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Legal View with Ashleigh Banfield

Hazmat Trucks Arrive at Dallas Ebola Apartment; Calls for More Training, Precautions in U.S. Hospitals; Ebola Questions Answered

Aired October 03, 2014 - 12:30   ET

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

DEBORAH FEYERICK, CNN ANCHOR: You can see that red truck there that moved in, that red and white truck. It's a hazmat truck.

Our Chris Welch is on the scene there. Chris, what are you seeing, and what are officials there telling you?

CHRIS WELCH, CNN PRODUCER (via telephone): Deb, you're looking at this live picture from our camera here and this is the Dallas Fire Rescue hazmat truck that just pulled up into the parking lot here at apartment complex where we know that these individuals, these immediate family members and relatives, have essentially been holed up, quarantined, for the last couple of days, court-ordered quarantines since a couple of days ago.

And we know that yesterday we were told that a hazmat crew would be in at some point to clean the apartment and remove those dirty towels, the dirty sheets. We were told that those would be removed yesterday, and a hazmat team would be here to clean.

An independent hazmat company from here in Dallas was here last night, ready to do the job. They told us that because of a permit tie-up at some level, whether it's state or federal level, a permit needs to be issued for the transport of these materials, and that hasn't been done.

So last night that independent hazmat crew left after sitting here for hours, ready to go in. They left and the scene was essentially cleared.

Now this morning we've been waiting to see if another crew might show up, and here we have it. The Dallas Fire Rescue hazmat crew is here. And we're also told that same independent hazmat crew from last night will be here again in just a few minutes, or may already be on the scene here behind the apartment building. We can't see. They'll be here to assist as well.

FEYERICK: And, Chris, quickly, do you know, while this cleanup is going inside the apartment, will the family, will the four people that are inside, will they stay there? Will they be allowed to at least come onto the balcony? What is your understanding if you are being told anything right now?

WELCH (via telephone): The latest we heard was yesterday from Dallas county judge Clay Jenkins. He had said that it was his goal to try and get this family, these individuals, out of this apartment and into a better living arrangement for their quarantine.

That obviously has not happened yet. In fact, last night we saw the Red Cross deliver more boxes of supplies. Blankets and socks were in there. And this morning they came out and picked them up and went back inside.

So we do believe they're still in there. And we're also told that, when the hazmat crew goes in, the family can stay inside. At least that's what the independent cleaning company has said. They can stay inside while they do their job.

FEYERICK: It will probably give the family great relief to know that at least they've got an opportunity to have this place cleaned, have it swabbed down with chlorine and other different products that can at least stand whatever might be in that apartment.

All right, Chris Welch for us there on scene at the family's apartment complex, we appreciate your reporting on that.

We're going to take a quick break, and we'll be right back.

And I apologize. We actually have Sanjay Gupta. Dr. Sanjay Gupta is here with us.

And, Sanjay, let me ask you. What are some of the things that the hazmat team is going to be doing? What is it -- how do you clean an apartment with Ebola like that, especially if these blankets, these towels have allowed to essentially fester without any sort of containment?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yep, I mean, there's some set priorities in a situation like this. You want to remove the potential hazardous materials. Hazmat, that's the origin of the name. And they want to do it in as obviously as safe a way as possible.

If it's like hospitals, and hospitals obviously have very set protocols, Deb, there's biocontainment bags. These are special bags which they may be putting some of the materials in and they may be bringing those materials out.

As Chris mentioned, there's really no reason the family and the people who are in the apartment couldn't stay in the apartment during this. You may see them in the hazmat suits or at least some stripped down version of the hazmat suit.

Given that they're not interacting with patients at this point, people who are actually sick with Ebola, they may not need to wear the entire hazmat suit. We'll see here, I'm sure, in a moment what they're in fact wearing.

But then they get the materials out, make sure the apartment is clean of any hazardous materials. That's really the goal. And it's interesting that there's sort of a private and public effort here. Looks like Dallas Fire and Rescue as well as a private commercial company as well, working in concert on this. I'm not sure why one or the other couldn't have done the job by themselves, but we'll probably see over the next few minutes how this all goes down.

