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At This Hour

Up to 100 Being Contacted in U.S. for Ebola Exposure; Texas Forcibly Quarantines Family of Man Diagnosed With Ebola; Can the Secret Service Clean Up Its Act?

Aired October 02, 2014 - 11:00   ET

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

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JOHN BERMAN, CNN CO-ANCHOR: @THISHOUR, as many as 100 people around Dallas -- 100 -- now being contacted about possible exposure to Ebola after the first person is diagnosed with that disease here in the United States.

MICHAELA PEREIRA, CNN CO-ANCHOR: And among a dozen being monitored, five children who may have been exposed, this is how some Texas parents found out.

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UNIDENTIFIED FEMALE: It has been confirmed that five students may have come in contact with an individual recently diagnosed with the Ebola virus.

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BERMAN: The parents' response, plus we try to answer the question, are doctors ready for an upswing in people worried about Ebola?

Then, minutes away from a dangerous deadline, tensions rising in Hong Kong, protesters surround government buildings, police say there will be serious consequences if they do not disburse now.

We have a live report ahead.

Good morning, everyone. I'm John Berman.

PEREIRA: And I'm Michaela Pereira.

We're going to start this hour with, of course, the latest on Ebola, new steps to contain Ebola here in America, now that it's been diagnosed here for the first time ever.

There's no telling how far it has already spread. We're learning that health officials are now reaching out to up to a hundred people in the Dallas area who may have been exposed or have come in contact with a patient that has the deadly virus.

They're monitoring those who came into contact with the Ebola-stricken patient and are tracing his contacts' contacts. The patient, Thomas Eric Duncan, pictured here, remains in serious but stable condition in isolation at Texas Health Presbyterian Hospital in Dallas. This is the same hospital that turned him away last week saying his symptoms did not warrant admission.

BERMAN: Yeah, so Duncan was contagious at that time, and family members with whom he was staying are now being ordered to stay home and not have any visitors.

Dr. Anthony Fauci, director of the National Institutes of Health, explains the importance of this step for both the family members and also the first responders.

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ANTHONY FAUCI, NATIONAL INSTITUTES OF HEALTH DIRECTOR: The people who were in the emergency response as well as the family who had very close contact, perhaps even with bodily fluids, they are relatively speaking, at a higher risk than some of the other people who came into contact also.

Although all of the contacts will be monitored, when you quarantine somebody, you feel that the risk is high enough, you want to make sure that you don't miss the development of symptoms and have them have contact with somebody else.

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BERMAN: There's so much news on the Ebola story. And we're covering all the angles this morning.

Our chief medical correspondent Dr. Sanjay Gupta is outside the CDC, and our senior medical correspondent Elizabeth Cohen joins us now from Texas Health Presbyterian Hospital in Dallas.

And, Elizabeth, it is from Dallas where we've been getting mixed and sometimes confusing information this morning about how many people are being contacted about possibly being exposed to this patient, how many people are being monitored and what the difference is.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: All right, John, as you said, we got a rush of misinformation early this morning and then a rush to correct it, so this is what we know to be true at this moment.

We are told that about a hundred people are going to get phone calls, and they're going to say, hey, what kind of contact did you have with Thomas Eric Duncan? What kind of contact did you have with him?

So this is casting a wide net, a hundred people who are possible contacts of Mr. Duncan.

As far as we know right now, authorities say only about 12 people are actual contacts of his. Only 12 people are known to have had contact with him. But we know that that number, that 12 number, will be going up. John?

PEREIRA: I'm going to pick up with Sanjay now., because I know that one of the things that you and Elizabeth and many of the medical professionals that have talked to us on the air about this is the awareness, the information.

The key is for people to be informed, so why don't we get down to brass tacks and inform our viewers just how is this virus spread. There are so many questions remaining here.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, and it's one of these things where I think there has been some confusion around exactly what constitutes someone as being high risk.

Let me tell you a couple of things. First of all, we talk about the fact that you have to have had direct contact with the person's bodily fluids in order to actually potentially be considered a contact or potentially be exposed.

And I want to put a graphic up if I can, quickly, Michaela. I don't want this to look too confusing to you, but just take a quick look -- what is considered high risk, what is considered low risk and what is considered somebody that they're keeping an eye on.

A high-risk person, somebody who has symptoms and obviously had contact with someone with Ebola, known exposure, they're high risk; they're going to get tested.

Someone who is a low risk, that could be somebody who lives in the same household, for example. They don't necessarily get tested. That's somebody you've got to keep an eye on. If they develop symptoms then that may warrant testing.

And then the third category, these are people who may be traveling through west Africa. They may be there as tourists. They have no exposure to anybody with Ebola. They've not been in the hospital. They are probably not going to get tested. If for some reason they develop symptoms, then they might get tested, only because they got exposed to someone with Ebola and didn't know it. That's sort of that third category.

