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The First Known Transmission of the Ebola Virus on U.S. Soil; ISIS Militants Just 8 Miles Away from Baghdad International Airport

Aired October 13, 2014 - 17:00   ET

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

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UNIDENTIFIED MALE: I never worry about what they can't do. I worry about what they can do. I'm building them up and stronger so they can live life like they're supposed to.

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DEBORAH FEYERICK, CNN NATIONAL CORRESPONDENT: Well, thanks for spending part of your Sunday here with us. I'm Deborah Feyerick. The next hour of the CNN NEWSROOM begins right now with Ana Cabrera in New York.

ANA CABRERA, CNN HOST: Hello. You are in the CNN NEWSROOM. I'm Ana Cabrera. Thanks for joining me. We begin with disturbing news from the CDC. A breach in protocol, that is what is believed to be the reason for the first known transmission of the Ebola virus now on U.S. soil. The latest case, a nurse who had extent of contact on multiple occasions with Ebola victim Thomas Duncan before he died.

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DR. TOM FRIEDEN, CDC DIRECTOR: 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 the breach in protocol resulted in this infection.

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CABRERA: Now, the nurse was involved after Duncan's second visit to Texas Health Presbyterian hospital in Dallas when it was confirmed that he had Ebola and was admitted for treatment. We know she was wearing protective gear all along -- gown, gloves, mask, shield, all used while treating Duncan. She reported a low grade fever on Friday night and immediately was isolated. But keep in mind, she was not part of that initial group that was being monitored.

Meanwhile, hazmat crews with the Dallas fire department have cleaned up the nurse's car and have plans to work on her apartment as well today. Now, just moment ago, the National Nurses United held a news conference with a very strong but simple message, stop blaming nurses, stop Ebola.

(BEGIN VIDEO CLIP) KATY ROEMER, REGISTERED NURSE: We cannot blame the healthcare providers who are on the front line risking their lives to provide care for patients and who are then faced with possible infection themselves.

(END VIDEO CLIP)

CABRERA: Even more developments now. CNN affiliate WCVV reports that hazmat team and emergency crews are now on the scene of a medical facility near Boston where doctors are assessing a patient with Ebola- like symptoms. We are working to get more information on that case. Nothing confirmed at this point, but we do know that medical professionals are on the scene. We are waiting a news conference and we will bring that to you as soon as that happens.

So let me bring in our panel of experts to discuss all these new developments today. Director on the National Institute of Allergy and infectious diseases Dr. Anthony Fauci, infectious diseases and public health specialist Dr. Celine Gounder, and former assistant secretary for health affairs at the department of homeland security Dr. Alexander Garza.

I want you all to take a listen to Dr. Dan Varga with the Texas health resources explained the hospitals plan of actions.

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DR. DANIEL VARGA, TEXAS HEALTH RESOURCES: This healthcare worker had been under the self-monitoring regiment prescribed by the CDC. And based o involvement and caring through a patient, Thomas Eric Duncan during his care that started on September 28th. The individuals who are being monitored are required to take their temperatures twice daily. And as a result to that process, the caregiver notified the hospital of imminent arrival and was immediately admitted to the hospital's isolation room.

The entire process from the patient's self-monitoring to the admission into isolation took less than 90 minutes. Patient's condition is stable. A close contact has also been proactively placed on isolation. A system of monitoring quarantine and isolation was established to protect those who cared from Mr. Duncan as well as the community at large by identifying any potential Ebola cases as early as possible and getting those individuals into treatment immediately.

This individual is following full CDC precautions which are very on droplet -- so gown, glove, mask and shield. But we are confident that precaution we have in place right now protecting our healthcare workers.

