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Concerns Rising over Ebola Transmission in the U.S.; Interview with Vanderbilt's Dr. William Schaffner; Massive Explosion Rocks Kobani; ISIS Nearing Baghdad Airport; FBI Warns of ISIS Threat

Aired October 13, 2014 - 09:00   ET

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


ANA CABRERA, CNN ANCHOR: Can airstrikes save Kobani, Syria from the grip of ISIS? This huge blast rocking the border town just moments ago. And at this hour, we are live from the front lines.

Good morning. Thanks for being here. I'm Ana Cabrera in for Carol Costello. Glad to have you with us on this Monday.

A huge explosion, signs of a coalition airstrike, rocking Kobani, Syria this morning. In fact, take a look at this. This is a massive blast sending smoke and debris billowing into the air. It comes as ISIS continues its swift and bloody march through this key Syrian town that's right along the border with Turkey.

Now CNN's Nick Paton Walsh is joining me live from this area.

Nick, last night we were reporting about the this eerie silence that had fallen over Kobani but it looks like that's the case there this morning. Fill us in.

NICK PATON WALSH, CNN INTERNATIONAL CORRESPONDENT: Yes, that broke early this morning into what many have been observing this since the start says, one of the worst days they've seen in terms of consistent noise of fighting and the explosions that have rocked this city.

We've seen four which most likely were large enough to suggest that they were airstrikes, possibly more. It's always hard to tell exactly where the blast come from. But they seem to be targeting roughly towards the center of the city. Now as I say, it's very hard to tell quite who's exchanging what part of territory, where the Kurds are pushing back, claiming that. Whereas ISIS, of course, have their advantage.

The fact the Kurds can't resupply themselves with ammunition and even food and water here. But suggesting where the actual strikes are would lead you to think that maybe ISIS still have quite good control of the center of the towns certainly. There's been a lot of discussion, too, about moves to try and take that key official border crossing with Turkey there.

The Turkish military, according to activists, telling the Kurds to stay away from it. And one Kurdish fighter suggesting, in fact, ISIS were moving in to try and take that right now. They've been aiming for that for quite some time.

One interesting thing, Ana, though, we have seen at the end of our lens down in the town, though, where about -- it seems about 50 men walking in single file quickly down one of the roads there. They didn't appear to be armed. We didn't quite know where they were going. They were heading from Turkish -- sorry, from the Kurdish to the ISIS held part of those towns. As I say, just signs of a lot of activity down there. And the sheer number of explosions suggesting the battle is reaching one of its higher pitches -- Ana.

CABRERA: Nick, the U.S. military has said openly that airstrikes aren't going to save this city from falling to the militants. So any idea the specific target or the purpose of this morning's strike?

WALSH: They seem to be concentrated in one particular part which does seem to be near the administrative center of the city. It's very hard from this distance to be completely sure as to what they are. But about four or five of the larger explosions seem to have come around there. Some of them could be airstrikes, some of them could in fact be explosions caused by ISIS. But a lot of the very big blasts which we think probably were launched by coalition jets have been to the east which suggests they found positions they're comfortable enough with hitting with large amounts of ordinates.

As I say, simply the fact they are still seeing most of the blast in the city center does suggest that the stage -- that the Kurds haven't achieved their goal of pushing ISIS too far back towards the east. And we see still the Islamist militants with control of substantial parts of the city itself -- Ana.

CABRERA: All right. Nick Paton Walsh, thanks and stay safe out there.

Now in Iraq, as we pivot to the neighboring country, ISIS militants forced the Iraqi military to abandon a strategic base just outside the city of Hit. That's a new detail that we're learning. Their retreat, it gives the extremists even more control over the Anbar Province which is a doorstep to Baghdad.

Still U.S. Defense Secretary Chuck Hagel tried to calm fears over the weekend about Iraq capital and its risks of an ISIS takeover. Listen.

