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CDC Head Testifies Before Senate Committee About Why TB Patient Andrew Speaker Was Allowed To Go On His European Honeymoon

Aired June 06, 2007 - 10:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

HEIDI COLLINS, CNN ANCHOR, CNN NEWSROOM: Good morning. I'm Heidi Collins.
TONY HARRIS, CNN ANCHOR, CNN NEWSROOM: I'm Tony Harris. Stay informed all day in the CNN NEWSROOM. Here is what's on the run-down. The man at the center of the TB scare tells his story to Congress. We will bring you his testimony live.

COLLINS: A Kansas teen missing since Saturday. Police are now hoping a new surveillance tape can help them solve the case.

HARRIS: Still doing time after a change in the crime, but a new bid for freedom for Genarlow Wilson this morning.

It is Wednesday, June 6th. You are in the CNN NEWSROOM.

If we could, let's take a look at the -- let's take you to Capitol Hill right now where the Senate hearing is underway right now. Again, it is titled "Crack In The System". And the featured speaker this morning will be Andrew Speaker, live on a speakerphone from National Jewish Medical & Research Center, where he's being treated for his tuberculosis.

It is going to be interesting this morning to watch this. Other witnesses to testify this morning include Doctor Julie Gerberding, director of the Centers for Disease Control & Prevention, and Doctor Anthony Foucci (ph), director of the National Institute of Allergy and Infectious Diseases. We will take you -- well, maybe we can listen to the Doctor Julie Gerberding right now, for a bit.

(BEGIN LIVE FEED, IN PROGRESS)

DR. JULIE GERBERDING, DIR., CNTR. FOR DISEASE CONTROL: In protecting the health of our nation, and really people around the world. I think Doctor Foucci (ph) and I will both agree that we are very, very fortunate to have that kind of support for our agencies.

What I would like to do very quickly is to talk about what should have happened in this situation, what actually did happen in this situation, and what we need to change to make sure that the problems that occurred don't happen again.

I'm actually very grateful to have the opportunity to be able to talk through this because I have been frustrated by some of the accounts that I have been reading. and not really having a good forum to be able to lay out the whole story and address questions and in a straightforward manner. So, I really do appreciate it.

You know, I'm a doctor. And long before I had this role I was a doctor at San Francisco General Hospital and I took care of lots of patients with tuberculosis. (AUDIO GAP) Some were medically indigent and poor people. We had to face -- (AUDIO GAP)

(TOUCH TONE DAILING)

(END LIVE FEED)

COLLINS: I believe that's a speaker.

HARRIS: Well, I mean, I'm being asked to explain what's going on. I don't really know what's going on.

COLLINS: That's Andrew Speaker.

HARRIS: Is that really what it is? Or we just think that is what it is because someone is dialing a phone? Is that what it is? Andrew Speaker dialing in?

(BEGIN LIVE FEED)

UNIDENTIFIED MALE: I was hoping to have Mr. Speaker for the proceedings.

HARRIS: Are we listening?

UNIDENTIFIED MALE: He is a witness for our second panel.

HARRIS: All right, let's go to CNN's Brianna Keilar. Brianna is covering the hearing for us. Brianna, we hear the dial tone. We hear the numbers being depressed. We are assuming -- why are we getting this feed is the question. Brianna, what's going on?

BRIANNA KEILAR, CNN CORRESPONDENT: Well, Congress is not immune to technical difficulties. That's what's going on there, Tony. There were some problems at the beginning of this hearing as they are trying to get Andrew Speaker dialed in. There seemed to be some confusion. Obviously, that continues to go on here.

Just to give you a sense of what's going on here, this is a hearing before the Senate Appropriations Subcommittee that deals with Health and Human Services. It is now underway. And the chairman of the committee, Senator Ron Harkin, said the committee will get it -- pardon me -- Tom Harkin will get it why there were gaps in planning that allowed Andrew Speaker to travel overseas despite warnings from health officials, not to travel.

He said they are also going to try to figure out why a U.S. Border Patrol agent allowed Speaker to enter the U.S. despite the fact the fact that there was a notification that health officials were looking for him. Andrew Speaker was supposed to have called in. They are trying to sort that out at this moment. He's calling in from a phone in his hospital room in Denver, so he can listen to the proceedings. And so he can testify before the committee. They were hoping to have him as a web cam situation or some sort of --

HARRIS: Yes, that was some of the early guidance for us. That he would be appearing on a web cam. What happened there?