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CABRERA: So Dr. Fauci, you heard it there first, precaution in place are working. But the question on everyone's mind, obviously not. This nurse, we are told, took the precaution and contracted Ebola anyway. So how do you explain that? DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND

INFECTIOUS DISEASES: Well, it is very likely that there was an inadvertent and innocent breach in protocol. And when I say breach, I want to make sure because I just heard the nurse from the nurse association saying, certainly, no one is blaming the nurse. She is courageous person to being able to do that. But sometimes when you are on the isolation and wearing PPEs which a Personal Protective Equipment, even though you believe that you are doing it precisely and correctly, something might happen, accidentally beyond your control or what have you, that need to inadvertent breach in protocol which is likely what happened. But by bi means, this person's fault.

CABRERA: When you think an accident could result in this, we gave been asking viewers for question today. And Scott on twitter had this question. Why is transmission evidence of a breach in protocol rather than an indictment of effectiveness of the existing protocols?

So Doctor Garza, this question for you is what is being done the most effective way to prevent Ebola from spreading the healthcare workers or others?

DR. ALEXANDER GARZA, FORMER HOMELAND SECURITY ASSISTANT SECRETARY FOR HEALTH AFFAIRS: Well, I think as far as that goes, Dr. Frieden is absolutely correct. The way to prevent Ebola transmit to healthcare workers and others is really to prevent it in western Africa. Now, as far as the patients here in the United States that were being treated, it's the strict adherence to protocol. But you have to remember that this is the first time that some of these people have encountered such a very violent (ph) virus. And so, there still is a learning curve and an understanding on how formidable of a virus this really is.

CABRERA: So I want you all to take a listen to CDC director, Dr. Tom Frieden, talk a little bit more about these protocols.

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FRIEDEN: The care of Ebola can be done safely, but it is hard to do it safely. It requires meticulous and scrupulous attention to infection control. And even a single inadvertent innocent slip can result in contamination.

Second, we are recommending to the facility that the number of workers who care for anyone with suspected Ebola be kept to an absolute minimum.

Third, we recommend that the procedures that are undertaken on to support the care of that individual be limited solely to essential procedures.

Fourth, we are looking at personal protective equipment understanding that there is a balance and putting more on is not always safer and may make it harder to provide effective care to all aspects of personal protective equipment.

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CABRERA: Dr. Gounder, I want to talk a little about the last point that he made. It sounds like it is very difficult to put on the equipment and take it off in the right way. How do we go about that? I mean, is there an easier solution here?

DR. CELINE GOUNDER, INFECTIOUS DISEASES AND PUBLIC HEALTH SPECIALIST: Well, doctors without borders, the leading experts on the treatment of Ebola in the world have a very ritualized approach to putting on and taking off the personal protective equipment. There is specific order in which this should be done so that when you take it off, you are at lower risk of contaminating yourself. In addition, they have a buddy system where somebody supervises you as you are doing this to make sure you don't contaminate yourself.

CABRERA: Is there anything that you can think of that maybe our hospitals or health departments here in the U.S. haven't thought of it yet in terms of what you're hearing and the way they are going to proceed?

GOUNDER: Well, in terms -- you have to remember, in the United States, it's the local and state health departments that take the lead in managing health emergencies. So that leads to tremendous variability in their capabilities and their plans. It's clear that many of these plans for emergency preparedness are fairly generic and we are not specific to Ebola. So we're having to fill in some of the details now.

So for example, 911 call operators in New York have been trained what questions to ask so that when EMTs arrive on the scene they are aware of the risk. This is not necessary being done throughout the country. For example, if somebody needs to be quarantine who has been exposed to Ebola, we need to have systems in place to make sure food is delivered to them. That they get payment for lost days of work.

CABRERA: Right.

GOUNDER: So there is a lot of details like that.

CABRERA: So much to think of that you don't know until you are faced with the situation.

GOUNDER: Precisely.

CABRERA: Dr. Fauci, another question for you. Doctors in Omaha, some good news today, those doctors are treating the NBC photographer who we know is battling Ebola. And they say his condition is improving. We know he was being treated with that same experimental drug that was given to Thomas Duncan but he also received a blood transfusion from an Ebola survivor, Dr. Kent Brantly.

