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New Ebola Case in Dallas; Troops Battling Ebolain Africa; Dow Plummets, Bounces Back; WHO Warns Ebola Outbreak Could Rise to 10,000 New Cases Per Week; Interview with WHO Spokesman Daniel Epstein

Aired October 15, 2014 - 09:30   ET

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

UNIDENTIFIED FEMALE: The hospital later said that their guidelines had changed and that the nurses needed to adhere to them. What has caused confusion is that the guidelines were constantly changing.

It is later asked which guidelines should be followed. The message to the nurses was it's up to you. It is not up to the nurses to be setting the policy the nurses say in face of a virulent disease. They needed be trained optimally and correctly in how to deal with Ebola and the proper PPE doffing, as well as how to dispose of the waste.

Nurses have been asked to volunteer regardless of their training or if they have ever been trained at all. They are still only given protective equipment that left their necks exposed. They for supplies that they were still unable two weeks after the Ebola crisis at the hospital. They asked for supplies and they're still unavailable after the Ebola crisis has begun.

Nurses have been left to train each other. Nurses have substantial concern that these conditions may very well lead to further infections of other nurses and patients.

(END VIDEO CLIP)

ANA CABRERA, CNN ANCHOR: Again, the hospital says it has numerous safety measures in place. Now back with me is CNN chief medical correspondent Dr. Sanjay Gupta in Atlanta and CNN medical analyst Dr. Alexander van Tulleken, here with me in New York.

Dr. van Tulleken, what is most poignant of what you just heard?

DR. ALEXANDER VAN TULLEKEN, CNN MEDICAL ANALYST: I think the idea that there were no protocols available or the protocols changed a lot and nurses were told it was up to you. Medical staff --

CABRERA: So it's (INAUDIBLE) confusion.

VAN TULLEKEN: Yes, and medical staff really like training. I mean these are people who have spent years at school and then have weekly trainings on all kinds of things. You're not dealing with a group of people who don't want new information and are dragging their heels, and yet the information simply wasn't available to a group of people that would seem were growing more concerned by the day. And the point that just concerns me so much about this is, if you go to the CDC website now and print off the protocols today, there are still two different protocols and you can choose which one. (INAUDIBLE). Then in the hospital level they're saying it's up to the nurses. Well, that's absolutely wrong. But even at the national level, you go to the CDC, they're advising two different ways of doing things. Neither of which I think is adequate.

CABRERA: Dr. Gupta, I know this isn't going to be a popular thing to say, but, I mean, is there some ownership that the nurses need to take in terms of making sure they're educated given that a lot of the U.S. hospitals had not dealt with Ebola and sounds like at least there was some education offered by the hospital system?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, no doubt. I mean I think -- and to the extent that there was training sessions available, and drills available, not only do those things need to be done, but they need to be done repeatedly. And that's true of this hospital and really any hospital. But I will say that I think it's dwarfed in part by the fact that maybe some of this protective gear was not even available to people. I mean that's just not -- I mean even if you were very, very diligent and trying to do the right thing, going to the training sessions, feeling comfortable with that part of it, if you don't have the right equipment and you're asked to take care of somebody who could potentially contaminate you, that's -- that's -- that has to be the primary issue here and that absolutely needs to be fixed.

CABRERA: We are now hearing of other hospitals around the nation who are conducting drills, going through scenarios in which they receive an Ebola patient, which sounds like a good step forward in terms of national preparedness. But, you know, there are still issues within this call that we just heard that could mean that more people are at risk than even initially thought. We heard that the entire tube system that handles all the labs from this hospital was potentially contaminated. Dr. van Tulleken, when you heard that, I mean, what does that really mean for the larger population who's at that hospital?

VAN TULLEKEN: I mean ordinarily, if you're handling blood infected with a disease like Ebola, you'd handle it in a special lab. I mean it's a category four agent, so there are only a few labs in the country that can do it. The idea of putting -- I mean, if you deal with these viruses, the idea of putting a tube with potential Ebola in it in a hospital tube system is staggeringly bad.

But, again, I don't think -- any -- I would say almost any hospital in the country, any hospital director listening to this list of criticisms, thinking about their practice on Monday, would have gone, yes, we'd probably be guilty of all of this. and so I think it would be very unfair to say that a lot of these mistakes couldn't have been made anywhere else. So, yes. But as a whole, they're absolutely terrifying.

