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Texas Authorities Holds Press Conference on Ebola

Aired October 02, 2014 - 15:00   ET

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

BROOKE BALDWIN, CNN ANCHOR: And we continue on. You're watching CNN. I'm Brooke Baldwin.

I mean, a stunner in the case of this first person diagnosed with Ebola right here in the United States. You had potentially contaminated waste, sheets, towels still in the Dallas apartment where Thomas Eric Duncan was staying before being admitted to the hospital.

Anderson Cooper talked to the woman Duncan was staying with when he got sick ,his partner, a woman named Louise. She told us that Duncan's sheets are still on her bed.

You will hear my conversation with Anderson in just a second.

But, first, got some more news as it pertains to this Ebola patient, first hearing from his half-brother who lives here in the U.S. In a CNN exclusive, he describes times of real hardship and his brother's search for a better life.

(BEGIN VIDEO CLIP)

WILFRED SMALLWOOD, HALF-BROTHER OF THOMAS ERIC DUNCAN: Well, Thomas Eric Duncan is a hardworking person. He's the last child from my mother. He love the work a lot. And we were refugees in Ghana. And I left and I came to the United States for a brain surgery.

And then he stayed there going to school. He went to school. He had some experience of -- or something -- something he did in school, and then he moved to Liberia (INAUDIBLE) refugees that were in Ghana, and a better life than Liberia, until recently when he got a visa to come to the United States.

(END VIDEO CLIP)

BALDWIN: That's the half-brother. Now we have information coming from Anderson Cooper as he talked to the partner of this man. Her name is Louise.

And here was my conversation with Anderson just a short time ago.

(BEGIN VIDEO CLIP)

BALDWIN: We're talking to Anderson.

You just talked this morning to Louise, we're not giving her whole name, who is the partner of Thomas Duncan, who is the patient, the Ebola patient in Dallas. And so she -- begin at the beginning with it was her apartment in which he was staying, correct?

ANDERSON COOPER, CNN ANCHOR: Right.

Louise has an apartment in Dallas. She's lived here many, many years. She says she's a caretaker. Thomas Duncan was visiting her. She's had a relationship with him. They're not legally married. It's not clear to me what the current status is. But he was visiting her and her family.

Started to feel sick. She took his temperature. It was about 101. She brought him to the hospital. She says as they were checking in at the emergency room, he was asked for a Social Security number. She said he doesn't have one because he just came here from Liberia. The person said, OK, that's no problem. They saw a health care worker.

Louise says she also told that person he had just come from Liberia. Louise didn't mention Ebola. Louise says she wasn't thinking about Ebola at all. Thomas Duncan apparently didn't mention it at all either and none of the health care workers, nurses or anyone else they had interaction with asked Thomas Duncan.

(END VIDEO CLIP)

JUDGE CLAY JENKINS, DALLAS COUNTY: After discussion with and on the recommendation of Dr. Frieden at the CDC, as well as David Lakey, the public health commissioner for the state of Texas, we have moved to an incident command structure.

That is being run out of the Dallas County EOC. And I have asked our partners in many important endeavors in the past like West Nile virus and refugee situation with the children to assist on this and to continue with the great work they're doing, but to also embed some of their key staff into that EOC operation, the Emergency Operation Center operation, so we have the emergency manager for DISD and some emergency management staff from the city of Dallas there as well to ask Dr. David Lakey, who was instrumental in the turnaround of Parkland Hospital and working with us on that as the state's top regulator, and who was at my side throughout the West Nile virus epidemic, and was helpful also on the child refugee child relocation efforts to embed in our EOC for the state.

He's brought some of his team here. I have asked Dave Daigle, who is the associate director for -- let me make sure I get this exactly right -- the associate director for communications and public health preparedness and response at the CDC, who was embedded in my office upstairs for a couple of weeks during the West Nile virus to embed there as well.