So Dr. Fauci, what do you say has made a difference in his case? Was it the transfusion?

FAUCI: We really don't know. When you have so few people and experience to compare it with really nothing because you are just giving it empirically hoping that it works. So I don't think any of us can make any definitive statement as to whether any of the interventions other than good medical care. We know that there are many people in West Africa, about 50 percent of them who don't get anything other than medical care do well and recovered, 50 percent plus dies.

So when you have those kinds of statistics where half of the people, even those who get no specific medical intervention survive, it is very difficult to evaluate definitively where there any of those interventions made any difference. We hope they do. And we hope that ultimately we will find out that they work so that we will have some proven intervention. But on the basis of a single patient getting those interventions, we don't know if they work.

CABRERA: Doctors, stay with me. Thanks for those thoughts.

We know three-fourths of the country's hospitals we are hearing aren't maybe prepared to handle the Ebola cases. This is according to the national nurses united who spoke out just moments ago. Their message, stop blaming the nurses for no following protocol when there is no protocol in the first place. We will hear more from them right after this.

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CABRERA: CNN have now confirmed a hazmat team and emergency crews remain on scene here at this medical facility near Boston. We are getting new live pictures right now where doctors are assessing a patient with Ebola-like symptoms. We now have been told by the facility that the patient has been to Liberia as was complaining of a headache and muscle aches. That patient has been removed now from the building, put into an ambulance and it is headed to Beth Israel Deaconess medical center. And we hope to learn more information throughout the next couple of hours. So stay with us.

Don't blame the nurses. Right now, hundreds of nurses are rallying in California. They are demanding better education and training on Ebola. Now, the CDC says it has done its part telling hospitals specific protocols follow to treat Ebola patient. But we are hearing a very different stories from the nurses. Listen.

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ROEMER: The nurse that has just become infected in Texas. We are seeing that caregivers who are not being adequately trained are being blamed and we are hearing that they have not followed proper protocol when we have been asking our hospitals throughout the country to provide us with training that allows us to ask questions. With training about how to put on the proper and optimal level of personal protection equipment, how to put it on and how to take it off, what is the plan for waste disposal? And we have seen in our hospitals in this country that they have not given us this information. And then, when the nurses become infected they are blamed for not following the protocols. That is not going to work. We cannot blame the healthcare providers who are on the front line, who are risking their lives to provide care for patients and who are then face with possible infection themselves and infecting their families and community members. It is not OK.

UNIDENTIFIED FEMALE: 1900RN (INAUDIBLE) the USA including the District of Columbia has responded to the NNU survey. Seventy-six percent still say that their hospital has not communicated to them any policy regarding admission of patients infected by Ebola.

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CABRERA: So we are hearing about a communication breakdown, now enough training. I'm joined on the phone now by one of the nurses that you just saw, Katy Roemer.

Katy, some of those comments we just heard are kind of alarming. Help us to better understand where you're coming from.

ROEMER (via phone): Well, as nurses, we are being asked to provide direct care. We are the people who are going to be taking care of these patients, spending the most time with these patients in the hospital. And so, I'm, you know, speaking on behalf of those very people who are being asks to risk our lives in caring for these patients without the proper preparation, training, and equipment to be able to do so. We have been asking for the last couple of months in order to protect ourselves, our patients and our communities for face to face training where we can ask, you know, ask questions, have our questions answered, have drills where we can actually put the equipment on, take it off properly, waste disposal plan as I said in the previous post and we are not getting that from our hospitals.

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ROEMER: Well, in many places we are hearing that nurses are being given a piece of paper or a link to a Web site or things like that. That's insufficient. That's not going to prepare you for caring for one of these patients.