The things that are most concerning to me are the exposure of the other patients, how do we now track all those people down and what do we do with them? What level of exposure have we got? And then we have a group of people who we now believe are being constantly exposed. So as we speak, people in the rooms being exposed without adequate gear, probably still without adequate protocols judging from the press conference this morning, and so what we need --

CABRERA: Are there (ph) still a lack of transparency?

VAN TULLEKEN: And so what we need now is really, really good procedures to do that. And I would say it starts with screening those people on a daily basis and isolating them and managing the flow of people who have been in touch with Ebola through that hospital because now all this is going on in real time.

CABRERA: All right, Dr. Alexander van Tulleken, Dr. Sanjay Gupta, thank you both so much for your expertise.

Still to come, U.S. troops dispatched to the hot zone to fight Ebola in West Africa. Now the Pentagon takes an unprecedented step to keep them safe. And we'll tell you what that is, next.

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CABRERA: The Pentagon is ramping up efforts to protect the up to 4,000 U.S. troops who will be sent to West Africa to stop the spread of Ebola. We know there are already 500 on the ground there. Commanders now have the authorization to quarantine troops. They have an elevated risk of exposure to this virus. And joining me now, CNN military analyst and retired U.S. Army Colonel Peter Monsoor.

Colonel, thanks for being here. This is an unprecedented step for the military. Your reaction?

COL. PETER MONSOOR, CNN MILITARY ANALYST: Well, you know, we have to keep the troops safe. The Ebola outbreak is a national security concern to the United States. That's why we're sending twice as many troops to West Africa as we currently have fighting ISIS in the Middle East and they're vitally needed. The medical systems in those countries affected are being swamped and the U.S. military has great capabilities in that regard. But on the other hand, we've got to make sure that the troops are kept safe and that they don't transmit the virus back to the United States.

CABRERA: Do you feel about the troops there have adequate preparation going in?

MONSOOR: One of the things the United States military is really good at is training. And given what's happened in Dallas and given what they know what's happening on the ground, I have the utmost confidence that the military medical personnel are training the troops such that they understand the protocols required to handle Ebola patients and to do their jobs without spreading the virus or getting infected themselves.

CABRERA: Five hundred troops, as we mentioned, are currently in this region. Up to 4,000 have been authorized to be deployed. Could the risk of infection cause the Pentagon to reduce the number that they initially had prepared to send?

MONSOOR: Well, I don't -- I don't think so, because the need is so great. And if this virus continues to spread at the kind of rate it's expanding at right now, it could affect the entire region. And then as we've seen, it won't stop at the borders of these countries. It gets around the world and then it becomes a global pandemic. The last global pandemic, the Spanish influenza in 1918 killed 2 percent of the world's population. It's a huge number. And so I think that we understand the mission and that the Pentagon will continue to provide the troops necessary to carry it out. But they are going to make absolutely certain that those troops are kept safe and are well trained going in.

CABRERA: Our thoughts and prayers are certainly with those troops that they stay safe and can do the jobs that need to be done there. Colonel Monsoor, thank you so much for joining me today.

ANNOUNCER: This is CNN breaking news.

CABRERA: Breaking news right now. Just in to the CNN NEWSROOM, the Dow, the stock market, taking a huge hit at this hour. Let's get right out there to Alison Kosik as we look at the big board there. It looks like the Dow is down 344 points, Alison?

Alison, are you with us?

OK, we will get back to Alison. She's gathering the latest information and we'll check back with her to find out what is prompting this huge plummet on the stock market right now with the Dow when we come back.

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ANNOUNCER: This is CNN breaking news.

CABRERA: Breaking news. The Dow tanking this morning, down more than 300 points since the opening bell. And CNN's chief business correspondent Christine Romans is with me now.

Is this about Ebola?

CHRISTINE ROMANS, CNN CHIEF BUSINESS CORRESPONDENT: This is not about Ebola. This is about global growth concerns. This is about a market, Ana, that has not seen a pullback, a real, substantial pullback in more than 1,000 days. For five years stocks have been basically going up with a few corrections but no real 10 percent pullback since 2011. And a lot of people have been saying it was time, it was time for the market to pull back.