We have the top doctor in the world, the top Ebola doctor in the world, here on the ground, Dr. Kuhar. He's embedded in another group at Presbyterian. We have got a good team of experts and people in place. And I want to stress to you that the people who are here assisting the great work that's already been done by our local health department and our local agencies are people that I and our Dallas County Department of Health and Human Services have worked well with, and Mayor Rawlings and others have worked well in the past, so we have a high degree of confidence in those people now to assist us in this action.

Dallas County will act as the lead agency, but when it comes to planning, those decisions will be made with the advice and counsel of our partners from the CDC and the state, the Department of State Health Services. Likewise, I want to get the input as we go forward and continue our strong partnership with the city of Dallas, DISD, and other agencies and groups in Dallas County.

The hospitals, all hospitals are represented through their agents over there at the incident command. And we're moving quickly to continue and expedite the investigation and surveillance into these matters.

A couple of things, and then I'm going to turn it over to someone. Last night, we placed orders on a family. We did that after balancing many things. We do not intend to have to do that again. But there's nothing more important than keeping you safe. And based on the information we had, which I will not be publicly disclosing to you today, it was clear to me, a Democrat, and Governor Perry, a Republican, and everyone who looked at that information that the action -- and the CDC today after we laid it out for them -- that the actions we took, while unusual, were appropriate.

And they're there to -- for the safety of the family, as well as the safety of the public. We have some hygiene issues that we are addressing in that apartment. This is a fluid situation. We have a contractor.

There are protocols that have to be followed to clean and to take care of the things that need to be taken care of in there. We have a contractor who will be there as soon as possible and will take care of those issues that are of concern to Dr. Lakey and myself and our Health Department.

We have food. We have delivered several days of food to that apartment. Those people in the apartment are part of Dallas County. And they're going to be treated with the utmost respect and dignity in this unusual situation.

Dr. Lakey and I are going to reach out and put our eyes on that. And I want to commend Jennifer Staubach Gates for her incredible work with that neighborhood. I realize that if you live anywhere near that neighborhood, you're nervous now, but the science hasn't changed overnight.

This is not like the flu. It's not something where it spreads broadly through the community. You can only get sick, you only contract it from someone who is having symptoms. And remember that the only person who had symptoms is Mr. Duncan, who is in the hospital, and no one who has been around Mr. Duncan during the time that he has been symptomatic has shown any indication of having contracted Ebola or being sick from any other related illness.

So this is a matter that we have a high degree of confidence we can control. And we are working to get the response, which has been a good response, strengthened every hour of the day. Let's see if there's anything else. Oh, on the incident command, the

name of the person that's going to be incident commander for us is Chief Doug Bass. He is our emergency management chief. He is not going to be available for interviews for you all.

Their job at incident command is to gather information and get tasks done that are given to them as the policy is laid down for them. And they are busy doing that, very busy doing that. So there's not going to be time for them or for any of our section chiefs in this unified command to give interviews for the next few days.

Lauren Mish, my chief of staff, will head up the PIOs there, and we will have a JIG (ph), a joint communication with the city and DISD and other entities. And we will try to get that information out in just as close to real time as we can, so that you can get that information to the public.

We want to be as transparent as we can be. And we want to have the public's confidence. And we know the best way to have the public's confidence is to earn that confidence every single day. And we're going to do everything that we can to do that. I see Dr. Theresa Daniel back there in the back. And you ought -- you should come up here because you're more than welcome to come up here.

And the county commissioner's court, the sheriff, all your county elected officials and department heads are working hard. They're working together. They're providing support. Same thing with the city and the school district.

And with that, and we're going to take some questions from you, but, with that, I'm going to turn it over to Dave Daigle, who is -- it's kind of like getting the band back together. Dave is here again.

So, Dave, you want to come say a few words from the CDC?

DAVE DAIGLE, ASSOCIATE DIRECTOR FOR COMMUNICATIONS AND PUBLIC HEALTH PREPAREDNESS AND RESPONSE, CDC: Hi. I'm Dave Daigle with the Centers for Disease Control and Prevention.

Thank you very much, Judge.