We are seeing that when patients are cared for at hospitals like Emery that the people that are transporting them have full hazmat suits on and full protective equipment. And we believe that nurses deserve no less in their ability to take care of these patients so that we can have other patients be safe and have ourselves be safe and have our family be safe.

CABRERA: Katy, we are hearing you and please do not think that any of us are blaming you. We appreciate the work that you are doing and your points are duly noted.

I want to bring back my panel -- Dr. Anthony Fauci, Dr. Celine Gounder and Dr. Alexander Garza.

Dr. Garza, let's start with you this time. You just heard those comments from Ms. Roemer. What are your thoughts about how the health care system in America is working regarding the Ebola threat?

GARZA: Right. So I think they are doing as best as they can. And so, I'm speaking from 15 years as an emergency physician and also, the son of an emergency nurse. So I completely understand the comment they are being made.

And so, I think the hospitals are doing the best as they can. But we have to remember that nobody has seen patients like this before in the United States and nobody has had to go through the drills and the exercises and the practice of taking equipment on and off. And for that reason that I think it might be time for federal officials to consider maybe consolidating patient care in a couple of those bio- containment centers either in Nebraska or Atlanta, at least that should be on the table.

CABRERA: Dr. Fauci, that is a good point. You know, we are seeing that hospital in Dallas treat patients but that was not one originally prepared to treat patients with Ebola.

FAUCI: Right. Well, I think the training is really important. And the CDC right now is examining what could possibly have gone wrong. And again, I completely agree with what the nurse just said that they cannot be blamed for this. And training is important. And there is protocol that if followed exactly should protect you. However, if you are trained well enough, and she makes a very good point, you need to look at the training. So we need to review specifically what might have happened in this case and is the actual training. And the protocol is a protocol and we know it works because we have years and years of experience when trained people like the people in doctors without borders use the protocol we don't see infections.

But the nurse made a good point. If train something lacking among them, we need to make sure they get trained properly so that they can implement the good protocol correctly. A very good point she made.

CABRERA: Katy, are you still with us?

ROEMER: I'm still with you. I would love to respond to that if I can.

CABRERA: Please do.

ROEMER: So, I just have to say that, you know, we do actually have some experience with drills. It's our belief that the hospitals are choosing not to put in place the training and that, you know, we have a very fragmented healthcare system in the United States. It is a healthcare system that exist for, you know, too often make money. And so, we are asking that we put our resources towards safe patient care and safe care for the healthcare providers putting their lives on the line.

So, you know, when you have this fragmentation you don't have the kind of overall sense of what, you know, implementing from a national level the proper kinds of protocols in place. And we're seeing that hospitals when given the choice to either put in place proper training and at the highest level of protective equipment that many of them are choosing not to do so up until this point and that's not OK.

CABRERA: Well Katy Roemer, thank you for your thoughts. Thank you for joining us. Panel stay with me. We have got to squeeze in a quick break.

But as she mentioned that sort of things like perhaps America is responding with, you know, figure it out as you go. We are going to talk a little bit more about the response and what can happen and what we can expect next when we come back, including how a nurse can wear full protective gear and still get Ebola. And should we re-examine the protocol for dealing with infected patients. We will have our panel weigh in on that next.

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CABRERA: Fear turns into reality. Tests confirm a person has contracted Ebola inside the U.S. So the question now, what's it going to take to stop Ebola from spreading? The CDC laid out some new guidelines following today's announcement that a healthcare provider who treated Thomas Duncan, even under its strict guidelines that were laid out to medical personnel there is now battling the deadly virus herself.

(BEGIN VIDEO CLIP)

FRIEDEN: The care of Ebola can be done safely, but it is hard to do it safely. It requires meticulous and scrupulous attention to infection control. And even a single inadvertent innocent slip can result in contamination.

Second, we are recommending to the facility that the number of workers who care for anyone with suspected Ebola be kept to an absolute minimum.

Third, we recommend that the procedures that are undertaken on to support the care of that individual be limited solely to essential procedures.

