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CDC: "Might Have Prevented" Nurse's Infection; CDC: 76 Health Care Workers Monitored; ISIS Surrounds Iraqi Air Base with Rockets

Aired October 14, 2014 - 15:30   ET

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

DR. TOM FRIEDEN, CDC DIRECTOR: When we understand that Ebola doesn't spread from someone who doesn't have symptoms that helps us understand where the risk is. If health care workers get the fact that they have to take a travel history from anyone with fever or signs of infection that gives them the tools to protect themselves.

And for the health care workers caring for the nurse in Dallas concrete information on what they can do keep their risk to the absolute minimum can address that fear and keep us able to respond to the needs of the community. Next question on the phone.

UNIDENTIFIED OPERATOR: Thank you, next question comes from medical news. You may ask your question.

UNIDENTIFIED CALLER: Hi, one clarification and a question. Did you say that the 48 -- of the 48 people who were in contact with the next patient because they're past the 2/3 mark, past 14 days that they're unlikely to get Ebola?

FRIEDEN: Yes, 2/3 of the incubation period is far more than 2/3 of the risk. Most of the cases happen within that 8-to-10-day window. We put it out to 21 days to be on the safe side. It doesn't rule out that there could be cases among those individuals, but it would be unusual. Your question?

UNIDENTIFIED OPERATOR: Thanks. The next question comes from Jackie Bishop with "Newsweek," you may ask your question.

UNIDENTIFIED CALLER: Hi, I just like to find out what if anything the CDC has learned from the response to the outbreak in West Africa by organizations like "Doctors Without Borders?"

FRIEDEN: We work very closely with MSF, "Doctors Without Borders." In fact, we have undergone and participated in and replicated their training course here. We've worked side by side with them in Africa. We have a very close partnership and relationship with them.

One of the challenges is that the African environment and the U.S. environment are different in terms of health care. So things down routinely in Africa in Ebola wards aren't necessarily transferable to the environment in the U.S.

But we think they do a terrific job and we'll work very closely with them. Next question on the phone.

UNIDENTIFIED OPERATOR: One moment please. Our next question comes from Jack Fink with CBS 11 Dallas. You may ask your question.

UNIDENTIFIED CALLER: Yes. Thank you, everyone. Appreciate it. I wanted to find out, have you been able to identify the breach in protocol that led to the nurse getting infected. How crucial is that and exactly how are you going about figuring that out?

FRIEDEN: We have not identified a specific interaction that resulted in the exposure and infection of the nurse. The way we do that is to review in great detail everything that occurred.

She's been terrific at assisting our investigators and going through the steps so we can all learn try to learn together how to keep health care workers safer against the virus.

It's something that we don't always come to a conclusion, but we always identify things that we can do to improve the process and improve the safety of health care workers there. Dr. Leahy, anything you'd like to add to this?

UNIDENTIFIED CALLER: I don't think so, Dr. Frieden. Again, the patient has been working with the team, looking at the procedure. There's no specific error that has been identified. I think they were looking very closely at the protocols and how we can maximize the ability to contain the virus. There's been no identified item at this time. Thank you.

FRIEDEN: Thank you. Next question on the phone.

UNIDENTIFIED OPERATOR: The next question comes from Alice Park with "Time," you may ask your question.

UNIDENTIFIED CALLER: You mentioned that --

PAMELA BROWN, CNN GUEST ANCHOR: All right, let me bring in now, Dr. Celine Gounder, an infectious disease and public health specialist and senior medical correspondent, Elizabeth Cohen. Great to have you both with us here.

We just heard from Dr. Frieden there from the CDC, and he made some additional points about what the CDC is doing now in light of what happened with Thomas Duncan, the Ebola patient who died and now Nina Pham, this nurse who has contracted the virus after caring for Duncan.

I want to go to Elizabeth Cohen first to talk about this. Dr. Frieden broke down some numbers for us, Elizabeth. And something that stuck out to me, he said 76 people were in contact in some way or fashion with Duncan or his blood once he was hospitalized.

First of all, that seems like a lot of people, and secondly, he said that some of them have come in and some of the health care workers have come in because they're concerned about their health. I can imagine they are frightened. What are you hearing there on the ground?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right, Pam. What Dr. Frieden said is that 76 people at the hospital, hospital workers may have had some level of contact with her. I know that sounds like a lot for one patient. But when you think about it, think about how many people are involved with taking care of any hospital patient.

It's not just the doctors. It's not just the nurses. It's techs. It's janitors because they're handling your waste, your gowns, your sheets, all of that. It is indeed a lot of people.

And you mentioned they were casting a wide net. I'll tell you. This nurse becoming infected is a huge black eye on the public health system of this country. This is the kind of thing that happened in Africa. Not the kind of thing that happened in the United States.