It's not cut and dry. It's not fever, travel west Africa, you automatically have Ebola, you automatically need to get tested. It's a little bit more nuanced than that. And that graphic sort of puts it in perspective.

BERMAN: And, Elizabeth, I want to go back to you on the ground in Dallas because part of that group that was not on the graphic are these people who have now essentially been guaranteed.

It's the EMTs, the first responders and also the family members of Duncan who had contact with him. Tell us about these groups?

COHEN: Right. So these four family members -- this is the group that I know about -- these four family members were told several days ago, hey, please don't leave your home, but we're told by the Texas Department of Health that these family members had challenges, that was their word, challenges in following these instructions.

So now they've sort of put down kind of the heavy arm of the law and said, all right, we're legally requiring you to stay at home. Now, we don't know why, and this is a huge question mark in my head.

We're told that these family members aren't sick, so, by definition, even if they're infected with Ebola, they can't spread Ebola. So I've been talking to my sources and no one can figure out why they want them to stay home.

Maybe they're worried that they're going to leave and never come back, and then you're really in a pickle. I really don't know what the answer is. But these four family members are told not to leave the house, and the state is working out plans to bring them food and whatnot so that they can stay put in their house.

PEREIRA: But, isn't that one of the challenges, Elizabeth -- and maybe, Sanjay, you can jump in on this -- is the fact that if you aren't showing symptoms, you're not going to test positive for Ebola.

But the incubation period, as you were talking to us about earlier this morning, Sanjay, is anywhere between two and 21 days. Sometimes we're not real honest about how we feel, and we might just brush it off as flu. We are getting into flu season, which is a concern, because some people might mistakenly say, oh, I'm probably just a little bit under the weather.

And therein lie as bit of concern for medical professionals, Sanjay.

GUPTA: Yeah, you know, it's interesting because Elizabeth brings up a really important point, which, I think, we had talked about, is this idea you're going to quarantine people, but why? Who are you protecting, really? Are you protecting the general public? They're not sick, so they can't spread the virus to the general public.

I asked that same question to Dr. Fauci earlier today, and what he said is, look, there are people, if you're worried enough about them, maybe they're out in public, maybe they're starting to get sick, as you pointed out Michaela, and because they're starting to get sick, they could start to become someone who could become infectious. They're not being closely monitored enough and they could become someone who could become a source of infection.

So the best sense, if you're truly worried, is to just go ahead and put them under quarantine. Don't let them out in the general public. They can still get monitored, in this case, in their own homes.

BERMAN: That makes, actually, sense to me. I mean, you don't want them to start to get sick, even if they haven't been feeling badly, whether they're out in public two hours or (inaudible) --

PEREIRA: Look at what we saw with --

GUPTA: That's right. PEREIRA: -- this patient that arrived from Liberia. He was fine. He had his temperature taken before he left, when he arrived here. It was only days later that he got sick.

So, again, that causes some discrepancies in how we can understand how it progresses and how it transmits.

Our thanks to both of you for joining us. In fact, we want Sanjay to stick around if you can. We have more questions.

BERMAN: That's right. And you can always send us your question, the hash tag is #EbolaQandA. Please tweet us. Like I said, I just got one questioned answered right there -- why they would be quarantined if they're not symptomatic. Because they could end up being symptomatic if they leave the house.

All right, ahead @ THIS HOUR, we're going to ask many of these questions that you're asking. One, how is Ebola spread. Experts say it is not airborne. But, really, do they know that, and what exactly does that mean?

PEREIRA: Something else in the air, this time, aiding in the search for missing college student Hannah Graham, they are now using drones. What exactly are they looking for?

BERMAN: And then an emotional plea for the government to help a U.S. Marine jailed in Mexico.

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MONTEL WILLIAMS: How dare we -- how dare we as a nation hesitate to get that young man back!

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BERMAN: We will talk to the mother of that young man still in prison in Mexico.

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NANCY WRITEBOL, EBOLA SURVIVOR: If they know somebody that's exhibiting symptoms that look like Ebola, to get help immediately.

Don't wait thinking, oh, this is just the flu, I'm going to wait or I'm just not really getting any better. Don't wait to seek out medical help.

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PEREIRA: She would know. That was Ebola survivor Nancy Writebol, the missionary that we know, covered her return to the U.S., offering her advice now that the virus has been diagnosed for the first time in the U.S. Health officials in Dallas now are monitoring people, about a dozen of them, including five children who came in contact with this man, Thomas Eric Duncan, during the four days he was contagious yet not in isolation.

They're also contacting as many as 100 other people who may have come in contact with him.

BERMAN: So the monitoring will last about 21 days. That is the longest that doctors would think it would take for Ebola symptoms to emerge.

And as they wait, four of Duncan's relatives have been told, as we reported, to stay home and not receive visitors.

