A negative ebola test result means a patient doesnt have ebola but just this week a physician died after being flown to nebraska for emergency treatment after initial tests showed a negative test. His colleagues are in quarantine causing greater anxiety in a medical profession lost more than 500 to ebola. Hospitals and Healthcare Workers were to have proper guidance on personal protective kwichlt. Cdc guideline do not require a threeweek selfisolation period for healthcare officials. They can return to work immediately. But the hospitals i talked to did not agree. I asked an er doctor from my district about whether any of his colleagues volunteering in west africa could come back to work immediately. He had a simple response. I quote him. He said, they should stay away. The administration continues to pose travel restrictions and quarantines yet respected institutions have policies to ensure Public Health is protected. Its impossible for the American People to understand why the government would have one standard for the military yet another for people who may have been in the same or possibly more perilous circumstances. Consider the cost of the administrations position. Senator shumer asked the government to reimburse new york 20 million for the costs associated with the Healthcare Work terz toog to prevent an outbreak in new york city because of the case of dr. Craig spencer. The taxpayers have every right to ask, wouldnt it have been costeffective for them to require all Healthcare Workers to adhere an isolation policy . We all niece honesty and humility today. The American Public is fine with a doctor who says this is sfienl based on we what we node but as the facts change, then we have to change our approaches. The public expects that. Anthony fauci said we should not look at the what ifs. I disagree. Thats what we need to do, what Congress Needs to do and everybody involved with this needs to do. What if the outbreak migrates to other countries. What if it extends to other continents . If we get new information that says a change in policy is needed, tell us what you have learned and why a change is required. We have a set of screening protocols at five different airports. Is this complex approach the easiest and safest approach . Can we track the hunts or perhaps thousands who might have been exposed if we have five u. S. Arrival points, countless destinations and numerous connections through europe . With a disease that has no margin of error, i would rather be good than lucky. We need to consider whether there should be a simpler approach of one arrival point that would allow us to track the returning aid workers and government professionals copping from west africa. The Administration Must review whether government charter flights are needed to help get workers to west africa. They have concerns about shipping supplies to africa. I would like to ask the administration czar to appear. We were told he wasnt ready. Another Congressional Committee made a similar request. I understand they were told the response coordinator had no operational responsibility. For a very few press interviews, he seems to be missing in action. No wonder the American People have concerns with the administrations response planning. We want to clear that up today. We have good panelists to do that. The public has been given plans led by a czar who isnt ready. We stand ready to work with the administration to keep the American People safe from the Ebola Outbreak and welcome all the witnesses and look forward to learning more about the latest Public Health actions and more details about the emergency funding request. I now turn to miss caster. Thank you very much for holding todays hearing, the second we sw had on the Ebola Outbreak. At our hearing last month, americans were concerned about the news they were hearing. It was weeks after Thomas Duncan arrived at texas presbyterian and days after two nurses who had been who had treated him had become infected. In response to the cases, cdc updated their protocols for treatment of ebola patients and issued travel guidelines for those who had treated order been exposed to ebola. Our hearing back then was held just three weeks before the election and it seemed that much of the discussion of quarantines and travel bans reflected political concerns instead of the advise of Public Health experts. But today, when we look at where things stand with regard to domestic preparedness, we are in a better place. No cases of ebola have been transmitted to any member of the general public in the United States. With new procedures in place and with the exception of dr. Craig spencer in new york, no individual has unknowingly entered the u. S. While affected with ebola. Airport screening and new cdc monitoring guidelines implemented by state and local Public Health departments are in place. And we have successfully treated eight ebola patients that have entered u. S. Hospitals. I want to give credit to these hospitals and Healthcare Professionals that have treated these patients. The professionals at emory university, the nih, the university of nebraska medical center, bellevue and texas presbyterian, their readiness has made a huge difference. I want to welcome dr. Gold from the university of nebraska and thank him for sharing his expertise today. Unfortunately, the news from west africa is not as good. While case counts in liberia have slowed, there continue to be increased in the number of ebola cases in sierra lee own and guinea. Officials are now concerned about the appearance of ebola in mali. That, mr. Chairman, is why we immediate to focus on the u. S. Response in