We're supposed to be able to protect our health care workers and we didn't and so they are going to be extremely careful. And what I heard Dr. Frieden saying in effect was, look, when we first got to Dallas, we thought about protecting people outside this hospital.

We let the hospital kind of take care of their own workers but no more. We are going into that hospital as CDC workers, and we are going to help them protect their own employees.

BROWN: Yes, it makes you wonder if, perhaps, we were overly confident about how capable hospitals are in dealing with Ebola patients -- Elizabeth.

COHEN: Yes, the experts I've been talking to, Pam, have been saying exactly that. That there was too much confidence that just any hospital could handle, number one, an Ebola patient and number two, the health care workers who were assigned to take care of them.

Folks at the CDC said to me months ago. Look, we put out guidelines, we held webinars. They should know what to do. I think one of the things we're learning both in Africa and in the U.S. is that having things on paper, having webinars is not the same thing as actually doing something. They are completely different things.

BROWN: And I want to turn now to Dr. Gounder to talk about this a little bit more because something else that struck out to me, Dr. Gounder was you said that there was one person in contact with the nurse.

That is perplexing because we hear these numbers thrown out that, you know, she was one of the 76 who was dealing with Duncan. So what about her colleagues? How is it just one person in contact with her?

DR. CELINE GOUNDER, INFECTIOUS DISEASES AND PUBLIC HEALTH SPECIALIST: It is very surprising. Even if she led the life of a hermit back at home, she has a lot of coworkers that she has at the hospital, nurses, phlebotomist, dietitians, janitors, and so on. So I'm a little surprised that they're claiming there's only been one contact to date.

BROWN: Do you think we'll ever find out how Nina Pham contracted this virus because that is the big question mark that was not addressed in this press conference that we heard before.

GOUNDER: We may never find out how she herself was infected. All we can do is go through the protocols systematically and figure out how can we strengthen our systems to prevent this kind of thing from happening. But, unfortunately, it's not as if we had a video of her taking care of the patient where we can then do a play by play and see where the contamination occurred.

BROWN: All right. I want to bring in now Dr. Robert Murphy, director for the Center for Global Health at Northwestern University. Dr. Murphy, you have said the way Texas is handling all this is the way it should not be done, if you would explain that.

DR. ROBERT MURPHY, DIRECTOR FOR GLOBAL HEALTH, NORTHWESTERN UNIVERSITY: Well, basically from the beginning, they made mistakes every step of the way. First, they had a patient come in, who had been in Liberia, only been in the United States for four days. Obviously symptomatic that it could be Ebola, written down and nobody looks at them.

The patient is sent home with some inappropriate medication and comes back three days later so sick he's in an ambulance. He's home exposing his family and people in his house. He comes back exposing people in the ambulance, although they had some protection on.

And finally gets diagnosed in the hospital. So that was step one. Then, once he got to the ICU, he was -- I had thought until just the other day that everything was going really well. It's a very good hospital. They know how to run an ICU and he's most likely got very good care in the ICU.

But meanwhile, his family and friends where he was staying have a court order against them. They're not allowed to leave. The leave is not decontaminated and they're sitting there in this contaminated apartment for four days. That was another mistake.

That's not the hospital's problem, but it's a system problem. OK? And now, what we have is the nurse gets infected, and I agree with the other guest here that we may never know really how she was infected. It could end up being a mystery.

BROWN: And that's, of course, so troubling for those health care workers that are right now at the hospital in Dallas caring for Pham who contracted the virus not knowing how she did is obviously very concerning.

And what I think sometimes we lose sight of here, Dr. Murphy, is that CDC is only responsible for making recommendations when it comes to safety guidelines, not enforcing what these hospitals do.

Why isn't there a central authority here, a centralized authority dealing with this? Who is really in charge here when it comes to Ebola in the U.S.?

MURPHY: Well, this is a problem worldwide, in the United States as well as in Africa and all around, who is in charge in a crisis like this? The CDC as you just said, I mean, what they are responsible for is providing guidelines, they can do laboratory backup, they can -- they can bring support teams in, which they're going to start as of today, I guess, from what I just heard. That's what they can do.

The public health is really up to the state. The hospital also takes its own responsibility and is governed by state rules as well as federal rules. The CDC actually doesn't have the authority to just march into a hospital and do something. They have to be asked to come in.

I doubt anybody's going to refuse them, but that's just the way our system is set up here. And, you know, in a crisis like this, maybe there's something wrong. It's even worse in Africa.

You have the Europeans now arguing about who is going to pay for flying an infected volunteer health care worker back to Europe. They can't get their act together. You know, they ended up contracting an American company to fly the person back to Europe to get treatment.