FEYERICK: It's so interesting, because when we think about stemming disease, obviously sanitation is critical, how you keep something clean.

The family that's in there right now, for example, what can they be doing to safeguard themselves in the event one of them is infected? Is it a question of staying away from one another? Is it question of wearing masks? Is it a question of swabbing everything down with a bleach or a chlorine? How can they themselves in that apartment take care of themselves?

GUPTA: One of the things, I think, that is important to note is that if one of them gets sick and starts to have symptoms -- that's part of the reason they're taking their temperature twice a day -- if one of them gets sick, at that point, they would -- they should, if it goes correctly, they should go to the hospital and be isolated at that point in the hospital so they would no longer still be in the apartment because of the very concerns that you raise.

If one person gets sick, then that person can now spread it to the other people within the quarantined area. You don't want that. Now you've just created a situation where one person is going to get a lot of people sick. So they would move that person out at that point, probably, to a hospital isolation area.

But, other than that, the reason we're told they are in quarantine is not because of the threat to the general public. They are not sick, so they can't spread the virus, so they can't be a threat.

The reason for the quarantine is basically to keep them in place so health officials can monitor them, and they can reliably be in one location.

We were told that initially they were told to go about their own business, but the health officials were worried about compliance, as they put it, whether they would show up, keep returning to the same location, be monitored consistently, and that's why the quarantine is in place. This isn't about a threat to the general public.

FEYERICK: Sure. You have to think, also, when you were a kid, you studied Venn diagrams and the sort of interlocking circle, and whoever was in the middle had sort of an overlap and then you went to all of the others, which is really how disease spreads in terms of who has contact with who.

There had been a report -- and, Chris, maybe you know the answer to this -- that one of the children may have returned to school even though they were supposed to remain in isolation.

Do you have any further details on that?

WELCH (via telephone): I can't tell you anything in terms of additional as to whether one of the children may have returned to school, but another thing I do want to point out.

hen we're talking about the containment and the quarantine that has essentially been ordered on the family, we do know that they have had visitors. In fact, as recently as late last night around 10:00 or 11:00 p.m., folks came to the door, and it looked like a government, county, or city official came to the door.

There were three individuals, went inside the apartment for a brief period of time, maybe 20, 30 minutes, and then came back out, so I think that raises another issue that I'm sure Sanjay could speak to, as to whether this type of situation, whether that would be obviously -- at least from a layman's perspective, that might be a no-no.

But it seems like a lot of questions here are raised and it's a very unprecedented situation, so a lot of things are unclear.

FEYERICK: Chris, were they wearing any sort of protective gear? Did you see them wearing any sort of gloves or any sort of a mask or anything like that?

WELCH (via telephone): They were not, and that's kind of what struck me in the situation. Here we have a family who has been quarantined in a home for fear of Ebola, and we have officials or what looked to be like officials, or some visitors visiting and coming and going.

So if this is a lockdown-type of situation, that does seem to raise some questions, at least in my mind, and I'm sure Sanjay could speak to that as well.

FEYERICK: Sanjay, the interesting thing, also, is I think the CDC put out a statistic saying that for there to be disease containment, for example, in a place like west Africa, you need to contain 70 percent of those infected in treatment centers so they can get the help that they need.

But that's not happening in a place like west Africa where the disease is so prominent and prevalent. Is that one of the things that officials here are thinking about, which is, you have to keep people in an area where you can monitor them all the time just in case? Are we dealing with a just in case situation?

GUPTA: Yes. I think if it's a just in case situation in the sense that they want to be able to monitor them. So if someone is very reliable and always show up to get their temperature checks and something like that, they could be going about and going out in public.

A very important point, if you're not sick, you're not spreading the virus. These people are not being quarantined because of the threat to the public health. The reason they are being in this apartment, according to Texas department of health officials, was they were worried that they wouldn't maintain their appointments, wouldn't come in for their temperature checks, whatever it may be. It was a compliance issue.