Why is it pulling back? Global growth is not as strong as we had thought. You've got Europe basically stalled. Germany is stalled. That's the engine of European economic growth. And you've got China growth slowing.

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CNN: This is CNN breaking news.

CABRERA: Breaking news, the Dow tanking this morning, down more than 300 points since the opening bell and CNN's chief business correspondent Christine Romans is with me now. Is this about Ebola? ROMANS: This is not about Ebola. This is about global growth

concerns. This is about a market, Ana, that has not seen a pullback, a real, substantial pullback in more than 1,000 days. For five years, stocks have been basically going up with a few corrections but no real 10 percent pullback since 2011, and a lot of people have been saying it was time, it was time for the market to pull back.

Why is it pulling back? Global growth is not as strong as we had thought. You've got Europe basically stalled, Germany stalled, that's the engine of European economic growth, and you've got China growth slowing. Add on to that signs of the American economy, that things were a little bit weak this morning. A retail sales number that disappointed, PPI, that's producer prices, also a disappointing number there. So you've got people concerned about what it's going to mean for the bottom line for companies and what those companies are going to report in their earnings reports and how that will affect their stock prices.

So you've got a market that has been primed and ripe for a pullback for so long, and really had -- so before we came into today's session, the S&P 500 was down 6.6 percent from its peak. So a lot of folks have been saying a full 10 percent correction we haven't had one in so long, they were gunning for something like that. They thought there should be some more -- that there would be more losses, because the global economy just isn't robust and there are these signs of weakness in the U.S. economy.

CABRERA: So interesting, especially when you consider we've been seeing unemployment going up, we've been seeing -- talking about how gas prices are going down.

ROMANS: That's right.

CABRERA: So we were all getting excited.

ROMANS: That's right. Gas prices are going down and bond yields are very low, mortgage rates are very low. You're going to pay less to put -- to fill up your tank. These are good things near term for the consumer.

But when you look at the macro economy, stocks have reflected so many of these good things for so long. They can't go straight up forever, right? So a lot of folks have been calling for a pullback.

I will say, for the people all earlier this year who said the market is going to pull back, they were wrong. There was always a reason to step in and buy stocks.

For most of you who have a 401(k), you need to make sure you know how far you are until retirement, what your risk tolerance is. If you're very close to retirement, you should not be 100 percent in the stock market; that is not a controversial statement. The closer you are to retirement, the more diversified you should be, not just in the stock market. And for people who have a longer time frame, for young people especially, people in their 30s, you want to see pullbacks because you're buying stocks at different prices all the time in your 401(k) and so you want to see that.

Look, you've got the Dow back above 16,000. That's important, down just 1.27 percent. So that means these early big losses, more than 350 points, look at how much it's come back from there. So you've seen a big bounce back off the bottom this morning.

CABRERA: But if you're saying that this is a correction, it sounds like this isn't going to be a one-day story. Could you think we could still see this dip even lower?

ROMANS: It already hasn't been a one-day story. We saw last week was one of the worst weeks for the market in a couple of years, and I think it was really tough. Now you're at the lowest I think since February. So this has been a slow, unfolding decline that we have been seeing over the past couple of weeks.

We have an earnings season that is just getting under way. What does that mean? Companies are opening their books, telling their shareholders how much money they made, how much their sales were up. Every one of those industries will be scrutinizing to see what they're seeing from the American economy, what they're seeing from the global economy, and what they're doing in terms of stock buy-backs and other financial moves that could make a difference for your 401(k).

CABRERA: All right, Christine Romans, thanks for putting this all into perspective.

ROMANS: You're welcome.

CABRERA: And helping it -- make sense of it all. Appreciate it.

ROMANS: No problem. A big bounce back from the low this morning, look at that. A big bounce back.

CABRERA: Oh, see, right as we started talking. Yay, things are looking up. All right, thank you.

Still to come, as health officials in Dallas scramble to figure out how many people may be at risk of contracting Ebola, there are new fears this morning this crisis could get worse before it gets better. Up next, why the World Health Organization says the number of new cases could spike by the end of the year. We're going to talk with a representative from the World Health Organization next.