KEILAR: That's right. Apparently there was some difficulties getting it hooked up at the hospital. It is obviously not panning out as Congress would like, you know. They are trying to go through this efficiently. And, obviously, that's not really the case.

This is going to be a very interesting hearing to watch. Because there's also going to be an official from the Fulton County Health Department in Georgia, who will be testifying. And remember, Speaker has said Fulton County Health Officials told him they would prefer that he didn't fly, but didn't tell him outright that he should not.

He has also said they were aware of his wedding and his honeymoon plans in Europe. This is going to be sort of a he-said, he-said situation maybe, and we will see if that situation can be cleared up.

HARRIS: Brianna, they're still having problems -- big problems trying to connect with Andrew Speaker. Why don't we do this? Why don't we go back and listen to Doctor Julie Gerberding.

(BEGIN LIVE FEED, IN PROGRESS)

GERBERDING: Has a very serious illness and I'm glad he's in the right place and I hope he gets the right treatment. Everything looks promising at this point in time. But we have to remember that above all, we are dealing with an individual who has a very serious disease. I think that needs to be behind our thinking in all of these cases.

Let me talk a little bit about what should have happened here. You know, every year there are 72,000 cases of TB diagnosed in the United States. Each time a case of TV is diagnosed, it needs to be tested for drug resistance. Health officials need to be notified and appropriate steps need to be taken to make sure that the patient gets treatment, and the public is protected from exposure during the period of contagion. And 72,000 cases actually represents the total of cases since I have been the CDC director, and I can tell you, in that period of time I've never had to issue a federal order of isolation until this time.

In fact, I haven't issued a federal order for isolation since 1963, when an isolation order was issued for smallpox. And I don't think any CDC director has ever had to issue an order for tuberculosis. This is a really unprecedented and unusual situation. The majority of times, in the last five years, TB cases have been managed by local and state health officials without this kind of complication. The system has worked very well to protect the public's health.

On a handful of cases, local isolation orders have had to occur. Occasionally state isolation orders have been invoked. We have also been able to make the system work on behalf of both the patient and the public. So we have to understand what changed in this particular situation. Now, in this case, what should have happened is that the diagnosis should have been made, the drug susceptibility testing should have been done and health officials should have been alerted. Those things were done. There has been some confusion about why did it take so long to know that he had XDR-TB, and the reason for that is this a very slow growing organism. And it takes a long time to do the tests when the organism is slow growing.

So there's nothing about the timeline from diagnosis of the disease to diagnosis of drug resistance that is unusual. Although, there are some new opportunities that Doctor Foucci (ph) might talk about to speed up that process using new technology and new diagnostics that are in the pipeline.

The patient was started on traditional therapy, but once it was learned that he had multi-drug resistant treatment TB, that treatment was stopped and so he was essentially untreated from that moment in time until he ended up at National Jewish and could be restarted on therapy.

The local public health officials assessed the risk. They determined that it was not zero. They recommended measures to protect others. And basically, in the vast majority of situations like this, they operate under covenant of trust. They give advice to the patient, they explain what needs to be done to provide protection. And patients generally cooperate, as I said. Almost all of them cooperate with that experience.

And certainly, in my own experience, I have never been in a situation where we were as surprised to see a patient choose a different route. But, of course, in this situation the patient had very compelling reasons to make an alternative judgment about what was in the best interest of himself and the people around him.

In Georgia, if a patient is to be isolated in an involuntary manner, it takes a court order, and the patient must first demonstrate that he's not compliant with medical advice. So the state could not issue such an order until the patient actually did something that was against medical advice. That's the way the laws Georgia are written.

If the state felt that they couldn't isolate the patient they could contact CDC to determine whether or not we could use our federal quarantine authorities in this case. Our authorities allow us to act when the state fails to contain the patient, they allow us to act in a situation of interstate movement when patients moving from one state to another, and they are written to act to allow us to prevent the importation of tuberculosis into our country. Those are conditions in which we can issue a federal order of isolation.

We recognize that in this case, everyone was giving the patient the benefit of the doubt and assuming that we would be able to find a way to satisfy our public health responsibilities, as well as his personal needs. On May 10th, I don't know from a CDC perspective what was said in a meeting, but because our quarantine officer was not present. But I know the health department met with the patient to explain his drug resistant tuberculosis and what needed to be done. And following that meeting, Doctor Sparrow (ph) did contact the quarantine officer at CDC and request information on what to do if the patient did not follow medical advice and made a decision to travel internationally. So we were contacted to ask what options would exist if a patient did not follow the advice of the health department and made alternative decisions. That advice was provided by the quarantine officer.