Chris raised the issue that people came to the apartment and did not seem to be wearing any gear or anything. That doesn't surprise me at all because, again, the people inside the apartment are not sick. They are not at risk of transmitting the virus to people who visit.

Why would the hazmat people be wearing clothing? That's because they are going in to grab some of these materials which had have been avoided by the people in the apartment and take those materials out.

The bed sheets, for example, could still have Ebola virus on it. The towels that Mr. Duncan used could still have Ebola on it. That's why they will be dressed in protective gear.

If Louise was outside of the apartment, you could be talking to them, you would not need to be protected because they are not contagious.

FEYERICK: Very quickly, Sanjay, there are reports that Mr. Duncan was sweating profusely, wrapped in blankets and laying on the floor.

Is it possible that the disease could still be in the towels and blankets? Is it still alive if it's transferred?

GUPTA: Great question, and the answer is yes, and that's part of why I think these hazmat -- these hazardous material folks will be wearing gear when they go in there because they are going to go after the material that Mr. Duncan was using in the apartment.

And the Ebola virus can live outside the body. There are a lot of viruses that cannot live outside of the body, but Ebola can. We don't know how many days it can live outside of the body, but it's several days at least. The risk is there.

You want to eliminate as much risk as you can and part of that is to remove these hazardous materials, remove anything that may have the Ebola virus on it still. So the family can be safer.

And also, I think, even more significantly, have peace of mind inside that apartment where they will be for 21 days.

FEYERICK: And peace of mind for the family will go a long way in this outbreak, that they have now -- I should say, this one case of Ebola that has sort of focused in on their friend and now on them because of their proximity.

Dr. Sanjay Gupta, thank you so much. Chris Welch there for us on the ground, we will keep you in the loop and check back.

We're going to take a break now.

(COMMERCIAL BREAK)

FEYERICK: The Dallas hospital's botched handling of the Ebola case is raising some serious questions about the readiness of the U.S. medical system to handle this disease. If doctors, nurses and first responders on the front lines are not properly trained in dealing with the deadly virus, then everyone could be at risk. Joining me now, Bonnie Castillo, director of the National Nurses United Unions Registered Nurse Response Unit. She's calling for more training, more precautions throughout the U.S. when it comes to this potential public health threat. Also joining me back, CNN's Dr. Sanjay Gupta. Bonnie, first of all, I spoke to a number of nurses when this first

happened here in New York, and instead of the sort of regular CDC precautions, they went up and above. They said, we want the suits. We want the suits. What do you think in terms of the nurses, are they in a position to be ready to properly handle Ebola if it should come to their hospital?

BONNIE CASTILLO, DIRECTOR, REGISTERED NURSE RESPONSE NETWORK: Well, nurses are on the front lines 24/7 in the hospitals and we are sounding the alarm because what we are seeing is that the majority of nurses are reporting to us that not - that they have not seen hospital emission policies for Ebola patients. That they have not been able -- they've received no education and/or training in terms of interactive education and training on how to deal with the patients from triage throughout their hospital stay. So we're sounding the alarm. We know that we can do better in the U.S. hospitals. But, unfortunately, it is a fragmented and disparate response.

FEYERICK: You know, one thing that's interesting, if you look at sort of the timeline on all of this - and, Sanjay, if you would weigh in on this -- the nurse apparently knew that the patient was from Liberia, that he had traveled there. She apparently put it into the system. The system crashed, didn't get to the doctors. But doesn't everybody have to be asking questions repetitively to make sure that everyone's protected? It's not good enough to say, well, I asked the question, why didn't you know?

CASTILLO: Well, this is a -

GUPTA: Yes, no - oh, go ahead, Bonnie.

CASTILLO: Well, this is a time, too, when it's important that we rely on the skill and professional judgment of the registered nurse and physician and they're communicating directly to each other and not an automated protocol by electronic health records who, as you noted, crashed. This isn't the time to - this is not the time when we should be relying on a computer who can -- that can crash. So we see that as a fundamental flaw in -- and actually prevented that patient from being admitted, which should have happened.