(BEGIN VIDEO CLIP)

CHUCK HAGEL, DEFENSE SECRETARY: On Baghdad, Anbar Province, the Iraqi Security Forces are in full control of Baghdad and continue to strengthen their positions in Baghdad. We continue to help them with airstrikes, with our assistance and our advisors, which I have at the direction of President Obama, added to our numbers there. I think in Iraq today, with our coalition partners, we are up around 300 airstrikes.

(END VIDEO CLIP)

CABRERA: So joining me now to discuss more about this, CNN senior international correspondent Ben Wedeman, who is live in Baghdad for us, and CNN military analyst Major Gen. James "Spider" Marks with me in New York.

Ben, let's start with you. Does ISIS even want Baghdad? Could they really overtake this city of nine million?

BEN WEDEMAN, CNN SENIOR INTERNATIONAL CORRESPONDENT: That they want it I don't think there's any doubt. Could they take it? I seriously doubt it.

This is a large city, almost nine million people. The majority of the population is Shia, very hostile to ISIS. More than anything, I think ISIS would like to somehow disable Baghdad International Airport, which is not only a civilian airport but there's also military hardware out there including the U.S. apache helicopters.

So if they could, they certainly would like to put that airport out of commission for its military value but also for its symbolic value. But Baghdad itself, too much trouble for an army -- rather a fighting group that doesn't really have that many men to field. They're trying to maintain order among a hostile population would be simply too much for them to deal with making life hell for them, though, is very much on their agenda however -- Ana.

CABRERA: Right. And It has. An -- it's an organization that has operated much like an official army.

General Marks, given ISIS' track record and the U.S.' underestimating perhaps of ISIS in the past, I mean, is it too much to think that ISIS could take Baghdad?

MAJ. GEN. JAMES "SPIDER" MARKS, CNN MILITARY ANALYST: Well, I think ISIS probably has no desire to take Baghdad. What they're interested in right now as Ben indicated is to try to disrupt operations in and around Baghdad. They would -- ISIS would deplete itself were it try to take Baghdad. I mean, you -- number one, you can't get into the city. It's a massive fight. The best military in the ISF is in Baghdad.

So they'd really be going against the very best military that Iraq has to present. Plus if they were to get into the city, how do you administer it? How do you get -- I mean, it would be a horribly bloody fight. ISIS doesn't need to take that on. But there can be a great psychological advantage by doing great damage to the airport, again as Ben indicated.

CABRERA: Right. You mentioned that --

MARKS: Sure.

CABRERA: That could be a target of theirs. As we know they've come within eight miles and it's so close in fact that the coalition launched some apache helicopters to go and try to protect it.

MARKS: Sure.

CABRERA: So that could be a serious concern. MARKS: Absolutely. And in fact ISIS is in a position where they've

already launched mortar attacks into the inner portions of the city. That just gives you a sense of proximity. Now these could be harassing attacks where they shoot and they withdraw. But be that as it may, it has a tremendous psychological advantage to ISIS. They can use this in their publication and then their marketing routines which they have to great effect that really just kind of continues to feed the recruitment process.

CABRERA: And I want to talk to you more about that, Ben. How might ISIS still have an impact in the capital city even if the terrorist group doesn't control Baghdad?

OK, unfortunately I'm now learning that we don't have Ben anymore. But maybe you can talk a little bit more about that. You mentioned the propaganda and really getting into the psyche of the Iraqi people. And perhaps that's what ISIS' goal is when it comes to surrounding Baghdad?

MARKS: It truly is, Ana. What -- they've been able to do is achieve a number of victories in northern Iraq, certainly in Syria. Baghdad is an incredibly tough nut to crack. They're not going to be able to do that. In fact, as I suggested, they probably don't even want to try to do that.

But any amount of success that they can enjoy on the ground just feeds their propaganda machine and really enhances their recruiting capabilities. Most the folks that they're trying to recruit have already been self-radicalized. This has now becoming a destination video. This is a place to go to get involved. And that's what we see right now.