We know the next day the patient made a decision to contact the airlines and move up his flight date. And then traveled on the 12th to Europe, his fiancee did not change her plans, apparently, and traveled on the 14th as the patient originally intended.

On May 18th, CDC was notified by the Health Department that the patient might be in Greece so we contacted airlines to try to ascertain if in fact he had flown out of the United States and went to Greece. We were able to contact Delta, which was the plane he was scheduled to fly on, on the 14th and we looked at the days, three days before, and after. The airline was very cooperative; could not find any information suggesting that the patient had left the country, so we had no documentation.

During this time we were on the Internet trying to find the patient's addresses, telephone numbers, the father's telephone numbers, and so forth. Trying to track down family members, including the father-in-law, of the patient, the father to see if we could contact them by cell phone or other means to figure out where -- there their whereabouts. We were unsuccessful of contacting them during this period of time.

On May 22nd, our laboratory determined the patient actually had extensively drug resistant TB. A form of TB that's extremely difficult to identify and respond to. CDC contacted the Customs & Border Protection and asked them to put the patient on the lookout list, because of this extremely difficult tuberculosis.

They were very cooperative. They were able to tell us when the patient was scheduled to return. They were able to put that alert out for all of their Border officers and that day we were able to make contact with the patient's father-in-law by cell phone. He was able to tell us that, yes, in fact, the patient had been in Greece. And they were international, they were on their honeymoon. They didn't know where they were; they would try to contact them.

At midnight in Rome, that night, or later that day, on May 22nd, the patient did in fact contact CDC, in a very cooperative mode and as -- as his family had asked him to do. We were able to have conversations with him while he was in Italy. Granted, it was late at night for him. Those conversations went on over the next 24 hours.

The communication from CDC focused in three areas. One, is to inform the patient he must not fly because he had extensively drug resistant TB. The second was that it was important that he report to chest hospital in Italy so he could be evaluated. We were concerned that since he had not been treated in the last two months he could be getting sicker and potentially more infectious; and he need to be seen by a medical physician so that we would have information about what other decisions and options were available.

We also provided the patient with information about what the options might be for bringing him home, either in the short term or long term. We -- as the U.S. government, the policy in the State Department is that travelers have to provide their own transportation home if they have a medical emergency, including a communicable disease. But we felt in this situation since he was not only a risk to himself but a risk to other people that we really should try to see if we could do something to facilitate and help him get home.

Options we considered included an air ambulance, which his insurer may or may not have paid for. We made efforts to contact Kaiser Insurance, beginning that day when we found out who his insurer was, to try to ascertain his if Kaiser could help us. We also contacted -- the military has an isolator they can roll on or off aircraft and put patients in respiratory isolation without posing a risk to the pilot or the crew.

That option was not immediately available and would have taken some time to Trans Com to order a military aircraft and how we would pay and reimburse the DOD for that, was not something we not planned for and that's an area in our action plan that we need to go back and revisit.

We considered CD aircraft. CDC has two small airplanes that we have to have available 24/7 to support strategic national stockpile and we have the CDC aircraft this committee helped us support in the context of SARS and the many public health emergencies where we had to take a fast action and move samples or people or specimens very quickly.

Unfortunately, our aircraft is not configured to allow safe transport of patients with respiratory diseases that require isolation. There's no way to completely separate the air in the airplane from the pilots or the crew of the aircraft. We used the same plane when flew the patient from New York to Atlanta, but in that case it was a short flight. It is not a short flight from Europe to Atlanta. We were just not able to safely orchestrate this.

We tried to think of various things we could do to rig the system to make the plane air safe. But we really could not transport the patient respiratory isolation. We have a gap there in our ability to move patients forward. But I -- I want to be completely clear we looked at every option and we have really, I think, done a lot of analysis since that time to figure you on how can we close the gap in our ability to transport a patient who requires respiratory isolation.

Keep in mind, at that time we did not know how infectious the patient really was because he had been off treatment for several months. The patient understandably was probably frightened. Here he was on his honeymoon. He's told now he has an extremely drug resistant tuberculosis. He's told he has to go to the hospital and knows nothing about. And we asked him to call the embassy to the travel assistance program because the State Department has a loan program to help travelers whose insurance or private means don't allow them to get home. There are many options that we presented but I think the bottom line was the patient was fearful and he was going to be isolated out of his own country and made a personal decision to travel as he put it, underground, to avoid any detention that could really provide a severe restriction of his movement over the long run.

