thosewere nurses at airports. They took my temperature. They made me fill out a form. Questions, sod me i was interviewed, twice. I then flew through germany. As i got off the plane, they fromi had just come nigeria. We got off the plane. Everyone line up here, they said. They took our temperatures, we filled out forms, we got interviewed. A plane from germany to washington, d. C. And theres nothing at the airport. Now, we have the resources. We have the people. We have the skills. Training. E and no one gave me again, there was no one there taking my temperature. Asking me questions. I didnt fill out a form. Theres no data base. Meres no history of traveling from nigeria, after having worked with ebola patients and stating that to immigration officers. And i dont blame them. But what i do, i blame the system at the moment. I also there was nothing handed out saying, if you get sick, ring this number. Is that an argument for a full ban on flights to and from, for betterargument screening a better screening process . I think we need a better screening process, better followup. And im seeing universities the country have already taken this initiative. I work a lot with universities. I do want to talk about just the flights. A plane has two levels. Passengers at the top and the cargo at the bottom. I have a lot of friends working in west africa now, risking their lives on ebola. Theyre relying on minutes. Re theyre relying on medicines, personal protective equipment. Issue. A Food Security you ban the planes, my friends are going to suffer, as they through this. In Infectious Diseases, we dont isolate countries. Virus. Ate the and thats what we need to be focusing on. Marcel froms arlington, virginia, on the independent line. Yes. The first, earlier callers who are concerned about spread to the United States fairly correctly pointing to what may be real problem for the cdc, because within the last two or three weeks, they have commented in medical journals this outbreak could go over a Million People. 50 orven if it goes up to 60,000, its very hard to believe that it will not spread countries in west africa. Manylived over there for years at different times over 40 years. And their airports are not as secure. That may be the case in nigeria. Show upe people could in other places and come into United States. I think you very accurately have wented to a problem that have here as people come into our airports. That problem should be addressed immediately. Cdc really has a problem, because if this happens again, here will become hysterical. Thats my belief. Thank you so much. Think youre making a really good point. Youve mentioned the cdc. The cdc as ak at disease detective. I have a lot of friends there. The Epidemic Intelligence Service officers. We went out and investigated outbreaks of any disease. What im really concerned about, the hub and spoke. Public health preparedness. It takes a team. We have the best emergency in the world. I can honestly stay say that here in the u. S. Around the world teaching Emergency Management with the curriculum that we have. We what we need at the moment, look at the incident command system, which was modified,designed, strengthened. Its a great system for managing any disaster. Putting the cdc, who are the experts, in the center. Its bringing all the other assets within the government that can help us. Thats going to include homeland security. Going to include department of transport and all the other agencies we have and the have. Ments we and its actually we need good managers out there, people who can do good coordination, collaboration, good communication. And let the cdc do what they do, and theyre real experts at, but added pressure of them having to manage the whole event. We need managers for these events. Few comments from john in north carolina. 21dayes, with a incubation period, airport screening is worthless. Id like to hear your comments on that one. After an ebola rested his arms there, it sounds like hes at risk for half an hour. Do the bodily fluids first. Bodily fluids on the ground, if theyre wet, the virus is still alive. Okay. What kills the virus is dry conditions. But we dont, in hospitals, we dont rely on that. We have to decontaminate. Use disinfectants or bleach or anything with chlorine. I go back to the hospitals i worked at in nigeria, we went down to the supermarket. We bought bleach from the supermarket. With etook that bleach we back. Hat bleach its anywhere from 3 to 5 . Corrosive tole too use in the hospital. It down to dilate about. 5 , a much lower which we know kills the virus, but it also doesnt cause anything to corrode. Its not dangerous to the person. So any bodily fluids that are cleaned up. To be thats what you have to do. If we talk about screening at airports, there are a number of mission functions to detect, prevent and stop the spreading. Now, i know when i traveled from nigeria, it was a 30hour trip. I left niem nigeria, i was fine. Flight from germany to the u. S. , anything could have happened. Airport,nt through the i left and i didnt know what i do, even though i worked with ebola. In the next 21 day, im going to andmyself under observation im going to work with my team. How are you feeling and how is your temperature . Brings up another important point, which is, as i understand it, ebola is only someone iswhen showing symptoms, not necessarily when they are in that incubation period; is that correct . Thats right. What we need to do as part of our airport screening is create education. Create as you leave the