And, first of all, I want to tell you that we're really happy to be here. We were invited by the state and the county and the city. And we get to work with them on this investigation and do the contact tracing, so we have a team of about 10 folks. And it's 10 folks here on the ground, but you have to keep in mind CDC has literally hundreds of folks back in Atlanta or working in emergency operation center, working on different teams, like Lab (ph) and EPI (ph), and approximately over 130 folks deployed in West Africa doing the same contact tracing work that we're doing here.

And we're fortunate that several of the team -- several folks on our team here in Dallas have experience in West Africa and doing contact tracing over there. We're doing exactly that. We're working with the county. We're going to do contact tracing. We're going to divide up into two teams. One team will stay at the hospital. We will do active surveillance

and contact tracing at the hospital. The other team is what we call a community team, and working once again with our partners at the county and state, we will do community tracing. And we're making great progress on that.

I think the formal contact tracing where I think you have heard already that there's a list of about 100 what we call potential or possible contacts. And that will be culled down to a list that we will begin contact tracing on.

And so, once again, it's great to be here. Thanks for having us. And I think probably do questions later and I will get out of the way.

QUESTION: Let me ask you a question, sir. How do you come to this number of 100 as you begin this circle of contacts?

DAIGLE: You know, I might let Dr. Zachary take that for you, if you will.

(CROSSTALK)

UNIDENTIFIED MALE: Let's for the questions at the end. Let's go through -- I think Mike is -- Mayor Rawlings next.

MIKE RAWLINGS, MAYOR OF DALLAS, TEXAS: Good afternoon.

As you can see, each member up here has a specific role to play on this team. County Judge Jenkins is kind of leading this effort. We appreciate CDC on tracking down these contacts and the expertise, and Mr. Miles is running the school front.

What we're trying to do at the city is to make sure that we create a calm and safe environment for those people to do their work. That's our primary focus. This business is very local. When I say local, I don't mean Dallas. I mean a very specific neighborhood in the northeast part of Dallas.

As Clay said, Jennifer Gates has been out there almost nonstop with the neighborhood talking to people and communicating with them. The second thing we have done is we have had reverse 911 calls to all of the residents. We have talked to them. We have explained to them what's happened. And we have given them the option to call us back.

As I have said before, if citizens have any questions, they need to call 311. We will be able to give them a full explanation of what's happening and answer any questions that are challenging. If they feel sick, they need to call 911. And we will make sure that they get the first-rate paramedics that worked on this at the very beginning, that sort of delivery system. And we will take care of them from a health standpoint.

We want to make sure that we hand out all of the same materials that were handed out at the schools. We have gone kind of door to door to make sure all of the people have, so we're getting the word out and people are starting to understand what is happening, what Ebola is and the science behind it, that you can't contract this unless you have contact with somebody that has shown signs of having this.

The last thing that I would say -- excuse me. The last thing -- one thing I want to add, we have also embedded police there in the apartment complex to make sure there is calm and nothing else happens. We know the sheriffs are doing their part in regards to the contacts, but we want to create a safe environment there.

That's where you come to play. I appreciate your professionalism as reporters and your aggressiveness. Just know that you will have a moment to be part of the problem or part of the solution, because it is at best disorganized out there. And we have some members of the press that are creating a little bit more of it.

I know that's hard for you to imagine. But we need everybody to be professional at this point. Safety is first and foremost, not only of our patient at Presbyterian, but these individuals that lived with the patient for a while and the contacts.

If we have a chaos out there, and we have got some reporters that feel it is their obligation to pay people to move into their apartments, it creates a little bit of a difficult situation for the CDC and the county to do their job. So, I'm going to ask you as a professional, one to another, be careful about how we interact there locally.

And that's why we have people out there. We have got a city person working with the apartment manager. And if you have any questions, go to them and we will make sure we're, as Clay said, be transparent as we can, but we need to do it in an organized fashion.

Obviously, a very important part of this is children and what's happening at DISD, and I will introduce Mike Miles.