Joining us to talk about all this, Dr. Jorge Rodriguez, an internist who's led all kinds of clinical trials. And, Doctor, you say the next few weeks will teach us a lot about how Ebola spreads.

But isn't that a little worrisome in itself, to say we will learn about Ebola suggests that there's plenty we don't know right now.

DR. JORGE RODRIGUEZ, INTERNIST: Well let's start off by saying there's plenty we do know, so there is, really, cautious vigilance is what we need to do. What I'm saying is that most of what we know about Ebola, we have gathered from people that have already been infected with Ebola. So we know what happens once you catch it and after the fact. What I'm most concerned about is that period before people start showing classic symptoms. What's called the prodrome. Or when - are people truly not contagious at that time? If we now, with the help of, obviously the CDC and the NIH, if we start seeing different patterns of infection occurring, perhaps in Washington, in Belgium, in Dallas, then perhaps there's a little bit more that we don't know. That will -- that's what we'll start learning in the next couple weeks. So yes, it's a little bit worrisome, but we know the majority of the facts about Ebola.

PEREIRA: You have given some tremendous recommendations. And I'll be honest, some of them were kind of high level steps to contain this virus. We'll throw them up and people can follow along with me. I'll read through them. Instructing all hospitals and physicians on what questions to ask, where to send blood samples, where to refer patients, creating a quicker test to diagnose Ebola, standardizing tests to diagnose Ebola, standardizing tests, rather, for all foreign travelers, not just people coming from West Africa. I want to go back to that first one, instructing all hospitals and physicians on what questions to ask. We see what went wrong in Dallas. The fact that a nurse didn't recognize the fact, or take the travel history of that man, who is now sick with Ebola. What do we need to do to make sure every hospital, every nurse's office, every clinic, urgent care, et cetera, across the nation is ready for proper screening?

RODRIGUEZ: Correct. And listen, this may be high-level decisions and I'm hoping some high-level people are watching, but it shouldn't be too difficult. There needs to be, perhaps, a hotline established. Like Nancy recommended, the woman who had Ebola, people are probably going to be coming to my office, my patients, when they have a fever. I need to know what number to call. I've gone on the CDC website. It's very confusing. Those couple of hours, in order for us to get information, may be crucial. So, information should probably be disseminated from the local health authorities, perhaps here in Los Angeles, the Los Angeles County Health Authority, to different physicians, via the Internet, via the American Medical Association. So that's one thing. We need to have quick access to inform the powers that be, the CDC, that we have someone that's suspicious. That's one thing. That's what I mean by that. As opposed to having us look --

BERMAN: So a lot of people. Sorry doctor, I was just going to say, a lot of people nervous right now about Ebola. A lot of the focus on Ebola. Meanwhile, there are people dying from Enterovirus D68. There are four people we know that have died, many from the respiratory issues. Now there are fears that it might also be causing paralysis in some other people. You know, do we need to be paying more attention to this? Is that virus getting more dangerous?

RODRIGUEZ: Well, like Dr. Sanjay Gupta said, that theoretically is going to be affecting hundreds of thousands, if not millions of people, like it does every year. So, we do need to be cautious. Parents that have kids that already have respiratory diseases like asthma, need to be paying special attention that they are at their prime and at their best health, so that if they do catch this, they don't get the highest chance of getting some complications. So, yes, that is a little bit more of a concern right now than Ebola, just because of the sheer numbers that it could affect.

BERMAN: On the soccer fields this is what people are talking about. Parents are very worried about this. Dr. Jorge Rodriguez, thanks so much for being with us. We really appreciate it.

PEREIRA: It's interesting to hear an internist, a man who has a medical practice that sees patients all the time, says that he finds the CDC site confusing. That is a concern, if you can't find substantive information about Ebola on the website.

BERMAN: I've got to say, the other key things he mentioned is this period we're in right now, that period between contact and when symptoms may emerge. That's the area that's the most unknown. That's what's happening right now.

PEREIRA: Big question mark.

BERMAN: Ahead @THISHOUR, a whole bunch of bad news sinks the Secret Service Director, but will replacing the leadership help that agency shape up? We're going to speak with someone who worked for them. That's next.

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REP. JASON CHAFFETZ (R-UT), OVERSIGHT COMMITTEE: Long-term, I think it would probably be best to not only bring somebody in from the outside to direct the Secret Service, let's bring in people from the military, from the FBI, from maybe private security to really take a top-down, a thorough approach for this for the long-term fix to truly be in play.

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BERMAN: @THISHOUR, that is one of the key questions facing the Secret Service. Can the agency clean itself up? There's a new director now, at least a temporary one, because the old one resigned after a congressional oversight committee spent a day, basically, grilling her over all sorts of revelations that just seem to come to light every day.