And so even though there was a border lookout for the patient, he was able to get into the United States through a very specific error that Homeland Security has addressed, accounted for, and is in the process of correcting, when he returned across the border into the U.S. from Canada. But after he crossed the border he called us; he was cooperative and went to Belleview Hospital in New York City as we asked him to do. We issued the federal isolation order there. He was hospitalized.

His sputums were checked. He's smear negative as he is still smear negative in Denver Jewish. What that really means is that while his cultures are positive he can transmit TB, he's not highly infectious. Meaning he has so many bacteria that you can directly see them under the microscope. I think his care and management from that point forward is clear to everyone.

Basically, here we are in a situation where we have tried to balance the need to respect the patient's needs and wants and emotional state and compelling needs with our requirement to try to protect the people's health. We gave the patient the benefit of the doubt at several points here. And in those cases, we failed to take the aggressive action that we could have used with legally sanctioned methods to restrict his movement more effectively. Let me just define --

(END LIVE FEED, IN PROGRESS)

COLLINS: We have been listening to the head of the CDC, Julie Gerberding, there at the Senate Committee hearings, the Senate Appropriations, to be specific. Regarding tuberculosis -- you would think I would know how to say it by now -- patient. Andrew Speaker.

Some interesting moments off the top of this. We were trying to listen to Andrew Speaker actually dial in. He is attending this by telephone only from his hospital room at National Jewish in Denver, Colorado.

As we listen to Julie Gerberding, Tony and I now, speaking with Elizabeth Cohen, our medical correspondent.

Elizabeth, she's talking about it right now. It all goes back to, for me, anyway, what type of jurisdiction the CDC had, what type of authority they had to both keep him from leaving the country and then possibly from coming back into it. Took a very, very long time to track him down in Europe.

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Right. Let's look at those separately. Let's first look at what kind of authority did they have to keep Andrew Speaker from leaving this country in the first place. Julie Gerberding just said, and I wrote it down, that we failed to take aggressive action, we were legally sanctified to use to restrict his movement. She's saying, "we", meaning public health officials, whether you are talking local, state, federal or combined, we had the legal authority to keep him from moving and we didn't use it.

Now, the reason for that is the public health officials don't usually have to. Usually when a public health official looks someone in the eye and says you have a big bad disease and we don't want to you get on an airplane, we want you to stay put here in the U.S., guess what, they listen. They do what they are told.

In this case, he did not do as they suggested. And he basically said look, they didn't legally tell me, you absolutely have to stay here. We are putting new an isolation room. So he left.

HARRIS: Once he was in Europe, they felt they had to move because in terms of trying to get him back, and intervene in a way that's curious, because they fell that he would continue to move. And he was at -- a risk to himself and others.

COHEN: Right. Heidi mentioned jurisdiction. It is very tough for U.S. health authorities to go -- you can't really just go to another country and pluck someone out of it. He was out of U.S. jurisdiction. Now, could they have contacted European authorities and tracked him? Yes, all of that is possible theoretically. This man was on the move. I mean, within this -- this is a timeline here that I have of where he went, and when he went there. And this man, within three days, was in three different countries. He was in the U.S., he was in Paris, and then he was in Athens. He was -- he was all over the place. It would have been very hard to track him down.

COLLINS: Just as sort of a talking point here. Clearly we don't have a lot of answers on this stuff. You know, as we talk to people out in the public about what type of scare this was, or is right now. A lot of people, I think, wondering -- and we heard Julie Gerberding talk about it, how much his wedding and this very, very special event, you know, once in a lifetime for most people, you know, ever happened. She actually made comments about that saying, you know, he was on his wedding, this was important. Do you think that actually played a role here? How serious they really went after trying to find him and keep him from traveling?

COHEN: I have gotten the feeling through all of this that they felt and said this at the beginning he had compelling personal reasons to want to travel. And so I think that that to some extent played a role. He said I want to go for my wedding. Now the question is -- now as they find themselves about -- a little more than a week after the story has broken on Capitol Hill, defending what they did. I'm sure that people at the CDC are saying well, gee, maybe we really should have exercised our powers to keep him in the country. Now, the issue is the CDC didn't know before he left, fully what was going on. Fulton County officials, they say, hadn't told them yet.