Fourth, we are looking at personal protective equipment understanding that there is a balance and putting more on is not always safer and may make it harder to provide effective care to all aspects of personal protective equipment.

(END VIDEO CLIP)

CABRERA: I want to bring back my panel now. It just seems that there is so much risk with treating patients and the risk of spreading.

Dr. Gounder, we just heard from that nurse in our last segment describing their concern about their own safety as healthcare providers. We are now hearing that in Liberia, nurses are threatening to strike because they don't feel that they are in the safe environment and being supported enough. I mean, now, that it is a real deal here in the U.S., should be concern that our hospital system is going to all of the sudden, you know, kind of go up and armed?

GOUNDER: Ana, I am very concern about how the nurses feel about the current situation. It is essential that nurses and doctors, you know, like they have the adequate training, equipment and supplies to do their jobs safely. We have seen physicians and nurses refuse to treat patients from the past, for example on their early '80s of the HIV epidemic because they didn't have adequate information to feel safe. Of course, there is a lot of stigma as well. But it is essential that people feel safe.

Another factor here is whether people who, physicians and nurses, who take care of Ebola infected patients should they get hazard pay to compensate them for the risk that they're taking?

CABRERA: Do you think they should?

GOUNDER: Personally, I don't. But this is certainly something that has come up, in Liberia for example, some healthcare workers are being offered hazard pay for taking on this extra responsibility.

CABRERA: Dr. Garza, you talked a little about this previously. But you know, after what happened in Texas, you mentioned maybe it's best to send these patients who have Ebola to the hospitals that are prepared to deal with them. However, shouldn't all hospitals be ready now that we are seeing the virus pop up where you don't expect it?

GARZA: Right. So don't get me wrong. That is a mere suggestion that something that we should be thinking about. But certainly, every hospital in the United States should be prepared to take care of an Ebola patient. My point being though is clear that even patients that are treated by treatment teams in West Africa, the healthcare workers still fall victim to them and they treat them every day and they treat hundreds of these people. And they follow strict protocol.

But there is something to be said about groups like doctors without borders that have very minimal infection in their healthcare workers because they follow such a strict protocol. And because they are so used to working in this environment. So I think it makes sense to have concentrated teams that know how to work on this take care of these patients rather than a rather distributed system where people have minimal or moderate education and training to take care of these highly infectious patients.

CABRERA: Dr. Anthony Fauci, I have a question from a viewer, Irene McDaniel tweets, are the nurses et cetera, et cetera, treating an Ebola patient assigned only to that specific case or are they seeing other patients, too?

FAUCI: I don't know specifically in that hospital. But I'm fairly certain that the protocol would be that they are essentially assigned to that patient and only that patient. I can tell you that in my own institution at the NIH, which recently admitted a person who had a risk exposure that we had a designated team that did that and only that.

CABRERA: All right. Well, thank you so much Dr. Fauci, Dr. Gounder and Dr. Garza. We really appreciate your expertise on this topic.

And moving to another big story today, we want to get to ISIS. It's only eight miles from Baghdad's airport. Could the city fall to ISIS? We will take you there live and discuss more next.

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CABRERA: Right now, ISIS militants are just eight miles away from Baghdad international airport. And behind the scenes here at CNN, there has been this heated email chain going on between our experts and our correspondents about whether Iraq's capital could really fall to ISIS. So we decided take this debate off email and actually put it on TV.

So joining me now from Baghdad, Ben Wedeman, our CNN senior national correspondent, also Pentagon correspondent Barbara Starr is joining me on the phone. And with me here in New York is former lieutenant colonel Rick Francona and he is the CNN military analyst and former U.S. military attache in Syria.

So Ben, we will start with you. You used a really interesting analogy saying if ISIS was eight miles from Dulles airport, would we not have fears for Washington? Is the battle for Baghdad feasible?