airport, youve just come back from a country in west africa. Like to point out that, you know, again ill go back to my children. Theyre really smart. Dad, when you dont know something, just google it. Were sitting there, talking the poison emergency number in this country. If you google poison emergency you get 8002221222. Lets google ebola emergency number. What comes up . Nothing. Google . Ven on not even on google, so it doesnt exist. So when you come through the airport, even though were your temperature and you may not be sick, were giving you something to say if get sick, well come to you. The white house held a briefing on the governments efforts to contain and control outbreak. They had this to say about the travel bans. F i will take the travel ban question first. I know that has been a an has been an issue that has been raised. Note of dr. Friedens comments in this regard, which is to say that in fact right now we believe those types of steps actually impede the response. The impede and slow down ability of the United States and other International Partners to actually get expertise and capabilities and equipment into areas. Ected and as weve said and stressed from this podium, the most and effective thing we can do is to control the epidemic at its source. Want to be able to do is ensure were getting the andstance, the expertise the providers into the affected region and not impeding that. Was white House Homeland Security counterterrorism bans. R monaco on the were going to hear now from lauderdale. Ort thank you for taking my call. My question is well, my questions are, people that are in the affected areas in africa it seems like it seems like i know i probably would do the same. People become desperate and they know theyre gonna die. To make it tory the u. S. , because of our great procedures. But what is the before the mean, how long is the virus in the body before people notice they have a fever or have a fever . And also, insects like flies and like that, can it be flies landing on food . Weseems like i think really are on the side of caution for maybe a couple of so, to get a handle on it. The airport,hat the u. N. Or somebody around the infecteds know areas they should know the infected areas before people leave. Also, do air conditioning airplanes, vapors that . Ings like richard, we got your questions. Richard, you raised two there. Important points lets talk about west africa. Were seeing a lot of social mobilization. We are seeing a lot of community resilience. Were seeing a lot of Community Involvement in west africa, because they know the community has to Work Together to beat ebola. Its not just the doctors, the nurses. Its everyone. When i was in nigeria, i spent a lot of time with church leaders. And i was saying, how do we bring in faith and prayer as well as ensuring that no one gets ebola . Sat again, we sat down i down with the nurses. And i said, well, if youre going to pray and youre going an ebola patient, we need you to wear gloves. Then we need you to come out and you witho disinfect bleach. Were not going to stop the prayer. Were not going to stop your to bring were going evidencebased medicine into this. Youyou you mentioned mentioned about the spread and transition. Again, we know that before this has been mentioned by the director from cdc, its been fauci fromy tony n. I. H. And many other experts. Unless you have clinical stms and the symptoms, and the ofl key is that sudden onset fever. Prior to that, the virus is in your body, but it cant get out. Developing those clinical symptoms, then we know it gets into your saliva. It gets into your what we call, again, the bodily fluids, the vomit, the diarrhea. What i saw in the patients, they came in with fever, body aches, feel reallynt well. Now, that could be a number of diseases. Looks likeica, it malaria. So we actually have to say, you dont have ebola. Saying you do have ebola. We have to rule out that you dont have ebola. We need to take that same u. S. Ach here in the were getting very close to flu season now. A lot of people are going to come in with fever and body aches. We need to say you dont have ebola because you dont have the travel history to west africa or you dont have that close, direct contact with an ebola patient. And thats really important. Is james from columbus, georgia, on the democratic line. Ahead. Youre on the air. How are you doing . Regardswo questions in to the aspect of the hysteria actually involves some of the information. I have friends, both republicans, independents and wereatic, and what seeing is that there has been a lot of hysteria and misinformation. Do you propose to deal with the misinformation . Also been in the 20someodd years. Ive developed an Information System thatn communicates to over five Million People in the minority community. Constantly seeking out that connection, back and forth. The highteche act, do you think now that we have that in place, do you think that that will actually help with the with the push that in theeen trying to do United States . I think its needed, to be able to help the Health Care System to actually work in medical records and everything else. How do you think that will this whole ebola breakout . Thank you, james. Again, communication, education, awareness is the key. This country, the ebola classroom, both virtually online . Dont. And, again, we have a lot of organizations putting out q as. Have, again, the cdc, now the Government Agencies distributing paperbased guidance protocols and procedures. That means that someone within