HARRIS: I'm still curious. I guess we are -- maybe we will hear from Andrew Speaker today, maybe not. I'm curious as to how he will respond, what -- what will he say to all of this. Perhaps we will hear a little later this morning.

Elizabeth, thank you.

COHEN: Thank you.

HARRIS: Tonight on "Larry King Live," we will hear from Andrew Speaker, his family, and the Centers for Disease Control & Prevention. That is CNN's "Larry King Live" tonight, at 9 Eastern, 6 Pacific, right here on CNN.

COLLINS: THE Vatican City security breach. Look at this. A man dives toward the pope mobile with the pontiff inside. We'll tell you what it was all about. Coming up in the NEWSROOM.

HARRIS: Republicans putting distance between themselves and President Bush, Iraq, immigration. We will hit the highlights on the GOP presidential debate coming up in the NEWSROOM.

COLLINS: President Bush meets with world leaders of G8 Summit amid new tensions was Russia. The latest from the summit site, in the NEWSROOM.

GERRI WILLIS, CNN PERSONAL FINANCE EDITOR: I'm Gerri Willis. What you don't know about your homeowners insurance may surprise you. "Top Tips" is next in the NEWSROOM.

(COMMERCIAL BREAK)

HARRIS: Homeowners insurance can be a godsend or it can be -- well, king of a grave disappointment. Before disaster strikes know if you are protected. Here with a check list, CNN Personal Finance Editor Gerri Willis.

Gerri, good morning to you. Good to see you.

WILLIS: Good morning to you, Tony. Good to see you.

HARRIS: You know, what -- look, I have homeowners insurance. We all do. We are covered, we're covered, we're covered, aren't we?

WILLIS: Maybe not. I mean, that's -- that's -- there are big problem out there. For example, the flooding coverage --

HARRIS: I'm covered.

WILLIS: No. Not so much. You are like a lot of people. A third of policy holders think flood damage is covered by a standard policy. But, no, to get flood insurance you need to go through the federal government. Go to floodsmart.gov, you'll be able to gauge your risk flooding and get price estimates for your home.

HARRIS: Buy, how did we learn that lesson post-Katrina? I'm thinking about -- OK, I have a bit of a problem with mold. All right. I'm covered.

WILLIS: No. HARRIS: No?

WILLIS: No again, Tony. And 34 percent of people think just like you do. But mold, like rot and a termite infestation is generally not covered under the standard policy. However, there are steps you can take to minimize your risk. Keep the humidity level in your home between 30 and 60 percent by using de-humidifiers, put exhaust fans in kitchens and baths. Don't install carpets in dam areas like your basement or your bathrooms.

HARRIS: That makes sense. All right, have a little backup. My sewer system, the line is broken. I will call the insurance company. I'm covered.

WILLIS: No. No again. You know, 37 percent of homeowners think damages from a break in a sewer line in their property is covered. No, no, no. In reality, homeowners are responsible for the maintenance and repair of the pipeline between the city sewer main and their house. Now, the cost is about $50 a month. You can get a rider on your policy let the insurance company pick up the tab instead of you.

HARRIS: Nice. OK, at least there is an option there. What about earthquake coverage, Gerri?

WILLIS: You can guess what I'm going to say here. Standard policy, no, it does not cover earthquake damage. You can get earthquake coverage from private insurers, deductibles range from 2 percent to 20 percent of the replacement value of your house. So, that's a lot of dough. However, in California, homeowners can also get coverage from the California Earthquake Authority. And this is a privately funded, publicly managed organization to help folks in California who face this problem.

HARRIS: Absolutely. And bring some clarity to the difference here between cash value versus replacement value, replacement costs.

WILLIS: Yeah. This is another misconception out here. The difference between these two things. Remember, actual cash value is the amount it would take to repair damage after you consider depreciation. That's how much the value of your flat panel TV costs after had you've had it in your house for a while.

Replacement cost is the amount it would take to rebuild a home, or repair damages without taking depreciation into account. So you want to make sure you understand the difference, ask for the right thing.

And Tony, I want to remind your viewers. Send us your questions, we love to hear from you, to toptips@CNN.com. We answer the questions right here every Friday and we love your smart questions.

HARRIS: All right. Gerri, great to see you and have yourself a great day.

WILLIS: You, too. Good to see you.

ANNOUNCER: Live in the CNN NEWSROOM, Heidi Collins and Tony Harris.