BEN WEDEMAN, CNN SENIOR INTERNATIONAL CORRESPONDENT: The battle for Baghdad as far as ISIS is concerned would be a serious proposition. This is a huge city about nine million people, many of them, in fact, the majority are Shiite who have absolutely no love for ISIS which considers the Shiite to be a (INAUDIBLE).

Now, as far as the defensive of Baghdad, though, they stretch out as much as 20 kilometers or whatever that is in miles to the west of here. And we understand that there are U.S. advisors with the Israeli and with the Iraqi troops that there are patchy (ph) helicopters at Baghdad international airport that are providing air cover for operations by the Iraqi army.

In addition to that, there are drones flying overhead. There are aircraft of the coalition that are striking ISIS targets on a regular basis. ISIS really would be up against quite a challenge trying to enter the city of Baghdad. Because if they did they would be faced not only by the Iraqi army but there are tens of thousands of arms Shi'a militias that have been called out. And they would provide quite a level of resistance for ISIS.

So I don't think in the immediate future there is any threat to Baghdad despite the proximity of ISIS forces to the Iraqi capital -- Ana.

CABRERA: Colonel, you say that we are still not taking ISIS' capabilities seriously enough. Why?

LT. COL. RICK FRANCONA, CNN MILITARY ANALYST: Well, I think we have underestimated them because if you look at what they are doing right now, they are conducting operations in Kobani, Syria. They are also conducting operations, as Ben says, right up by the airport there. They are also moving forces from Mosul down to fight in the Iraqi, the dam at El Haditha. They are just fighting there at heat.

So they are commanding and controlling a lot of forces over a battlefield, about 400 miles. That's much more -- that's much larger than we ever gained (ph) and credit for. And despite the cost impound in their take from the coalition airpower, we have not been able to degrade their capability. We been able to slow the dam, but haven't been able to stop them.

And the Iraqi army, the leadership had seems to have evaporated because they are almost in capable in taking back any ground from ISIS. So, I think Ben is right on there with the assessment that the city of Baghdad might be too difficult of a target (INAUDIBLE). But the outskirts and Euphrates valley are still well within their sites.

CABRERA: Barbara, a White House source says CNN, we have been overstating ISIS abilities. But the point was raised in that email chain we mentioned that sometimes the administration doesn't think something as a real problem until it is on fire.

BARBARA STARR, CNN PENTAGON CORRESPONDENT (via phone): Well, you know, Ana, I keep wondering if everybody doesn't need to sort of have a revolution in their military thinking here. The Pentagon warned right from the beginning that airstrikes would not solve this. And on that point, they are absolutely right. Airstrikes are not solving it. It's not really rolling back ISIS in any fashion.

And airstrikes, of course is maybe a 35-year-old, 40-year-old concept of how to conduct warfare. You know, we're really still doing it the same way. The technology is better. But you fly a pilot in an aircraft over. You look for a target and you bomb it.

In the meantime, ISIS is making in places, making friends and terrorizing people at the same time. They don't need to go for Baghdad to do perhaps what they want to do. They can sit on the outskirts. They can use long range mortars to shell what they want to shell. They can hold people in territory in absolute (INAUDIBLE). Why do they want the trouble of going after Baghdad? At the same time if you go, Colonel Francona was making the key point, ISIS has only tactics, only strategies. Much of what they are doing is conducting this war on social media, recruiting thousands of new adherence (ph) around the clock. They don't have to respond necessarily to the 40- year-old strategy that the U.S. military is doing. (INAUDIBLE).

CABRERA: You bring up a good point there, Barbara, about motivation of ISIS. So -- and we are all worried about Baghdad because the proximity of ISIS now taking over Anbar province.

But, Ben, there on the ground, do you feel that ISIS has even the desire to go in and try to take over Baghdad? Would that be part of their strategy?