So it's really everywhere. Probably the only place where the organization is starting to come into play is the military response we have in Liberia. And what I heard today from Dr. Frieden, I was really very encouraged.

It's too bad it didn't start 14 days ago, but it has started and it looks like if this is the approach that's going to be taken, I really don't think we have too much more to worry about.

BROWN: Yes, he's talking about implementing a buddy system where doctors can watch each other, doctors dealing with Ebola patients, talking about more training, and also sending teams to hospitals, a team of experts from the CDC to hospitals where Ebola patients are.

So some new measures in place in the wake of what we've seen with Thomas Duncan as well as Nina Pham, the nurse. Robert Murphy, thank you so much for coming on and talking with us and sharing your perspective.

And we're also following major developments out of Iraq at this hour. ISIS terrorists have surrounded another Iraqi air base and they are preparing to launch an attack, this while President Obama meets with leaders of 20 other nations on how to deal with a terrorist group. This is CNN's special coverage.

(COMMERCIAL BREAK)

BROWN: Breaking right now on CNN, we are just getting word that ISIS militants have surrounded another Iraqi air base, one of the largest in Anbar Province. We are also hearing Iraqi Security Forces are fleeing for the second day in a row.

And in Syria, ISIS fighters are moving deeper inside the city of Kobani right on the Syrian/Turkish border. And let's take a look at some of these new pictures right into CNN after the U.S. carried out the biggest number of airstrikes since the war on ISIS began.

All of this as President Obama hunkers down at a secure facility along with top defense chiefs from 22 different nations. So joining me now to discuss this, Jim Acosta, senior White House correspondent and from Baghdad, Ben Wedeman, CNN senior international correspondent.

Ben, I'm going to start with you. What are you hearing about this assault on an Iraqi air base and how far is this from Baghdad?

BEN WEDEMAN, CNN SENIOR INTERNATIONAL CORRESPONDENT: Yes, Pam, this is the Ein Al-Assad air base, a very large base about 110 miles to the northwest of Baghdad. According to police and security sources, it is currently surrounded by ISIS, which we are told are attacking from two sides on the base.

We're told also that already some of the soldiers on that base have fled. Now, what's important to note is that just yesterday, the Hitt military base, which is not far from there was also abandoned by Iraqi forces.

Those soldiers fled to this other base, the Ein Al-Assad base. This is really sort of one of the last remaining strongholds of the Iraqi government in Anbar Province, which according to our sources is at this point 80 percent or more under the control of ISIS so yet another possible disaster for an army that since June has registered quite a few -- Pam.

BROWN: And, Jim, with that in mind, you know, we have ISIS advancing in Kobani. Now in a good position to take another airport in this area not far from Baghdad has been mentioned. Do you think the White House is premature in saying that the strikes are actually succeeding?

JIM ACOSTA, CNN SENIOR WHITE HOUSE CORRESPONDENT: Well, it may be, Pam. But at this point, the White House is looking at this as a glass half full. The president right now is meeting with some 21 international Joint Chiefs of Staff, the equivalent of a Joint Chiefs of Staff that we have here in the United States.

Martin Dempsey, the Joint Chiefs chairman is at that meeting right now over at Andrews Air Force base. But the White House says at this meeting, the president is not looking at adopting a new strategy when it comes to degrading and destroying ISIS.

They believe that the strategy, this approach is working, and the White House press secretary said as much earlier this afternoon. Here's what he had to say.

(BEGIN VIDEO CLIP)

JOSH EARNEST, WHITE HOUSE PRESS SECRETARY: Yes, we're in the early days of the execution of that strategy, but certainly the early evidence indicates that this strategy is succeeding.

(END VIDEO CLIP)

ACOSTA: Now, one thing that Josh Earnest went on to say just a few moments later after saying that is that he doesn't want to leave anybody with the impression that these airstrikes are going to result in a victory overnight. They say they've been very upfront about that. And they say that this is going to be a long-term struggle, but no question about it. What you saw in Kobani overnight, Pam, I think was pretty striking, you know, 21 of the 22 airstrikes in Syria were in and around Kobani.

We asked Josh Earnest whether or not this is some sort of new escalation, some sort of new pivot point for the U.S. led coalition in Syria. He said, no.

But I did ask Josh Earnest, does the president believe that at some point in the future he may have to escalate this air campaign and he said that the president reserves the right to do that in the future. So I would say at this point this is very much a work in progress -- Pam.

BROWN: Jim Acosta and Ben Wedeman, thank you. Back after a quick break.

(COMMERCIAL BREAK)

BROWN: Her push to end her life has restarted the debate on the right terminally ill patients have to die. Today, the 29-year-old Britney Maynard open up to CBS about why she wants to ask before brain cancer kills her.