HARRIS: Bottom of the hour. Good morning, everyone. You're back in the CNN NEWSROOM. I'm Tony Harris.

COLLINS: And I'm Heidi Collins. The case of the TB traveler and a frightening lesson to Homeland Security. Congress demanding answers this morning as we look at the live shot from Andrew Speaker. He will face questions, by phone, over the public health threat he posed.

The Atlanta lawyer infected with a rare and potentially lethal form of tuberculosis when he traveled to Europe. Then a lone U.S. Border official ignored health alerts and allowed him back into the U.S.; the security failure prompting a tightening of procedures.

Stating their positions, Republicans square off over immigration and Iraq. Who said what coming up in the NEWSROOM.

HARRIS: He's still doing the time after a change in the crime. Genarlow Wilson's attorneys try again to clear his name. That story coming up for you in the NEWSROOM.

(COMMERCIAL BREAK)

HARRIS: Police in Kansas are expanding their search for a missing girl. They've released this new surveillance tape. It is difficult to make out, but police say you can see barely there the alleged abductor struggling with 18-year-old Kelsey Smith. Police are also looking for a 1970s pickup truck that may be involved. Smith was last seen Saturday entering a Kansas city area Target store. Police have identified a person of interest in the case. A $30,000 reward has been offered for information leading to her safe return.

COLLINS: Now to a high-profile sex case in Georgia. Lawyers for Genarlow Wilson are launching a new bid to free him. Wilson is serving a ten-year sentence for aggravated child molestation. He was convicted for consensual sex act when he was 17, the girl was 15. Among other things, his attorneys claim the sentence is grossly disproportionate. The law that was used to convict Wilson has since been changed. CNN is monitoring this case. We'll let you know once there is a development.

HARRIS: A new rift between the United States and Russia, the focus of attention as world leaders gather for the G8 summit this hour. Global warming and aid to Africa among the key issues up for discussion. But, along with that, rising tensions over U.S. plans to deploy a missile shield in Poland and the Czech Republic.

President Bush is trying to calm Russian fear, saying the plans are not a threat to Russia. Russian President Vladimir Putin also at the summit. He has accused the U.S. of starting a new arms race and threatened to retarget Russian missiles on Europe in response to the U.S. plans.

COLLINS: Tens of thousands of people on the Arabian peninsula head to higher ground as a powerful storm heads their way. Evacuation orders issued in Oman as Cyclone Gonu roars toward the strait of Pemus (ph), that artery a key shipping route for Persian Gulf oil. Oil prices are rising after Oman's suspended oil exports and shut down a major port ahead of the storm. The cyclone is also threatening parts of Iran. While the storm has weakened, it's still believed to be the strongest cyclone to threaten the region since record keeping started back in 1945.

Chad was actually talking about that the other day.

HARRIS: And he's tracking the cyclone now, Chad, good to see you.

(WEATHER REPORT)

HARRIS: Support for the Iraq invasion, criticism over the handling of the war. That was the view for most of the Republican presidential candidates during last night's New Hampshire debate.

(BEGIN VIDEOTAPE)

MITT ROMNEY, (R) PRESIDENTIAL CANDIDATE: I supported the president's decision based on what we knew at that time. I think we were underprepared and underplanned for what came after we knocked down Saddam Hussein.

SEN. JOHN MCCAIN, (R-AZ), PRESIDENTIAL CANDIDATE: The fact is that Saddam Hussein had used weapons of mass destruction before on his own people and on his enemies. And if he'd got them again, he'd use them again. That was his commitment and his belief, that he was going to, and we did the right thing. The problem was the mismanagement of the conflict.

RUDY GIULIANI, (R) PRESIDENTIAL CANDIDATE: It's unthinkable that you would leave Saddam Hussein in charge of Iraq and be able to fight the war on terror. And the problem is that we see Iraq in a vacuum. Iraq should not be seen in a vacuum. Iraq is part of the overall terrorist war against the United States. The problem the Democrats make is they're in denial.

TOMMY THOMPSON, (R) PRESIDENTIAL CANDIDATE: The first thing the president should do is demand the al-Maliki government to vote as to whether or not they want the United States to stay in Iraq. We've been there four years. Give the government the responsibility of voting. If they vote yes, how are they going to help us win this war? If they vote no, we should redeploy our forces outside.