community, within the Health Care System, within the hospital, has to go on the internet, download the document, read the document, and ensure they understand the document, and teach andlate tell that information to other members of their staff within the hospital. Im not when we did this back in 2004, we had a coronavirus called sars. One of the things we used was a lot of videos. Know that my students give them ae, i can document and they can read the document and then i test them. I can get them to watch a video, and they do better in the test after they watch the video. Videos on can make best practices and guidances and myths and rumors. All over theources place. Whether its the ebola highly Infectious Disease classroom or youtube. When we talk about a medical records here in this country, we know we have to prevent we cognizant of the privacy of the patient. We also know that the medical favor. Can work in our i carry a cell phone. I do so much of my work on a cell phone. I have a hipaa compliant telemedicine platform on this i can talk tot hospitals in privacy. Encrypted. No one can hack into this. I can have confidential phone,ations on my cell 24 hours, seven days a week, and we can talk about patient care. Within ourt Electronic Medical records, we need to improve our between nurses and physicians. But we also know that we can lot, very quickly, a lot of our medical records if the patient says i have just back from a country in west africa, flash it up, flash on screen, this is a warning to you, because again people were overlook this. Just because you say liberia, sierra leone, it doesnt youre sowhen stressed in a hospital situation. Caller. A is our next sheila, you are on the air. Sheila, are you there . All right then. We will move to carol from carolina, on the republican live. Are you there . Yes, i am. First, i would like to thank the doctor for saying something and prayer in a positive way. I am very concerned. An rn for 51 years. Given the colossal failures and incompetence of obamas appointees and his judgment and lies, i cannot trust anything. Not trust the cdc. Withlook at what happened mr. Duncan. For daysy was left with his bodily fluids in that apartment. Only decontaminated it yesterday. The judge who accompanied the of the home did whichve hazmat stuff on, he should have, because these people had truly been exposed to and other bodily fluids. A nurse and ag director of nurses for many, goes onrs, i know what with hand washing, Infection Control. Using gloves with needles, people not using gloves startinging blood, ivs. This is dangerous. Ableoure not going to be to educate people in a month on how to do that. Says thatthing, obama we have a very low chance of theing the ebola in United States of america. However, in this one week, we four regions of the country who may be affected. Say start the flights stop the flights. Thatyou people are saying you have to isolate the virus in these countries. Be realistic. You dont have the resources to do that. Getting things in that are necessary for care, for the specialor hospital beds, you have the to get special military like you did ships with the tsunami in japan. Doing thisays of without going through the airport. Gentleman, the doctor who came through i think it was reagan national, with a hazmat not even was questioned in the United States of america, coming from africa, why he was dressed like that. They did no screening at all. All right. Thats carol from South Carolina. Thank you, carol. Youve raised a number of important points here. Of people travel all around the world to come to the u. S. Health care system too the best to get the best treatment they can. I know from working in comingls, we have people from many countries, including people from west africa, pregnant mothers come to this to have their babies because their babies are going if theyre born here compared to what they might have. I know, you cant blame the limited resources we have in west african countries. We know theres people coming here all the time. So we have to put in these systems. The systems in place, which we to ensure that people traveling back here are screened, are under observation and they know where to report. We you talked about the team inroach and what happened dallas and how things were delayed and slowed. Ist we need to put together everyone disasters happen locally. At the local level, lets put thatsr the team required, include the emergency managers, include all the different stakeholders and Critical Mission elements of the community thats going to be hazmat teams, the decontamination, the disposal of that extra waste management. Thats got to come together. You talked about nurses and gloves. When we work in a hospital, we wear lots of gloves and we take those gloves off really quickly the new gloves on really quickly. When you come out from an ebola patient, you have to believe been expose exposed and youre covered in in a and we have to work different way. What we teach in hospitals is you work in a buddy system, just like noahs ark. You work in pairs. We sit there. You take off your protective equipment and if you make a mistake, im going to tell you. Sure we disinfect and decontaminate those areas. But you have to take the gloves thatn a special way, and requires extra training, which we need to do now. You also talked about that family. In family of the patient dallas. They are not criminals. You cant take a highly Infectious Disease and when people are affected, theyre not now. They just happened to have very close contact with