PEREIRA: Julie Pierson telling Bloomberg News, quote, "Congress has lost confidence in my ability to run the agency. The media has made it clear that this is what they expected. I can be pretty stoic about it, but not really. It's painful to leave, as the agency is reeling from a significant security breach."

Joseph Clancy is now running the shop for now. He's serving as the Interim Director, a former Special Agent in charge of the Presidential Protective Division.

We have with us here in studio, Andrew O'Connell, is a former Secret Service Agent, now a security consultant. Nice to see you again. You were with us yesterday on "NEW DAY." Good to have you here. Right decision for her to step down? Is this a step in the right direction? Do you feel hopeful that the agency can move in a new direction now?

ANDREW O'CONNELL, FORMER SECRET SERVICE AGENT: Yeah, I think as it relates to the director, I think she made the right decision, given Congress, apparently, has made it clear that they lost faith in her. I don't think she should have stepped down because of the recent security incidents. I think she was a great Special Agent, a great supervisor. But when people lose confidence, I think she made the right decision.

BERMAN: Our Jake Tapper is reporting that the final straw with the White House, the White House lost confidence in her, too, not in her abilities, but in her truth-telling abilities. What they say is the final straw was the fact that she did not tell them about that elevator incident where there was an armed security contractor on the elevator. She did not tell that the White House, despite all the questions, all the investigation over the last few weeks. And they felt that there was a problem with forthcomingness. Is that a cultural thing in the Secret Service?

O'CONNELL: Absolutely not. I think if you look at the history of the Secret Service, remember the Secret Service has been around for 150 years, at least 100 protecting the president. Incidents happen over the years. We had an assassination of a president, we had attempted assassinations. We've had things that have happened. The key is to figure out what happened, what went wrong. Certainly, what happened at the White House is awful. It shouldn't have happened. There's a security plan in place that wasn't executed at the White House. People need to be held accountable for it. But, I don't think this relates to some broader cultural issue within the Secret Service. I mean really, you have to look at 100 years of pretty good service of everyday protecting the president. It's not easy. Things will happen. And when they do, you have to recover from it. I think they will.

PEREIRA: So let's talk about going forward. Cause there's no sense, really, in dwelling in the past. Make sure you fix the problems and move on, I think, is key. We have an Interim director. This is a guy who has been in the Secret Service a long time himself. He was part of the Presidential Protection format. So he clearly has insight into what needs to be done here. Some are saying he might not be the right guy to stay there in a permanent role, because he's an insider, and has suggested, as you heard -- say a second ago, maybe we need to bring somebody in from the outside, maybe bring somebody in from the military. Do you agree with that or no?

O'CONNELL: Well first of all, with respect to the new director, I think he's a great selection, he's an agent's agent. They respect him, to the extent morale is in a difficult place right now, I think that helps bring that up. As it relates to the question of what to do now at the White House, look it's a balancing act that the Secret Service does every day. The president, Congress and the American people want him out there. They want him accessible. The Secret Service is constantly trying to pull him back.

How do you find that balance? You can make that place into a fortress, you can bury it, make it so it's minimized the risk completely that something is going to happen to the president. But that's unreasonable.

So what do you have to do? You have to continue to take steps and learn from problems in the past. You know, trying to find out what happened to all the officers on the grounds that day and why there was not a response or the response was inadequate, is really critical to better securing the White House. I think that making a military institution or bringing in a general, if that's what the American people want and that's what Congress wants and they think the American people accept a militarization of the White House, and security at the White House, well then that's what's going to happen.

BERMAN: First of all, I don't think anyone questions the bravery or the courage of the people who serve in the Secret Service. No first family ever questions it either. But tell us -- you tried to explain the conflict there inherent between what the president and political advisers want in any administration and what the Secret Service wants.

O'CONNELL: That's the most difficult part, I think, of being an agent. And that is, you constantly have White House staff, the families making requests, that in some ways, could compromise security. I heard recently that there was an alarm that was muted at the White House at the request of someone at the White House. You think something like that would make it to the highest levels of the Secret Service and be denied. But there are certain requests that the Secret Service gives into. It really is a give and take. After all, it's the president. He gets what he wants. If he wants the Secret Service to back off in certain ways, that will not jeopardize security, the Secret Service will do that. There comes a point where there are certain standards they won't fall below. I think that's the case here.

PEREIRA: Andrew -

BERMAN: Did it fall below this time, is the question.

O'CONNELL: It certainly did that day at the White House.

PEREIRA: Let's see what happens in the next days, weeks, et cetera. Likely you'll be back with us. Andrew O'Connell, thanks so much for joining us this morning.

Ahead @THISHOUR, 100 people, 100. That is how many may have been exposed to the Ebola patient in Dallas. They might not even have known about it. We'll tell you what you need to know about Ebola. Dr. Sanjay Gupta will answer some of your questions. You can tweet us at #EbolaQandA.

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