west africa. Its a credit to our country that were leading the effort to end the epidemic in west africa. The early results from liberia indicate that our efforts and the efforts of our partner countries can milwauky s caies. But theres much work to do. I want to acknowledge all of the medical professionals who are doing that work. In particular, say a few words about dr. Martin sal ya. We learned yesterday that dr. Salia, who had been flown to nebraska for treatment after developing ebola while working in sieree sierra leone died fr disease. We sent condolences and acknowledge his bravery in helping fight this disease. West africa is balanced on the edge. If our efforts and the efforts of the World Health Organization are not successful, millions of people in these countries faying a looming humanitarian crisis will continue to suffer. I am grlad that mr. Isaacs is here to give the perspective of the International Aid community on the west african outbreak. Mr. Isaacs, your group and other groups like youres are doing difficult but critical work. You deserve support. We are in a better position to address cases of ebola that appear in the United States than we were a few months ago. I appreciate dr. Frieden, dr. Lucniac for joining us to share Lessons Learned and tell us how we can move forward. Im looking forward to hearing about the supplemental ebola request. Its Critical Congress support the appropriation request. It would support domestic preparedness, help treatment centers. It would support treatment and vaccine and it would support us a d and the military in their effort to eliminate ebola in west africa. Mr. Chairman, i suspect in the year to come we will have our share of discussions about the budget. We support the goals of the president s Ebola Outbreak plan to combat it. I hope we can move quickly to provide the requested appropriations. Thank you. I yield back. Now recognize the vicechair, ms. Blackman. Thank you, mr. Chairman. I appreciate the hearing. I want to say welcome to all of our witnesses. We appreciate your time. I think we have to realize with the nearly 15,000 cases and over 5,000 deaths that this ebola epidemic is the worst since the discovery of the vice russ in 76. You need to look at what the precedent is there. 2,400 cases known cases of ebola prior to this outbreak. We know that this is something that is this is something that will be difficult and take time to deal with. We appreciate your efforts. There is good news out of liberia. There is a mixed bag of news thats coming out of the region. It all leads us to look at the magnitude of the situation in front of us and the human to human transmission of the virus which leads us to keep america safe. Thats the goal. Most believe it ises the job of oh the cdc to keep americans safe from Infectious Disease. And that all efforts need to be on the table when it comes to keeping americans safe. Dont take anything off the table. The chairman mentioned some of the suggestions made at the last hearing. Indeed yesterday i was at Fort Campbell with troops trying to build hospitals and training medical personnel. They have been opposed to items they think might work. Even the institute held a workshop where there were a number of questions about the characteristics of the ebola virus. They concluded, and im quoting, many of the current risk, quarantine policies could be better informed and more effective if the means and potential routes for transmission were more thoroughly characterized. Until we know more about the nature of the deadly virus it seems prudent to keep all common sense measures on the table. With that, i yield to dr. Burgess. I thank the gentle lady for yielding. Thank our witnesses for being here. Dr. Laky, good to see you. This will be one of the most serious Public Health crises of the last hundred years. At our last hearing we had a great deal to discuss. Many of the brave pronouncements from september were found to be nonoperational by the middle of october oh. There were failures in dealing with the crisis. Certainly communication was lacking. Systems and protocols broke down. Provisions that we all thought were readily at hand were never in place to begin with. I hope we know better than to let it happen again. This summers emergency, to me, emphasized one thing. Have a lot of hue mill ti when dealing with the virus. It is difficult to predict. As a physician, one of my big concerns, since july has been the safety and protection of Health Care Workers. I want to thank the cdc for being responsive to my telephone calls and the various Conference Calls we had over the summer were helpful. Ive got to tell you. Until you have this thing in your backyard its hard to estimate how it will affect daily life on so many levels. Sure, we had a hospital that was hurt by the crisis. We are probably lucky we didnt have more than one hurt. Trash collection, sewer treatment, school districts. Every one down the line was affected by having this virus in our area. We do have to take great care. It is important that it be brought under control. I have to tell you i al grateful for services of the hospitals that handled the known ebola patient. I was much more worried about the unknown patient who could walk through the door at 3 00 tomorrow morning, unknown to anyone, unannounced and provide the same set of circumstances that we have already been through. Im not sure we have learned entirely the lessons. Thank you mr. Chairman. I will yield back. The gentleman yields back. Now mr. Waxman is recognized for five minutes. Thank you. Im pleased you are holding this hearing. This is an important topic. Its appropriate