someone who dearly, who is now in a hospital and could die with the ebola virus. Theyre not criminals so lets not stigmatize the patient. Lets not stigmatize the family. Thes not even stigmatize community where the family lives in. Thats really important. So we need to have counseling set up. This is like hiv aids years ago or other diseases where we provide reliable, evidencebased counseling services. Theyre a team player and they and io be on the team dont see them there at the moment. Bear the, who should responsibility for the fact that the United States seems to have been unprepared for the extent of this outbreak . Rr errorsbeen and information made and Lessons Learned. Using those Lessons Learned to ensure that it doesnt happen. We havent used all of our resources. We havent used all of our tools. We havent made it easy for ourselves. To go on to a website and download the guidance and read it. We arent even sharing the Lessons Learned from the hospitals that have successfully treated the patients. And they are our champions, our heros at the moment. Were not talking about the whole system within the hospital of people who have to provide and to the ebola patient then wash up the cups, the plates, the utensils. How about the people who have to in and clean up if vomit and the vomit and diarrhea floor . Sweat off the f auxiliary staff. Again, theyre part of the team and were not addressing that. Whole ofe that Community Approach in the hospital, in our neighbors, in our community. Now couple of the questions we received over email, two of them are related. Hand soap is regular effective in preventing the infection of the virus . Washow long should you your hands for . And also, joanne writes, what is the original source of this virus . Where did it come from . First one was lynn . Lynn. Lynn, washing your hands with soap. Were talking Infectious Diseases here. Any Communicable Disease that can go from person to person, hands with soap is so, so important. So, again, we need to be in our schools. We need to be ensuring that people are washing with soap. Nigeria i want to give you an example of the whole Community Approach. We had 116 people when we arrived and we listened to all their concerns and all their problems. Needse said this is what to be done. An Insurance Company, of all companies, on Insurance Company for the Public Service announcements. What would you like us to say . Every 10 minutes on the radio, on the television, tell people soap. H their hands with the Insurance Company said, yeah, we can do that. Who would have thought an Insurance Company would have a role in fighting ebola . How long . The rule of thumb is sing a song when you wash your hands, right . 20, 30 seconds. The song. Youve got to wash them properly. Watch washessh their hands quickly. Its 20 seconds. Yourat a long time out of day . No, its not. Its constant washing with soap and water, thats really important. And the original source of the virus, where did this emerge from . The 26th outbreak of ebola. What makes this Ebola Outbreak special, soo important . Its in a location where we havent had ebola before. Weve had ebola in uganda, in years, but weve never had it in west africa. Thats really, really significant. Strains of ebola. The strain that we have now is the zaire strain. Again, unfortunately, thats the worst one. Wild animals. Rom we believe it lives in bats and experiments and tests and samples taken from other animals. Animalhuman health interaction. Areall that where humans interacting with animals and we try to look at the diseases diseasesave and the humans have and we call that a where weh approach protect animals and humans. So it is transmitted through animals, and that probably started in guinea. Fromxt up is marv wisconsin. Marv, go ahead. Dr. Skinner, thank you for coming on this program. Its a very informed program. Thats beeninarian practicing for many years. Viruses,th encephalitis, so on and so forth. Question. Pecific its not hard a hard stretch to determineation how the gentleman thats hospitalized in texas now could been picked could have picked up the virus, with the very sick woman. But im worried about the worked forho only nbc for two days, who had lived in the area for two years, wo was informed who was informed on this whole outbreak. And he must have knowingly about ituch or more than we do, as far as the contracting it. How out of the blue he picked it up . When the medical people from nbc are queried about that, and they know. They just say well, he wasnt toking for us long enough make an educated thing of how he got it. That bothers me. And i agree with you. Its really hard to get a good patient at anyy time for any disease. Know whatt really his direct contact was. Im emphasizing, you have to have that direct contact either with the patient or the virus. We dont know where that happened. Think about a cameraman. Hes carrying all the equipment. Hes hot. Hes sweating. Hes fatigued. He might have put the camera down numerous times to take a break. He may have rested. May have done something. He had to have done something taken the virus, hes put his hands in his mouth, andis eyes or in his nose, its transferred to those mucus membranes. Its not going to come through the skin. Had anyknow whether he open wounds. I havent heard that. But, again, thats probably the reasonable wayy it was transmitted. Where it was picked up, i dont know. Wasntd he do when he working . I dont know. You mentioned several times recently came from nigeria and treated ebola patients there. That country