REP. RON PAUL, (R-TX) PRESIDENTIAL CANDIDATE: Well, we've had four years to do this, and it hasn't worked. The biggest incentive for them to take upon themselves the responsibility is just for us to leave. We don't need to lose 100 men and women every month, a thousand -- one and a thousand per year. And so, you want it done, you want them to take over. You've got to give them an incentive.

So, I think we should immediately stop patrolling the streets. That's a policeman's job, it's not the work of the army. We're not fighting a military battle. We are in a different type of warfare right now. So, the sooner we recognize that, the sooner we can make sure that no more Americans will die.

SEN. SAM BROWNBACK, (R-KS) PRESIDENTIAL CANDIDATE: It's not about leaving and it's not about being defeated. It's about getting the situation to a point that we can turn it over to Iraqis and then us pull back from the front of the line.

(END VIDEOTAPE)

HARRIS: Senator Brownback said he planned to introduce a bill today to divide Iraq into Kurdish, Sunni, and Shia states with Baghdad as a federal city.

COLLINS: Senior Political Analyst Bill Schneider joining us now from Manchester, New Hampshire, where those debates took place.

Hi there, Bill. All right, so, are you ready for this? Who's going to be the Republican nominee?

WILLIAM SCHNEIDER, SENIOR POLITICAL ANALYST: Oh yes.

Well, look, ten Republican candidates, maybe soon 11. Confused? Join the crowd.

(BEGIN VIDEOTAPE)

SCHNEIDER (voice-over): Was the Republican race getting any clearer? Actually, no. It's been getting muddier. Look at CNN's poll of polls over the last three months. Rudy Giuliani is the front runner. Has he been picking up speed? Nope, he's been slowing down. Giuliani's support averaged 37 percent in four national polls conducted in March, 36 percent in four April polls, and 30 percent in seven polls taken in May.

Is anyone catching up with Giuliani? Not so much. John McCain has picked up a few points. But he remains firmly in second place at 22 percent. Fred Thompson hasn't even declared, but he's already running third. He's an actor, and a lot of Republicans are looking for a new Ronald Reagan.

And Mitt Romney? If slow but steady wins the race, watch Romney. His numbers have been creeping up. What about the other seven contenders? Brownback and Gilmore and Huckabee and Tommy Thompson and Hunter and Tancredo and Paul? Not one of them has been getting over two percent.

So, what are we left with -- confusion. Partly because with the vice president not running, there's no heir apparent, no one to carry the Bush administration's banner. And it doesn't sound like the candidates really want to.

UNIDENTIFIED MALE: We did, however, not do a great job after we knocked down Saddam Hussein.

REP. TOM TANCREDO, (R-CO) PRESIDENTIAL CANDIDATE: I have been so disappointed in the president in so many ways since his action -- for the last several years, not just the immigration issue, but several other things ...

SCHNEIDER: Plus, the fact that conservatives had no champion to rally behind. For them, the leading contenders are all suspect.

RUDY GIULIANI, (R) PRESIDENTIAL CANDIDATE: My view on abortion is that it's wrong, but that ultimately, government should not be enforcing that decision on a woman.

(END VIDEOTAPE)

SCHNEIDER: The Republican race has been becoming more and more muddled. Now, will last night's debate help clarify matters? We're going to be polling voters here in New Hampshire this week to find out -- Heidi.

COLLINS: All right, can't wait to see what the results of those polls will be. Bill Schneider live from Manchester, New Hampshire, thanks, Bill.

HARRIS: Big payout for a little investment.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: You hit the big one, you know, where do you go from here?

(END VIDEO CLIP)

HARRIS: Well, to the bank, for a start. A penny spent is $3 million earned, in the NEWSROOM.

SUSAN LISOVICZ, CNN CORRESPONDENT: I'm Susan Lisovicz at the New York Stock Exchange. When NEWSROOM returns, I'll tell you why the breakfast of champions will require some heavy lifting -- financially, that is. Details next, you're watching CNN, the most trusted name in news.

(COMMERCIAL BREAK)

COLLINS: Another one of our favorite stories that we like to revisit. Finding harmony after a brawl at the Boston Pops. Remember this? Two audience members who got into fisticuffs in the balcony agreed not to press assault and battery charges against each other -- nice.

HARRIS: Oh, come on.

COLLINS: The decision announced after a hearing yesterday. You see they are kind of laughing. The fight broke out on opening night when one of the men told the other to be quiet.

HARRIS: Prices in the cereal aisle at your local supermarket might seem like they're actually coming down. But, as Susan Lisovicz is about to tell us, the price for your morning bowl of Cheerios is actually going up.