This becomes a great deal for ISIS. And then juxtapose this to what's happening in Kobani right now, this is a major, major challenge for the international community as we recognize ISIS and we try to galvanize what we're going to do in terms of next steps.

CABRERA: One quick question about Kobani. How significant is it if Kobani falls?

MARKS: It's significant because ISIS has taken it. The significance of Kobani by itself really doesn't matter. It's significant in that there are a number of PKK, the sworn enemy of Turkey, which is really obviated against Turkey getting involved. Anything that would strengthen Assad, in other words, decrease the ability of ISIS, Turkey is not in favor of.

So that's why we see this incredible standoff. And it's hard for us to understand why Turkey doesn't get involved more than they are right now.

CABRERA: Right. Because if ISIS takes Kobani, it would take a 60- mile long stretch of the Turkish-Syria border essentially.

MARKS: Sure. Absolutely. It's at a big deal for ISIS to take Kobani, it's a big deal for us to acknowledge that it has fallen. Strategically in the larger what I would call the operational sense it's not significant. But it's a big deal and we need to insure that Turkey is on board to take some additional next steps.

CABRERA: All right. General Marks, thanks so much for your information.

MARKS: Thanks, Ana. Sure.

CABRERA: Ben Wedeman, thanks to him as well.

And as ISIS gobbles up more territory in Syria and Iraq there are new concerns closer to home. Homeland security officials and the FBI are issuing new warnings about the threat of ISIS rallying homegrown terrorists to attack here in the U.S.

Now the potential targets according to the intel from online chatter U.S. law enforcement, even news media could be targets.

Now joining me now is Philip Mudd, CNN's counterterrorism analyst and former CIA official.

Phil, we're not talking necessarily about ISIS fighters, per se, rather sympathizers who perhaps are trolling extremist Web sites, social media, and they might be motivated to do something.

So how serious do you view this threat?

PHILIP MUDD, CNN COUNTERTERRORISM ANALYST: I think it's pretty serious because you can't look at the U.S. in isolation. You've got to look at us in the context of what's happening in Australia. We see ISIS linked arrest. In Western Europe where we've seen ISIS activity.

This is really tough for law enforcement to follow because historically you can follow terror groups by looking at the center of the group and determining how they're sending out operatives from the center. In this case you can't do that. There's potentially a kid in Chicago or New York or Washington who's simply looking at video online and saying, as we again saw in Europe and Australia, I'm going to do something here in the United States. It's very tough to stop that.

CABRERA: The FBI has said that ISIS has shown alarming success in its online campaign to recruit foreign fighters. This no doubt has perhaps a better call to action for westerners to go and join in the fight. But it doesn't require travel, really doesn't even require conversations. So someone could read it and then want to act on it.

How difficult does it make detection?

MUDD: Detection in this case is difficult because you're looking at kids who are sitting around two, three, or four of them. Some of them may break off from a larger group. If they hear people talking about Iraq, and the kid starts saying, hey, nobody is doing anything. We want to do something, we're going to organize our own cell.

If they don't have connectivity with the central group that has traveled, communications, you have to depend on them making a mistake. And three or four kids sitting around a room, it's really hard to find vulnerability.

I think the likelihood that we see something here in the United States is higher from kids who are simply affiliated with the ISIS idea than from kids who are affiliated anyway with the ISIS group. Very tough to stop.

CABRERA: How does the U.S. government maybe stop or combat that online propaganda?

MUDD: There's a couple of ways you can do this. The first obviously is you can look for people talking about acts of violence online. But, you know, think about the Internet activity in this country. There's 330 million people. And there's a debate in this country -- remember the Snowden revelations about how appropriate it is for the National Security Agency, the CIA and the FBI to watch people online.

So you've got to balance looking for people with the civil liberties we have in this country. I think the chance that there are people engaged in talking about acts of violence in this country right now that we don't know about that is the FBI is really high because you just can't follow everybody in an open society.

CABRERA: And that's scary certainly.