has been able to contain the outbreak of the virus there, whereas other liberia, sierra leone, are having a much more difficult time. What is unique about what what can otherd countries, including the u. S. , learn from it . Paper. Ria had a plan on the Nigerian Government actually invited my team from the and paid fordation us to come over and work with their plan and implement that plan, make it work. Was unique about the nigerian plan, it was a whole Community Approach. About social mobilization. It was saying, dont talk about the bad things about ebola. The good things, the positive things we can do to protect people in neighborhoods, ebola. Ties, from and thats what they really focused on. In. They brought everyone and i mean everyone. I had, again, the church leaders. I had the army, the navy, the airporte, the authority, the port authority. Im sitting in a room, saying, where do you work . Well, im with the funeral services. Wow they invited you guys . If an ebola patient dies, goes to the morgue to be teach usou have to what to do. Theyve got virus all over them when theyre dead. Suddenly were talking to so many different people and theyve got everyone on standard guidelines. Ed and they didnt change those guidelines. Once we taught something, we standardized and rereinforced. Everyone has the hospital and have the basicff skills. We had to strengthen those skills. Again, they picked people within community that were leaders, decision makers, to tell what to them. People listened to they selected celebrities. Have a celebrity out there player or have a pop singer tell the story. And people listen to them. Thats really important. From st. Augustine, florida, is calling on the independent line. Whats your question this morning . Good morning. Okay . U hear me we can hear you. Thank you. Toave a quick shout out judge jenkins and the mayor of who have taught us that compassion is so much more tool than fear. I just wanted to say that. Secondly, your guests can this. T on ive read online that 30,000 average people die a year in the United States from just plain influenza. Will put somet perspective on the fear. Doctor . Yes. Donald, really, compassion is so important. Important. Is so lets focus on the hospital, first of all. All the hospital staff that are treatingin ebola patients, theyre nervous. If they really want to admit it, theyre scared. I know i was scared. Teameing honest now, my was. We need to be able to provide that encouragement, provide that support. Honestly, the hospitals, the hospital staff in emory, nebraska, they need an external conscious. They need to be we need a talk to their family and friends, everything is going to be okay, because were doing medicine. Ased disease fectious this is really important for the u. S. Health system yes, we are challenged right now by the ebola virus. Dont just talk about the ebola virus. Talk about all those highly Infectious Diseases. So were coming into flu season. Lets look at the way we do how we triage. This is really important. How do we triage at urgent care centers, Health Clinics, travel clinics and our hospitals . Come into influenza season, people coming in with fever, body aches, fatigue, just the early stages of ebola, lets teach our staff to where good face protection. Crossed me about ebola. I can i can wear this. I can talk to you. Me. Can see you can see my facial ex preks expressions. To a realtalking person. Youre saying all hospital staff should be wearing this if in direct contact with patients . I think we need to look at moment. Riage at the when we had pandemic influenza, strains ofm are influenza. We saw some hospitals set up tents in their park. You were coming to the hospital, dont come into the ob gyn ward. Into the Emergency Department ward. Come into the tent, where the nurses are wearing gloves and face shields or masks or protection, and we will look at then. Ymptoms there and you brought another mask as well. Do they guard against Different Things . Yes, they do. Again, here were protecting from the coughs and sneezes. But were also protecting from dont put your hands above your shoulders, into your mouth, into eyes. This will protect you. This is whats called an n95 a really specialized mask. This in the with hospital, and i wear this in the field, ive been fittested. There are many of these the market. And i get fittested to find out which one fits me. I wear this. And its called n95 because it theects all the viruses and barkt bacteria from going its. Gh what happens . I sweat. Its hard to breathe in this. I cant wear this all day. I have to take it off at some stage. So as were teaching our nurses and physicians in a hospital to treat and do great patient care with ebola patients, theyre going to have these. One of have we trained for that . Are you used to wearing it . Uncomfortable. You want to scratch your face. You want to take it off and go, ah, i got some fresh hair thats important fresh air. Is for medical staff who might actually be treating folks who have diseases, not peoplerily for everyday who might be concerned about catching it through some other means. Yes. And the u. S. Government has certain guidance on how you should wear this mask, how you should take it off. Else that isone going to come in direct contact with an ebola patient needs to on. Something like this i want to get in a few more calls. Northp is bill from myrtle beach, South Carolina, on the republican line. Youre on the air. Good morning, everyone, especially good morning to dr. Skinner. I want to say thank you for your