MIKE MILES, SUPERINTENDENT, DALLAS INDEPENDENT SCHOOL DISTRICT: Thank you, Mr. Mayor. Hi. I'm Mike Miles, superintendent of DALLAS ISD.

And for us, there are three priorities. The first and foremost one is our children's safety. That's always going to be our priority, so we're looking after that. The second is providing information. We did a lot yesterday. We are going to continue to do that. We're do that today, information to our parents, to our staff members, to our students, so that they also understand the situation and we're as transparent as possible.

And the third is what we do every day, and that is to make sure we have high-quality instruction. And so those are things that are going on today. We have continued to do what we did yesterday and it's having an effect. We have additional nurses and health professionals on staff today, yesterday and we will continue that tomorrow, and then probably into next week, and those health professionals are answering questions from parents, from students.

Our nurses are making two rounds, they don't usually do this, during the school day to every classroom, also just to check to see if people have questions or if there's any symptoms of anything and so we're being vigilant there. We had additional custodians last night and we will have today as

well. Today, during the day, we have additional custodians just to the take the -- we don't think there's any virus at any of those buildings, but we will take that off the table. We're doing extra cleaning and disinfecting.

And now we're -- also enrolled the five students into the Homebound program so that they will get curricular supports and technology supports to continue their education. I know there is some interest in our attendance. I can tell you I'm very proud of the staff. We have our staff at the school. The attendance rate for teachers is the same as it always is. And then for students, we're down a little bit. We're at 86 percent attendance for those five schools.

The rest of the district is the same. For those five schools, it's 86 percent attendance. It's usually around 95, 96 percent for those five schools. So, we're down a little bit. But I think the message was getting out and people do feel safe. That's why you have that high percentage of kids attending school, and we just think that number is going to grow. And I will take questions afterwards.

JENKINS: I guess what we can do is, you will ask a question, whoever you ask it of, we will just have them come up.

So, Sean (ph), go ahead.

QUESTION: Yes. My question remains for either Dave Daigle or Health and Human Services Director Zach Thompson. My question remains, how do we -- as we establish this concentric circle of contacts, starting with those most intimate out, how do we expand -- how do we get to 100 today that we're assessing for interview or more? That's my question. Who are those numbers? How will it get there?

ZACHARY THOMPSON, DIRECTOR, DALLAS COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES: Well, two points.

Let me make sure -- I want to thank Mayor Rawlings, Judge Jenkins for the support that Dallas County Health and Human Services has been involved with over the past week.

One point before I get to that question. I want to also thank our top doc. We talk about a top doc nationally. We talk about a top doc statewide, but the top doc locally is Dr. Christopher Perkins. It's his staff that's been involved in doing the contact tracing.

The elements that we looked at is -- let's start with the actual close family members. Those family members were assessed and determined that they are part of the immediate contact investigation that we start from. At that point, we look at interviews with other members of the family or friends who might have come in contact with the patient or the family members.

So you begin to build your tracing based on that information. From that, Dr. Perkins' staff has done extensive interviews and done extensive evaluation determined based on Judge Jenkins, Dr. Leahy (ph), from that standpoint, an order was delivered on last night, signed by Dr. Leahy, signed by Dr. Christopher Perkins, that a control measure needed to be put in place.

This was a way to ensure that the public's fear would be put at rest in terms of any interaction with anyone who was the primary contact. From that, you begin to build your circle with the other individuals that makes up the numbers -- i.e., the best example I can give, if 50 of us went to a restaurant, two of us got ill. That's a 52 number that we have to look at, but only two people got ill.

From that aspect, we still have to follow up on the other 50 people to rule out whether or not they had food poisoning or any other issues from that restaurant. So, from that concept, you build your well to be large. Then you reduce your number.

A lot of the individuals that we come into contact will not have any -- they will not have any symptoms. They will not have any association other than the fact that someone said they were there or they might have had contact.