Philip Mudd, thanks so much for your insight.

MUDD: Thank you.

CABRERA: Still to come, it is the first case of Ebola transmission in the U.S. And now a Dallas nurse is at the hospital as hazmat crews decontaminate her apartment.

CNN senior medical correspondent Elizabeth Cohen is following the developments out of Dallas -- Elizabeth.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Hi. We're learning more about what might have caused that breach in protocol that led to a nurse becoming infected with Ebola. I'll have that after the break.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

DR. TOM FRIEDEN, DIRECTOR, CENTERS FOR DISEASES CONTROL AND PREVENTION: We don't know what occurred in the care of the index patient, the original patient in Dallas, but at some point there was a breach in protocol. And that breach resulted in this infection.

(END VIDEO CLIP)

CABRERA: There are more concerns this morning about Ebola and how it can spread or be transmitted. A Dallas nurse who helped care for Thomas Duncan, the man who died last week from Ebola, has now contracted the virus herself despite wearing that protective gear. The head of the CDC now says this nurse probably breached protocol,

perhaps while removing parts of that gear. So now more training is in the works. For thousands of health care worker across the country, the CDC is planning a nationwide conference call tomorrow to make sure workers know what to do if they have to treat someone who has Ebola.

Now, the World Health Organization says, of more than 4,000 Ebola deaths during this recent outbreak, one in 20 have been health care workers. CNN senior medical correspondent Elizabeth Cohen is outside that Dallas hospital this morning where that nurse is being treated. Elizabeth, I understand you have some new information for us. What can you tell us?

COHEN: I can tell you that an official tells me that, up until yesterday, workers like this nurse were not getting daily visits from health authorities. They thought, well, while taking care of Mr. Duncan, they were wearing protective gear, so they must have been protected. But as we see in the case of the nurse, that is not exactly what happened.

(BEGIN VIDEOTAPE)

COHEN (voice-over): This morning hazmat crews continue to decontaminate the Dallas apartment of the first person to contract Ebola in the U.S. A female nurse tested positive for the disease Saturday night after officials say she had extensive contact with the now deceased Ebola patient Thomas Duncan.

FRIEDEN: There was a breach in protocool.

COHEN: The CDC says the nurse was wearing protective gear -- gloves, gown, and mask -- and the infection could have resulted when she took the contaminated gear off.

FRIEDEN: The care of Ebola can be done safely, but it's hard to do it safely.

COHEN: The CDC also says two procedures performed on Duncan at the very end of his life, intubation to help him breathe, and kidney dialysis were unusual, both putting health care workers at high risk of exposure to his bodily fluids.

FRIEDEN: I'm not familiar with any prior patient with Ebola who has udnergone under either intubation or dialysis.

COHEN: And as the crisis continues, health care workers across the U.S. say nurses haven't been adequately trained.

KATY ROEMER, REGISTERED NURSE: We're hearing that they have not followed proper protocol, when we have been asking our hospitals throughout the country to provide us with training.

COHEN: This as another possible Ebola patient who recently traveled to Liberia is being isolated in a Boston hospital, complaining of aches and headaches. The medical center currently treating the man is awaiting his results, but a spokesman says the chances he has Ebola are extremely low.

Meanwhile, more Ebola scares over the weekend. On Sunday, a female passenger who recently traveled to Africa became ill on a U.S. Airlines flight from New York to Los Angeles, but Ebola was quickly ruled out.

(END VIDEOTAPE)

COHEN (on camera): An official tells me that there may been inconsistencies in the type of protective gear that this nurse used and also inconsistencies in the process that she used to put the gear on and, even more importantly, to take the infected gear off. Ana?

CABRERA: Elizabeth, it seems like it's trial by fire with these Ebola cases here in the U.S. We heard Dr. Frieden talk about a couple of new recommendations about limiting the number of people who are in contact with these Ebola patients in the U.S. as well as limiting the procedures. And I want to ask about that part, the intubation and the dialysis procedures that you mentioned in your piece. Why are they now in question?