Maynard wrote an opinion piece for cnn.com calling for more states to adopt laws that allow some terminally ill patients to obtain lethal medication.

(BEGIN VIDEO CLIP)

BRITTANY MAYNARD, TERMINALLY ILL WITH BRAIN CANCER: I don't want to die. If anyone wants to hand me like a magical care and save my life so that I can have children with my husband, you know, I will take them up on it.

I think until anyone has walked a mile in my shoes and knows what they are facing and has felt the just bone-sweating headaches that I get sometimes or the seizures or the inability to speak or the moments when I'm looking at my husband's face and I can't think of his name and most of my sadness centers around how much I wanted a family.

And it feels like for me, that was always how you created was through your children and sort of inadvertently, there's a legacy in creating it this way. I'm not ashamed to attach my name to what I think is the right that should belong to all terminally ill patients. I really do.

(END VIDEO CLIP)

BROWN: She is certainly creating a legacy and CBS reports Maynard's current drugs have caused her face to swell. Maynard intends to end her life sometime after her husband's birthday on Oct 26th.

Well, all this week, CNN anchors are digging into their roots. Erin Burnett found her own in Scotland along with a famous distant cousin with a name a lot of us are familiar with. (BEGIN VIDEOTAPE)

ERIN BURNETT, CNN HOST, "OUTFRONT": It turns out Ronald McDonald has done work for the IMF, for the World Bank, and he was a very significant player in Scottish independence. I buy a newspaper and I'm reading about Scottish independence and there's a prominent economist named Ronald McDonald.

I guess that's a common name around here and then I get to sky and they say, well -- and you're the most famous person in Scot. And I'm like, my gosh, he's the Ronald McDonald. Ronald really wanted to show us one particular picture, a picture that he had taken of our land. This is where we are all from.

UNIDENTIFIED MALE: This is basically where we are all from, right about here.

BURNETT: So when you took this picture, you obviously knew we were from here?

UNIDENTIFIED MALE: Yes, I did.

BURNETT: Ronald is one of the most accomplished economists in the world, but I had originally started in business journalism so I felt a kinship with him. It's such a joy for us to meet you.

(END VIDEOTAPE)

BROWN: Erin Burnett joins me now to talk about this. Erin, you're finding out so much on this journey. The fact that you're related to Scotland's most famous economist, did you ever think you'd find out off relative like this?

BURNETT: You know, that was the most amazing thing about the roots project. I knew I was Scot-Irish. I have some Russian blood. Maybe I'm related to Vladimir Putin. I didn't know anyone was still related to anyone on that island.

I knew Scotland but I probably would have assumed -- I had no idea it was an island and people were still there and they really care about their genealogy. They'd have a list and say, this is how we're related. They knew. It was very close and present to them and as a way as an American, you know but you don't know the specifics.

BROWN: Right, you may know that you're Scot-Irish but not the specifics.

BURNETT: Right.

BROWN: The people there are so friendly and I can imagine, as they said in the piece, when you visited sky they were so excited to have you there and how did they receive you coming in to visit?

BURNETT: Well, at first there was trepidation. There was one man who owns hotel and he was sort of a phantom. We finally met him and he's like, wait, don't have a camera. And another guy they call Goldfinger. He owns the car dealership and they all feel that he kills them on the car deals. There were some people hesitant to meet us, but basically they embraced us and a lot of them are in the pub business.

BROWN: That's not surprising. Something else in the special, we see your parents packing up your childhood home. Tell us about that. That was emotional.

BURNETT: That's my mother. We -- they live -- I have lived on this farm on the eastern shore of Maryland for nearly 50 years and we found out we have this roots project on a Wednesday. I was going home that weekend because they were moving on Monday.

BROWN: Wow.

BURNETT: And they are now living with my sister and they were moving away from the farm. It was our last weekend together that we were able to film this. So it was actually -- I have to say, Pamela, it was a wonderful gift to be able to have that moment memorialized with my parents and for my parents. It's a blessing I would never have expected to have happen.

BROWN: What do you think our viewers, in watching this special, may learn about you or take away from this?

BURNETT: Well, I think they might be -- I guess it's always interesting to find out where people come from. I'm so fascinated in everyone else's stories because I knew them as adults and completely developed in what they care about and where they came from. I came from the middle of nowhere.

BROWN: I'm certainly interested to see it. Thank you so much, Erin, for chatting with us and I love to know that you have a relative named Ronald McDonald.

All right, you can watch the full story of Erin, tracing her roots, tonight at 7:00 Eastern Time right here on CNN. Thank you so much for watching. "THE LEAD" with Jake Tapper starts now.