This is local public health surveillance at its best and what we do day in and day out. Another example, shorter than 30 seconds, is when we do T.B. investigation. You have covered enough T.B. supposed cases at a school. You see that we may test 100 students, 150 students, based on one confirmed case. We later come back and report there were no confirmed cases based on the testing done on the other individuals.

That's the clear 101 of the epidemiological assessment, and that's what's done to come up with that circle. The circle is a wide circle. Then it gets reduced. Finally, I want to thank Erikka, our PIO. If you go to our Web site at Dallas County Health and Human Services, you will see updated information on Ebola.

Lastly, Dr. Perkins went out and assessed the family members today and determined that there is no symptoms, that everything is fine based on his assessment today. So, I wanted to be very clear on that process.

QUESTION: I have a little follow-up. Maybe Dave Daigle can answer this, as it relates to the surveillance or contact tracing of the paramedics and the workers there at Presbyterian both on Friday and Sunday, sir.

DAIGLE: You know, I'm sorry. What was your question about the follow-up?

There is a team, we do have a team that's called -- that's working at Presbyterian and they are going to take a hard look at the health care workers. You guys probably know from covering this that certainly in West Africa, the health care workers have been hit very hard by Ebola, so we're concerned about infection control.

So they will be doing the same active surveillance and contact tracing that we're doing in the community, but at the hospital.

QUESTION: Are those workers now being told not to work at the hospital?

DAIGLE: I don't know the latest. I think part of this is the -- I'm sorry -- the evaluation is still going on. Happy to update you when I find out. I don't know what they have been told right now.

And we're going to -- as Zachary was saying, we're going to break that list down into high risk, no risk, and low risk. And that's going to be the basis of our contact tracing, based on whether the 100 possible candidates are either high risk, low risk or no risk. That's really -- as you mentioned, it's very fluid and it's ongoing right now.

QUESTION: So, we know that there are other people that have come in close contact with his bodily fluids, so we have been told to expect a potential other patient. When that happens, theoretically, our local medical authorities will know it first. Where will that patient be taken?

THOMPSON: That's part of our evaluation and discussion that we're having with Dr. Leahy. We would have to determine the appropriate facility in which to take that individual to.

One of the things that individual in our assessment of this, you're correct, of the contact investigation, we will determine if a person showed some type of signs or symptoms. At that point, we would get them to the appropriate hospital. At this time, all our hospitals are set up to be able to deal with that process.

But to give you a specific location, I can't do that since we don't have that issue at this moment.

(CROSSTALK)

QUESTION: Wouldn't you want to keep them all in one place?

(CROSSTALK)

THOMPSON: Again, that would have to be evaluated.

QUESTION: Wait. Why would wait until the last minute to evaluate?

(CROSSTALK)

THOMPSON: But, Janet, we're not going to wait until the last minute.

QUESTION: (OFF-MIKE) why did you decided to keep -- to isolate them in the apartment complex and not to move them to a hospital or another medical facility?

QUESTION: (OFF-MIKE) if they try and leave the apartment?

JENKINS: Let me answer -- say a couple things.

In all likelihood, if -- first of all, we're very hopeful and working very hard so that there won't be other cases. If there is another case and that presents at any of our emergency rooms, we have prepared our emergency rooms, so that they are all ready to handle this. And that was done back in August and they're continuing to work on that.

If a case is picked up by an ambulance, in all likelihood, although that's a -- any plan is subject to change in the planning stage. That person would be taken to Presbyterian, where they are doing an excellent job of taking care of the patient that they have now.

Your question about why are they -- what was it about isolation?

QUESTION: Why have they been -- why have the four been kept at the apartment complex, instead of taken to a medical facility, and have they attempted to leave since they were asked to stay home?

JENKINS: They were noncompliant with a request to stay home. And I believe that's touched upon in the press release that was sent out. I don't want to go too far beyond that.

QUESTION: And that was yesterday?

JENKINS: That was yesterday or this morning, whenever that was sent out. It's important that we balance a couple of things in doing that.