WEDEMAN: No. I don't think so. No it wouldn't. But what they would like to do is on the one hand, and what they're doing already, they are -- every day there are several car bombings in Baghdad. There was one last night that killed more than 40 people. There was one in Tiala (ph) province which may have killed as many as 60 people. Three, actually, three bombings in that instance. So what they want to do is really sow tear among the populations and they are looking for is to spark a backlash among the Shi'a population, angry that they are constantly being bombed against the Sunnis because sectarianism,, the conflict whether it's between Shia, Sunni or the Yazidis or in various other of the many minorities here in Iraq. What they want to do is create division and decent. Therefore, there will be Sunnis who are already alienated by the government in Baghdad will be alienated from the entirety of what is Iraqi society today. So that is their tactic is to sow division and terror and anger and hatred. And they have proven to be quite good at that.

CABRERA: And Colonel, you're shaking your head. We have to get in a quick break so hold your thought for just a moment and we will talk about it on the other side. Stay with us.

(COMMERCIAL BREAK)

CABRERA: The U.S. and the world under estimating ISIS and specifically their ability to take the Iraqi capital of Baghdad. That's the question we're putting to our panel.

Joining me now Barbara Starr, Colonel Rick Francona and Ben Wedeman in Baghdad.

Colonel, first, to just follow up on what we were discussing in the last segment and what Ben had to say, So ISIS is not in Baghdad in terms of total control, but they have sort of shaken some things up, right?

FRANCONA: Absolutely. I think Ben is actually right. Although, they're not going to be able to take the city. And I don't think they will even try it. But they are able to use indirect fire and mortars and artillery to shell inside the city. And not only does it spreads terror, but it undermines the credibility of the newly formed Iraqi government. This all, this supposedly inclusive government, that's how you appeal to the Sunni population to bring them out of ISIS and back into the fall. I think that ISIS is attach really undermine the credibility of that government.

CABRERA: Ben, even if they don't take the city which sounds like it is very unlikely. We have been reporting from our sources that at one point, ISIS wanted to take everything surrounding it. So what happens then?

WEDEMAN: Well, what they were trying to do is we understand for instance, our colleague Nic Robertson spoke to an ISIS sympathetic Sunni tribal leader who said that it is the airport that they want to do. Simply take over, simply for its symbolic value.

Short of that, I -- clearly what they want to do is make life as difficult as possible for the inhabitants of the capital and for the government of (INAUDIBLE), the new prime minister. If you look at a map, ISIS has a presence to the west, to the southwest, and to the north as well. And slowly, slowly, they are taking little bits of territory. They, for instance, surrounded the town of Haditha which is on the Euphrates river to the northwest of here. And it's completely cut off.

So Baghdad is really just far more than that organization can swallow and would really want to swallow. But to make life difficult, to undermine, as the other guest was saying, the credibility of this government, that's definitely part of their plan -- Ana.

CABRERA: Barbara, I know you have said Barbara that the real challenge for the Pentagon in the U.S. is to make sure none of the places reach, a tipping point, but it has been like that is happening. So the track record of predicting, really, has been great. Is the U.S. again underestimating ISIS and maybe overestimating Iraqi security forces? STARR: All indication are the answers Ana to both questions is yes,

yes, yes. I mean, how does ISIS take this territory? As Ben is pointing out they do it because the Iraqi forces are unable to fight and push back in many cases. I was very surprised in the last week to hear sources that I speak to regularly very senior defense and military officials for the first time really express their dismay at the lack of response by Iraqi security forces even after all of these months of having U.S. advisors there. How do you turn that around? And really ISIS in the cross hairs probably, the airport, as Ben said, Baghdad international airport. That's the crown jewel for them. They don't have to take the city. If they can take the airport, they sends the message to the world, it sends a message to Iraq. And it is a nightmare. That is the ultimate nightmare in the short run for the Obama administration there. About 1,000 -- over 1,000 U.S. troops, plus diplomatic personnel with the U.S. mission in Iraq. If the airport goes, that is the only way out for them. It will be very difficult to evacuate over 1,000 Americans potentially under fire, one of the most difficult things for the U.S. military to do. They have got to keep that airport open.