FEYERICK: And, Sanjay, look, every single hospital is responsible for making sure that the safety of its people is guaranteed. Do you think the CDC is putting enough -- out enough guidelines to make sure that there are hard and fast rules so that everybody is on such high alert, nobody slips through the crack, everything from the moment you isolate, to how you treat that individual once they're there? Is there enough protocol, Sanjay?

GUPTA: You know, I've looked at some of these protocols closely yesterday. I saw some of the protocols that are going to hospital. They're pretty clear to the extent that, you know, there's always going to be some nuance in situations. For example, one we were talking about earlier, Deb, you get a lot of patients coming back from West Africa that have fevers. The vast majority of them are not going to have Ebola. So trying to take the next step within hospitals, even within emergency rooms, trying to figure out, this person - they fit some of the criteria but are they actually going to be someone who we should test for Ebola? Just having a fever and having been in West Africa doesn't automatically mean that your fever is being caused by Ebola. So there are some nuance to it.

I think the larger problem, and I think Bonnie's making this point as well, is that even if there's some good information out there, it doesn't sound like it's being disseminated well. Not everyone is being trained. And, look, this is - there is an understandable amount of fear out this. So people want to be very, very sure of the protocols before walking into a situation. And that does involve lots of preparation and lots of training and this is the first time this has ever happened.

FEYERICK: Yes. And leadership. Let's not forget leadership. All right, Dr. Sanjay Gupta, Bonnie Castillo, thank you both so very much.

CASTILLO: Thank you.

FEYERICK: And getting a handle on Ebola will require stopping it at its source. Next, a U.S. microbiologist who has made numerous trips to Africa joins us to talk about what's being done to prevent the disease from spreading even more widely.

(COMMERCIAL BREAK)

FEYERICK: So, we want to know what questions you have and we're always asking for your input on the Ebola conversation. So any questions you do want answered, we'll put to our medical expert.

But now I want to talk to Dr. Robert Garry, a gurologist (ph) at Tulane University in New Orleans.

And, Dr. Garry, you created a test that could easily diagnose whether, in fact, somebody has Ebola in their system. Talk to me about how it works and how it's different from other tests.

DR. ROBERT GARRY, CO-INVENTOR OF EBOLA DIAGNOSTIC TEST: Well, one of the problems with the situation in west Africa and we also saw that in the case of the Dallas patient was, the long delay between actually being able to identify symptoms and then to know if that person has Ebola or not. So what we've developed is a rapid diagnostic test.

With this test, you can get an answer of whether that person with the fever or these other symptoms has Ebola virus disease in the space of 10, maybe at most 15 minutes with this test. And so it's simple. You take a drop of blood. The test is very durable because we made it to last in West Africa. It has to stand up to ambient temperatures in the environment of 100 degrees or so all the time. So we think a test like this could make a big difference, not only in controlling the outbreak, but it's needed here in the U.S. and other places around the world as well.

FEYERICK: Is this getting FDA approval now? What's the holdup if it works?

GARRY: Well, what we need to find out is, does it work in the field? And so those tests are in West Africa right now. We're doing the test. If we have to tweak them a little bit, we'll do that. But we anticipate that we're going to have a good -- good test that can work at the bedside of a patient or in an airport or something along those lines where you need to have an answer really quickly in just a few -- in a very short period of time.

FEYERICK: And that's an amazing point you bring up, and that is, not just testing in hospitals, but also at airports, because, obviously, travel is such a big question right now.

When you think about the way to contain this, aside from all of this, the U.S. is sending troops. They're going to be building hospitals. What happens if they simply don't have enough people to staff those hospitals?

GARRY: Well, that's going to be an issue and we need to be able to move health care workers into these areas. We need to able to control this outbreak with people on the ground and technological things can help but really it's a person and a logistical thing.

FEYERICK: All right, Dr. Robert Garry, thank you so much.

And thank you all, everyone, for staying with us, for watching. I'm Deborah Feyerick. Wolf Blitzer starts right after this.

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