All right, Susan. Take your time, walk us through this one, please.

(BUSINESS HEADLINES)

HARRIS: Still ahead in the NEWSROOM this morning, feeling the heat in Baghdad. Wires, wires everywhere and still not enough electricity to go around. Power struggle, in the NEWSROOM.

(COMMERCIAL BREAK)

HARRIS: It's tough to keep the lights and the water running when your city is at war. CNN's Hala Gorani checks on residents in the dark and the heat.

(BEGIN VIDEOTAPE)

HALA GORANI, CNN CORRESPONDENT (voice-over): This may look like a random tangle of multi-colored wires. But to dozens of families in the northern Baghdad neighborhood of Tupchi (ph), it is their only connection to basic electrical power.

Follow one of these cables, and you will end up in the home of the Obedi (ph) family. In the baking summer heat, there is only one hour of power a day from the national grid, six with the generator they share with other neighboring homes. In this cramped living room, there is sweat, there is no air conditioning, and there is frustration.

"You share with a private generator and pay $80 for six hours of electricity only," says Isma Younis. "But, we can't even turn on the refrigerator or freezer or other electrical machines."

In a country where power cuts sometimes affect even the Parliament, legislators fanned themselves in the sweltering heat, everyone is affected.

Take this medical testing laboratory. Attia Mohammed Homod said that without electricity, his work comes to a standstill

"It all depends on electricity," he says, "when the electricity is cut, then we have to delay all test results."

It may be less vital, but power shortages are putting added pressure on businesses that would go broke in a few days without generators. An ice cream shop in Sadr City, and nearby carpenter and his power tools, he needs two machines and the cost of fuel to operate them is rising.

(on camera): There are estimates that a third of power supply in Iraq comes from those private generators. And some say the proportion in Baghdad is much higher. Continued insurgents attacks and failed policies to restore electricity means supply in Iraq is still much lower than before the war.

(voice-over): And that means big generator owners like Mohammed Jassam (ph) are more in demand than ever.

"We operate nine hours a day from 1:00 p.m. to 5:00 p.m.," he says, "and from 8:00 p.m. to 1:00 a.m."

Back at the Obedi home, it's time for bed. The heat's so intense indoors that they relocated bedrooms on the rooftop. Mortar attacks and other violence make this dangerous. But in a city where death, destruction and despair are the norm, many here say they will take any short-lived comfort they can find.

Hala Gorani, CNN, Baghdad.

(END VIDEOTAPE)

HARRIS: Far more than a leap of faith, you see it right here. A man tries to jump into the back of an open-air vehicle carrying Pope Benedict XVI. Did you see it there? The Vatican says the man is from Germany and has a history of mental illness. He is being held at a psychiatric institute in Rome. A Vatican spokesman tells us the 27- year-old student was not armed and that the pope's life was never in danger. It is not clear if the man will even be charged.

COLLINS: Wow.

A fast moving wildfire on the move in northern California. That blaze fanned by high winds. We'll have an update on it for you coming up, in the NEWSROOM.

(BEGIN VIDEOTAPE)

NICOLE LAPIN, CNN CORRESPONDENT: Last night, ten Republican presidential hopefuls debated the issues. If you want a full run- down, just log on to our Election Center at CNN.com.

First, we get the facts on the candidates from their political biographies to their positions on issues like abortion or the war in Iraq. And you can see how they match up with our side-by-side comparisons. And then check out slide shows and videos from each of the debates along with a political run-down by our own analysts. And you can vote for which candidate you think won the debate with our debate scorecard.

So, we know the candidates and the issues and where they stand. But, how would they stand up against each other in a friendly game of ping-pong? Well, we have no clue. But, maybe you can choose your favorites and pit them against each other in our own interactive presidential pong game. For this and complete recaps of both of the debates, just log on to our CNN Election Headquarters at cnn.com/election.

For the .com Desk, I'm Nicole Lapin.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

HARRIS: And good morning, everyone. You're with CNN, you're informed. I'm Tony Harris.

COLLINS: Hi everybody, I'm Heidi Collins.

Developments keep coming into the CNN NEWSROOM on this Wednesday, June the 6th. Here's what's on the rundown. Dropping the ball ahead on the TV case? The head of the CDC testifies before Congress.

HARRIS: Jailed for teen sex even after a change in the law. A judge may decide if Genarlow Wilson can go free.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.voxant.com.