COHEN: Right. Intubation and dialysis, those are sort of last ditch efforts that you use to save a patient. But doctors tell me, look, this is an Ebola patient. There's not a chance really that that patient is going to live. And so you're doing these procedures for the teeny tiny chance that the patient will live and these procedures involve possibly coming in contact with bodily fluids. So I think there's some thinking here - why are we, why are doctors doing these procedures when they probably won't help the patient, but there's a pretty high likelihood that they could hurt a worker?

CABRERA: All right, Elizabeth Cohen, thanks so much.

This new Ebola case of course highlights the dangers nurses and other health care workers face. So is it a question of whether they need better training or perhaps whether the protocols aren't working?

Dr. William Schaffner in is the chair of Department of Preventative Medicine at Vanderbilt University Medical Center. Doctor, thanks for being here. We know the CDC has some specific guidelines for health care workers in dealing with Ebola. And we've heard that the CDC chief has said protocol had to have been breached. But what might that entail and how can he be so sure, especially since we don't know exactly how this nurse contracted Ebola?

DR. WILLIAM SCHAFFNER, DEPT. OF PREVENTATIVE MEDICINE, VANDERBILT UNIV.: Well, Ana, it's as follows. The nurse, as far as the reports go, noticed no breach in her interactions with the patient, no breach in infection control precautions, and her coworkers have not reported any. So we go to the area in which the hazard is also great, actually maybe greater than actual contact with the patient, namely in taking off protective gear at the end of your shift.

It has to be according to protocol, one thing after another in a specified fashion. And you have to take your time doing it, because it's in that context that you can contaminate yourself. In fact, that's so important that we often ask a buddy to watch you and coach you while you're doing it.

But although that's important, let me get in a word. I have the informal information that there has been a patient in the United States with Ebola infection who needed dialysis and ventilatory support who actually recovered after the use of those procedures. That's informal information. So we shouldn't rule them out in Ebola patients.

CABRERA: So, Doctor, is it a question of proper training then? Do you think that these local hospitals and health care workers are prepared to deal with Ebola?

SCHAFFNER: Well, you know, we really have paid a lot of attention to that at Vanderbilt. We've done a lot of training but we had a conference all yesterday. We're renewing training procedures so that people really feel comfortable in doing that. We're going to get them to get in and get out of this equipment numerous times until we can assert that they are confident and competent in doing this.

And I think these events are necessary and appropriate lessons for hospitals all across the country. We've got to redouble our efforts such that, should a patient with Ebola come to our institution, we're really comfortably ready to give them just not only excellent care but safe care.

CABRERA: And on that note, there has been an ongoing debate about where Ebola patients in the U.S. should be treated. And I'd like to get your take. Should Ebola patients perhaps only be treated at just those four specialized biocontainment units here in the U.S., not at the local hospitals?

SCHAFFNER: Sure, and that's a valid debate and it's an ongoing. There are lots of downstream events; that has to be organized. But let me make the point. These patients can come into any hospital's emergency room. So that group has to be well aware and confident. And then we're not going to transfer these patients, should we decide to do that, right out of the emergency room. They're going to have to be admitted to the hospital to be evaluated and stabilized, and certified that they're not too ill to transport.

And then, who knows, maybe we'll get a patient that comes into the emergency room that's so sick transport is not possible. We're going to have to take care of the patient in the hospital. So hospitals are going to have to be ready to care for these patients regardless.

CABRERA: Very good point. Dr. William Schaffner, thanks so much for your time. We really appreciate you offering your expertise this morning.

SCHAFFNER: Thank you.

CABRERA: Still to come, a storied high school football program now tarnished, the season now over and seven players face serious charges. CNN's Andy Scholes has this story.

ANDY SCHOLES, CNN SPORTS: Ana, a high school football team in New Jersey won't be playing again this season after alleged locker room hazing. We'll take a look at the shocking allegations when NEWSROOM continues.

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