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CABRERA: The latest case of Ebola in Dallas is sparking new fears that U.S. hospitals may not be equipped to handle the deadly virus if more cases are confirmed. And adding to these worries, the World Health Organization warns, by the end of the year, just in the next couple of months, there could be up to 10,000 new Ebola cases per week in the hard-hit countries, especially Guinea, Liberia and Sierra Leone. Now, since the start of this current outbreak, more than 4,000 people, in fact nearly 4,500, have died from the virus. Nearly 9,000 have been infected. Let's talk more with spokesman for the World Health Organization,

Daniel Epstein. He's joining us via Skype this morning from Washington. Daniel, 10,000 cases per week. That's a pretty scary number. How troublesome is it that another patient now has contracted Ebola here in the U.S. and do you think the hospitals in general are being properly trained to handle this virus?

DANIEL EPSTEIN, SPOKESMAN, WORLD HEALTH ORGANIZATION: I think the CDC and state health authorities are handing the situation in the United States as best they can and quite well, but the situation in Africa is much more worrisome because we're not going to be able to halt this outbreak anywhere until we stop it in the three countries in West Africa that are heavily affected.

CABRERA: We heard President Obama yesterday, as he met with defense chiefs from over 20 different countries around the world, talk about Ebola and call for more action by the international community. What kinds of steps need to be taken today to prevent that forecast we just talked about, the 10,000 cases in the next couple of months per week, to prevent that from happening? Or is it destined to get worse before it gets better?

EPSTEIN: Well, it's going to get worse before it gets better but we can stop this outbreak if we have enough money and people. We estimate that we need about 1,000 more international staff in these three countries and about 20,000 health workers working on isolating and treating these cases. And our goal --

CABRERA: How do the numbers compare to what you have right now?

EPSTEIN: They're lower. The WHO has deployed about 600 people to the field since the beginning of the outbreak. Some have gone twice. We need more people, and some countries have stepped up. Some countries have sent staff, of course including the U.S., China, Cuba, the U.K., and other countries are making contributions. But we need more people. We need -- we estimated that we need about $978 million and we've only received about a third of that for the entire response.

CABRERA: So who needs to step up, do you think? I mean, without unfairly trying to single out certain countries, I mean, who isn't stepping up? Who isn't coming to the table or who isn't reacting fast enough?

EPSTEIN: Well, look, we have 193 countries in the U.N. We've had responses from maybe a dozen or 15 of those. I think if additional countries can help by sending staff and by sending funds, we'll be able to get a grip on this outbreak.

The main thing --

CABRERA: I really want to -- I'm sorry to cut -- I keep cutting you off and I don't mean to. Go ahead. Why don't you continue?

EPSTEIN: I was going to say, the main things we need to do are stop the outbreak in these major capitals in the three countries where it's spreading very rapidly. And that's why we're afraid that it might go up to 5,000 or 10,000 cases a week.

Health workers themselves have been heavily affected in the Ebola outbreak in West Africa. We've had 416 health workers infected and 233 of those have died. So it's a worldwide problem and if current trends continue, it's going to get worse. That's why the goal of WHO right now is to ensure that, within the next 60 days, 70 percent of all cases are properly managed and isolated and treated, and 70 percent of burials are done safely. That's been a huge driver of the cases in Africa, unsafe burials.

CABRERA: Walk us through how the World Health Organization differs in terms of protocol from the CDC. Since we're talking about these U.S. cases, do you have different protective gear? Is it in how they put it on or it's being removed? What's the difference?

EPSTEIN: I'm not sure there is a difference. We have guidelines for putting on and taking off personal protective equipment. There are various types and there are various uses. It's very important that people be careful in putting it on and taking it off, and it certainly varies by country and it varies by area.

I think the guidelines that the CDC has are very useful here. We have different guidelines for different localities. You know, it's very difficult in Africa, in non-air conditioned hospitals where it's 95 degrees, for people to put these on. And some people have been putting on three or four extra layers and we don't recommend that, because they get tired out and when they get tired, they can make mistakes.

CABRERA: Right. Daniel Epstein, thank you so much for joining thuis morning and talking about this global health crisis. We do appreciate your time.

The next hour of CNN NEWSROOM with my colleague Anderson Cooper live in Dallas begins right after a break. Thanks for being here.

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