service to humanity. Incredible, courageous job youre doing over there. Want to sayan, i thank you for bringing such a factual perspective to this crisis. Call it a crisis. Observed thishave wonder if you i might address from the the hazard that that brings [inaudible] bill, youre kind of cutting out. You said you wanted to something about students . I lost you there. You,ted to thank dr. Skinner, for your service. Just commentould about the fact that this crisis politicized. I wonder if you wouldnt speak to the hazards that that brings and how it would affect addressing this Program Going forward. On that note, i do want to that the hill newspaper is reporting that the house panel will be calling an ebola hearing. The story says that the federal Health Officials will testify about the u. S. Response to the ebola crisis at a hearing later this month. The panel is before the House Commerce Committee on october 16 to examine the federal response to ebola. Time that the fourth lawmakers meet to discuss the virus. Thats a really good point, bill. Dealing with these highly Infectious Diseases like ebola, we need our decision makers. Our politicians, at all levels, to understand that we need resources. Need their blessing. We need them to put this in a perspective that, yes, we can it, but were beating it with the details. And the details are this, this, mobilizingnd were the community and all our resources. We need to be really honest. Of weve heard of statements that every hospital in the u. S. Is prepared. Wherent seen any process weve gone in and said to every hospital, would you like to patients . You have to make that decision. Or if you get an ebola patient, an putt nem in them in an isolation room and ensurentact us and well somebody will pick up that patient and take them to an hospital . Y like i said, if you have back from west africa and you develop fever and fatigue, we dont want you to bus. N a we dont want you, with symptoms, to hop in a taxi. Intont want you to come an Emergency Department and sit next to the little child with a the pregnant mother. Wed like you to stay in your house, call us, and then well sure weyou and make wear the appropriate protective equipment and well get you to a the isolationhas suites and the trained staff to take the patient. Dont have awe very large number of patients at the moment. We can do this. Next up is anne. Anne, go ahead. Yes. I was just very surprised to director of nursing from South Carolina say that did not wear gloves or wash forr hands appropriately this ebola, any type of when hospital. King in a i was just really surprised at that. And also, her comment about the president. Bringing the president into this . Closer,rnor of texas is perry, is closer to this situation than the president and closer to the the person in the local area is actually the responsible. I think just by one hospital there making a mistake of back homee patient originally, it does not mean that all of the hospitals are that. To do i think thats creating hysteria, by saying Something Like that. Think most hospitals would know to follow a different procedure, especially now that so much emphasis has been put on that. Think just blaming it because it happened at one hospital, that its going to hospitals. Ll the anne, well leave your comments there. Is wallycaller today on the independent line. Go ahead. Dr. Skinner. Ng, thank you for the valuable information youre providing. Awas just wondering, theres lot of discussion about the movement of the ebola virus in patients, special patients, with the ebola virus coming into the United States. Wondering if you can provide some history, if there instances where diseases from the United States have moved to that part. Good question. About what to talk ann said. Its great that the president for the nursing association, for hospital, told the truth. We have a real challenge in the Health Care System to say when arent working, to tell the truth. Shes now told us that they have a situation we can fix by training. This is really important. I get, through my foundation, lots of phone calls from lots of theytals, saying, well, told us were ready, but in honesty, were not ready. Its good to tell the truth. About diseases going from the we. To other areas, really, saw had the i want to talk in general,america when we had the pandemic influenza, it came from mexico spread globally. We know that all the transportation we have with the planes and ships and everything possible. S but we dont because of our Health Care System, both in human health and in this country, we controlled many of the highly infectious veryse, nearly all of them well. Weve seen viruses move out of africa and other parts of the world. With west nile virus, when it arrived, moved across the country. That we areware under threat all the time. And i have many colleagues and friends that are working on issues, 24 hours, seven days a week, to protect all the u. S. Ens of the dr. Gavin macgregorskinner, r. Griffinizabeth foundation, thank you so much. On the next washington journal, david wasserman, with the latest on the 2014 house races and Public Opinion and politics with brian and stefan hankin. We will take your calls and you can join the conversation on facebook. At 7ing the journal, live a. M. Eastern on cspan. Cspans 2015 student cam competition is underway. The nationwide competition will award 150 prizes totaling 100,000. Create a seven minute documentary on the topic three branches and you. They must be submitted by january 20, 2015. Grab a camera and get started