It's very important that Dr. Perkins' team has the patient there to test that temperature on that regular schedule twice a day. If people leave -- even though they are asymptomatic, if they're not home when we go out to do our surveillance tests on them, then that defeats the purpose of the surveillance test and that endangers them. And if they were to be infected, they need to know that as quickly as possible.

So, it's for their benefit and everyone else's. When they send children to school after being told not to send their children to school, you just heard Mike Miles say that we're usually at 94 percent to 95 percent. Today, we're at 86.

I'm concerned about those children in that apartment. But I'm concerned about every other child in the county. It's not an easy decision to make. I can't give you all the facts that we look at. It actually is an easy decision to make, if you had all the facts that we looked at.

But I recognize that there are competing interests in their rights to freedom and the overarching public concern.

(CROSSTALK)

QUESTION: You said you went to the complex and you served papers there. Dr. Perkins has been there to check these patients. Can you describe for us your visit there and what precautions you took when going into that apartment and Dr. Perkins as well?

JENKINS: I believe you -- sir.

THOMPSON: As we went into the apartment last night, we felt that the appropriate action was to hear out the family members, if they had any concerns based on our conversation.

And, of course, they may have interviewed with other people. But based on our conversation, they understood what the process was about. And we didn't meet any resistance in terms of them understanding. We thoroughly read each line of the order and asked them, would they be willing to comply. And they emphatically said they would comply with the order. So, I never saw any resistance from them.

QUESTION: Judge, can you go into detail --

(CROSSTALK)

QUESTION: -- went into the apartment.

Can you explain what happened last night?

UNIDENTIFIED MALE: Well, keep in mind these individuals are asymptomatic. So as far as them being contagious or being able to transmit this infection, that is virtually non-existent to zero, as we clearly indicated on yesterday.

So in regards to going out and monitoring them, that I do not perceive as a personal threat. So as a physician, a clinician, I'm there on their behalf to monitor them and if they become symptomatic, get them the appropriate treatment.

(CROSSTALK)

QUESTION: -- living conditions? We know that this is a population density. Explain how many people were in that apartment --

(CROSSTALK)

UNIDENTIFIED MALE: I cannot comment on this.

QUESTION: Superintendent Miles, quick question.

JENKINS: Let's just do two more because...

QUESTION: OK. Quick question for Superintendent Miles.

A couple -- we talked to a parent today and they said their daughter was actually in class while the health department came and removed one of these kids from school.

Is that correct?

MILES: No, I would have to have more information. I'm not sure what they're talking about.

QUESTION: What can you tell us about the cleaning company that's coming today?

What is their background?

What are they focused on?

QUESTION: And can you elaborate --

(CROSSTALK)

QUESTION: -- how many people you had to go through before they agreed to do this?

We're talking about the apartment.

UNIDENTIFIED MALE: It -- you want information about the cleaning company?

QUESTION: And the dirty sheets and --

QUESTION: Well, how many -- how many companies did you have to go through to get them?

What they -- what are they specifically going to do?

JENKINS: All right. So the company that is doing the cleaning -- whose name I was given, but it escapes me at the moment; we can get it for you -- the company that is doing the cleaning has worked for hospitals and for Dallas County before.

They're a company that cleans up. We have used them in HIV/AIDS situations where we needed to do a cleanup in other blood-borne illness cleanups. They use appropriate disinfectants and are appropriately licensed to do that.

As far as the question about the sheets, the sheets were placed in a sealed plastic bag and have been in the bag as well as the belongings of the -- Mr. Duncan (ph). Those were also in a bag. They will appropriately dispose of those items.

And as information becomes available, we will continue to bring it to you and I thank you all for your attention and --

QUESTION: Seriously? Is this transparent -- ?

BALDWIN: All right. So you have been listening to local Dallas County leaders, talking about the situation, this Ebola patient, this Thomas Eric Duncan (ph), this individual who flew over from Liberia to Dallas and is now infected, in serious condition at this hospital in Dallas.