CABRERA: Colonel, what's it going to take to make sure that airport doesn't fall?

FRANCONA: Well, they are using the Apache helicopters right now in a support role in trying to push ISIS back, keep them at bat in supporting Iraqi army as they are fighting to keep that airport secure. The problem is as you get these helicopters involved they're at risk. They're more at risk than the fighters are because they're down low.

Just the other day, ISIS was able to shoot down in Iraqi helicopter, Iraqi army aviation, bell helicopter, these Apaches are operating in the threat envelope of the shoulder fired missiles. So it puts them much greater risk than the fixed wing aircraft so we're doing that now.

At some point, though, the Iraqis are either going to have to stand up or we are going to have to get more involved. And I don't means putting U.S. advisors at a lower level, maybe replacing the leadership structure at some of these Iraqi battalions. But the situation as it is right now the Iraqis are incapable of defending that airport.

CABRERA: Ben, we know there have been dozens of airstrikes. Are you seeing ISIS change its strategy at all?

WEDEMAN: We have seen ISIS change its strategies over the last few weeks as those airstrikes intensified and began in Syria. Now, they have been going on in Iraq now for over two months. But speaking to, for instance, I was with Northern Iraq with peshmerga, the Kurdish forces before and now we have spoke to many Iraqi officers as well. They say that in the past, for instance, then you have probably seen the videos of those long convoys of pickup trucks, humvees lifted from the Iraqi army driving through the deserts, driving through highways. They have stopped doing that. They now drive around in individual trucks, pickup trucks, one or two by themselves and motorcycles. They've really switched their tactics quite smoothly to classic guerrilla warfare. Small units. Low profile which makes a very difficult target for coalition aircraft.

CABRERA: All right, Ben Wedeman, Colonel Rick Francona, and Barbara Starr, thanks to all of you.

A Dallas nurse has now become the first person to contract the Ebola virus inside the United States. Could we see more cases in the week ahead? We'll discuss just ahead.

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CABRERA: When you hear the word root in conjunction with Anthony Bourdain, you might wonder what strange new concoction or dish he's trying now. But the roots he's looking for torrent are connected to his family. He spoke to Anderson Cooper for the search of his family's past in Paraguay.

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ANDERSON COOPER, CNN ANCHOR, AC360: What's Paraguay like? It is one of those places that I have always wanted to go to. And I always get it confused with Uruguay.

ANTHONY BOURDAIN, CNN HOST, PARTS UNKNOWN: Paraguay, we know almost nothing about it. Maybe we know, yes, it's a place the Germans hid out after the war and they had a secession of incredibly lurid over the top, like, insane military dictatorships, really, you know, lampoonable (ph) ugly stuff. My great-great-great grandfather is Jean Bourdain disappeared in Paraguay in the mid 1900s. Well, we knew he was in Argentina and Brazil doing some kind of mysterious business but has recorded of having died (INAUDIBLE).

COOPER: Wow.

BOURDAIN: So I went to look into this question and while doing that, looked into Paraguay which is at various times seen as a sort of utopia for German colonists, French colonists, Mennonites, dreamers, lunatics.

COOPER: What drew them there?

BOURDAIN: The promise of unlimited wealth, agricultural wonderland. And unlike anywhere else I'm aware of in Latin America, the primary language is not Spanish or Portuguese, it is (INAUDIBLE) which is something I had no idea. One of their early maximum leaders commanded all citizens to intermarry and to, as best as possible, mix and/or eradicate the stain of their European heritage.

COOPER: That's really interesting.

BOURDAIN: It is very interesting and it is a mixed -- very mixed culture, and a very remote one. I mean, who goes to Paraguay? Also a very friendly, lovely one with great food and a lot to do.

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