for congress to learn about it. The American People want to know whats happening and want some answers. I picked up a couple of comments from the other side about having humility, learning from whats happened. And hope we know better because of what we have learned. When we last had a hearing in october, there was a pronounced disconnect between what the Public Health experts were telling the committee and the rhetoric of the committee members. Some members called for quarantines and travel bans that experts determined would be harmful. Some claim the administrations protocols for screening and tracking travellers wouldnt work. Some even insinuated immigrants with ebola would soon be crossing the southern border or that ebola had hue tated and become trance misable by air. This is mister call rhetoric. It induces a great deal of fear. Mr. Chairman, none of these things were true. After two cases were transmitted in texas the cdc acknowledged the gaps, revised protocols. It learned from its experience. It was 33 days since the last ebola hearing. Since then, not one case of ebola has been transmitted this the United States. Only one with traveller since then, dr. Craig aspencer, has brought ebola into the country. It appears our Health Care System responded effectively. Dr. Spencer knew how to immediately report symptoms, was isolated and safely transported to a hospital equipped to treat a patient with ebola and his close contacts were monitored. The Health Experts told us that our Public Health measures could protect the public from ebola. It turns out, mr. Chairman, they were right. Its good that we have a chance today to show humility and acknowledge that the fears expressed openly this this hearing at our last meeting were not justified. As i said in that first hearing we should have a sense of urgency about the epidemic in africa. There is a lot of work to be done to stop the ongoing humanitarian crisis there. And we should view the appearance of ebola caseses in the United States as a wakeup call about the need to invest in Public Health preparedness at the federal, state and local levels. President obama is trying to address these challenges. We should support those efforts. If we dont stop ebola in africa, it could travel to other places. It could spread. Weve got to control the epidemic where its happening. The president submitted a 6. 2 million emergency supplemental funding request to congress to improve domestic and Global Health cap cities in three critical areas. Containment and treatment in west africa, enhanced prevention, detection and response to ebola entering the u. S. , and butt residencing the u. S. Public healthle system to respond rapidly and flexible many the future. Its critical that congress support the request. In november of 2005 the Bush Administration requested 7. 1 million in emergency supplemental funding to speed up the development of a vaccine and fund preparedness. A Bipartisan Congress provided funding. In 2009 congress provided the Obama Administration to combat h1n1 influenza virus. Congress did the right thing by making the investments. They saved lives, enhanced preparedness and congress should do the right thing now. We are joined by dr. Thomas frieden from the cdc, nicole lurie from preparedness and response at the department of health and Human Services. Rear admiral Boris Lushniak who oversees operations of the United StatesPublic HealthCommission Corps comprised of 600 uniformeded health officers. I will swear in the witnesses. You are aware the committee is holding a hearing and when doing so had the practice of taking testimony under oath. Do you have objections to testifying under oath . All the witnesses say they do not. The chair would advise you under the rules of the house and committee you are entitleded to be advised by counsel. Do you desire to be advised by counsel today . The panel waives that. Would you all please rise and raise youre right hand . I will swear you in. Do you swear the testimony you are about to give is the truth, the whole truth, and nothing but the truth . Thank you. The panelists have answered in in the affirmative. You are now under oath. You may now each give a fiveminute summary. Well start with with you. Thank you very much. We appreciate the opportunity to come before you and discuss whats happened in the month since the last hearing. In the basics of ebola we continue to see the pattern we have seen over the past four decades. In fact, in the more than 400 contacts with we have traced in the u. S. We have not seen spread outside of the one incident in dallas in the Health Care Setting among travellers monitored since arriving from west africa. We have seen a series with fevers but none with ebola. Nothing changes the experience we have to date that ebola spreads from someone who is sick and spreads through unsafe care giving in the home or Health Care Facility or in unsafe burial practices. Emergency funding is critical to protect americans. Its critical to stop the outbreak at the source in africa and strengthen our protections here at home. Globally, in each of the three epicenter countries we have seen rapid change and flexibility is key to the response. In liberia, we have seen promising developments in recent weeks. We have some decrease in numbers, but still the number of oh new cases each week is in the many hundreds. Our ability to stop it is very challenging because it is now present in at least 13 of 15 counties of liberia. Our staff are now responding to as many as one new cluster or outbreak per day compared with the past four decades with one cluster or outbreak per every year or two. Its