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Nurse Flew Before Diagnosis; Ebola Fighter; Nurse Precautions

Aired October 15, 2014 - 14:00   ET

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

ANNOUNCER: This is CNN breaking news.

BROOKE BALDWIN, CNN ANCHOR: All right, here we go. Wolf Blitzer, thank you so much. Let me just pick up where you left off.

I'm Brooke Baldwin. Thank you so much for being with me on this Wednesday.

Listen, this Ebola story, it is fast-moving. A lot of changes today, a lot of developments we're watching for. A, we're watching for the White House briefing happening just a few minutes from now, and, two, we're going to keep a close eye on this picture. Guys, throw it up, the live picture in Cleveland, Ohio, where we should be getting a brief. There's the White House. Here is Cleveland, waiting to hear from the mayor and possibly someone from the airline in which this second health care official flew to just in the last couple of days.

Let me back up. We're talking about the second nurse here from Dallas who contracted Ebola at that hospital. She violated CDC protocol by traveling to Cleveland and then by flying back to Dallas one day before reporting Ebola symptoms. That is what we've just heard from the director of the CDC, Dr. Tom Frieden.

(BEGIN VIDEO CLIP)

DR. TOM FRIEDEN, CDC DIRECTOR: Because at that point she was in a group of individuals known to have exposure to Ebola, she should not have traveled on a commercial airline. The CDC guidance in this setting outlines the need for what is called controlled movement. That can include a charter plane. That can include a car. But it does not include public transport.

(END VIDEO CLIP)

BALDWIN: So you heard that, she should not have been on that commercial airline. We are going to explore all angles of that in just a couple of minutes with our chief medical correspondent Dr. Sanjay Gupta.

First here, though, Dr. Frieden, he is vowing that that won't happen again. That people who are being monitored for Ebola will not be able to jump on a commercial plane.

This latest Ebola patient is being transported today to Atlanta to Emory University Hospital there. Remember, Emory is one of just four hospitals in the United States certified to treat Ebola patients, and also where three Ebola patients have been treated.

Meantime, back to the White House. President Obama is actually postponing his campaign trips today to both New Jersey and to Connecticut in order to stay put to meet this next hour with high level government agencies who are coordinating the government's response here to Ebola.

So let's get right to Dallas to kick this coverage off here to CNN's senior medical correspondent Elizabeth Cohen.

And so, Elizabeth, as I mentioned, lots of moving parts on this story right now. Let's begin with this 29-year-old health care worker there from the hospital in front of where you stand. Who is she? How did this happen?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Her name is Amber Vinson. As you said, she's a 29-year-old nurse, Brooke. And we don't know much more than that except that she -- we do know that she is moving to Emory. Now, we don't know if that's because she requested it or maybe the hospital said look we think you'd be better off elsewhere, or maybe it was that a government official, state or federal, said to the hospital, look, we think she ought to be moved. We just don't know the answers.

But, Brooke, there is one thing that we're learning. At the press conference, our colleague, Ed Lavandera, asked Dr. Frieden, do we know how these nurses got exposed? Was there any skin exposed when they put on their personal protection equipment? And the answer he got was, yes, at times skin was exposed.

Another possibility is you're supposed to wear one or sometimes two pairs of gloves. We were told that they were sometimes wearing three or four, which might sound like more is better, but, Brooke, experts tell me that it can be a problem because then you have more dirty stuff to take off than when you started out.

BALDWIN: I thought that part was fascinating. We'll talk to -- we'll talk to Sanjay about that, who's had to put on a lot of this, you know, personal protective equipment. The more you put on, it exposes you more.

Here's the next question, do we know, as we're trying and everyone else is trying to determine the timeline, how close was she to, you know, Eric Thomas Duncan, the Ebola patient who came over from Liberia, who died last Wednesday at that hospital? At what point in his treatment -- I mean was she really in the thick of it during those days in Dallas?

COHEN: Brooke, it sounds like she was in the thick of it, that she had frequent contact with him between September 28th and September 30th. Now, those dates seem to be significant for two reasons. One, that was at the very beginning. He was admitted on the 28th and it seems like this hospital was sort of getting their sea legs a little bit, trying to figure out how to use this protective equipment and what kind to use. We were told they used a variety of kinds. They were not consistent, which is -- sounds like it's not a good thing.

Also, on those dates, he was putting out copious amounts of bodily fluids. I don't mean just bleeding a little bit or vomiting a little bit.

BALDWIN: Yes.

COHEN: You know these -- Ebola patients can put out liters of fluid. When that splashes on you, it's then tough to take that equipment off.

BALDWIN: That's why the conversation about having these site managers, these people who are teaching, you know, the medical personnel how to put on the personal protective gear is so incredibly important.

Elizabeth Cohen, great reporting from Dallas. Thank you so much.

Meantime, again, we talk about this nurse's travel. I want you to look at the flight that 29-year-old nurse Amber Vinson took just a day before reporting symptoms of Ebola. All right, so you see Dallas there on the map. We know that Vincent was on a Frontier Airlines Flight 1143 from -- of course she went from Dallas to Cleveland last week and she returned just this past Monday, October 13th.

Now, the CDC now wants to talk to all 132 passengers on board that flight. Here is the number to call if you are one of them or if you know someone who was. Pick up the phone, you need to call the CDC. 1- 800-CDC-INFO. Again, 1-800-CDC-INFO.

Joining me now to talk about this angle, CNN aviation analyst Mary Schiavo, who is also the former inspector general of the U.S. Department of Transportation, and our doctor, Dr. Sanjay Gupta, our chief medical correspondent.

So, welcome to both of you.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Thanks, Brooke.

BALDWIN: And I have a lot of questions. My first question was -- really the question, Sanjay, we know that this 29-year-old nurse, she treated Thomas Eric Duncan, who died of Ebola last Wednesday morning. She then gets on this commercial airline, she flies to Cleveland, and this, according to Dr. Frieden, absolutely violated CDC protocol. Would she have known that?

GUPTA: Well, she should have known that. But I'm giving her the benefit of the doubt. My guess is she was not told that. Two points to make here. First of all, the CDC is not an authority that can sort of mandate things like this. They provide guidance and recommendations. So they talk about -- Dr. Frieden talked about this idea of controlled movement. They recommend that people who have been in contact with somebody who's had Ebola have controlled movement. They don't get on commercial airlines. If they want to fly, they take a chartered plane. They can get in cars, but they need to be monitoring their temperature every day.

So she shouldn't have -- this shouldn't have happened. Whether she was told this and knew this or not, I -- I'll give her the benefit of the doubt and say she didn't in that maybe she was being diligent and still reporting in whether or not she had a fever.

Also going to give her the benefit of the doubt that she did not have any symptoms when she got on the flight. Very important, obviously, if she had any symptoms or not. But if both those things are true, the fact of the matter still remains that that airline flight was not -- should not have been in the cards for her.

BALDWIN: I want to loop back with you on the symptoms issues, because I do want to ask you about what sounds like a low-grade fever.

But then, Mary, to you. OK, so you have these, what, I'm hearing 132 people on board this plane from Cleveland to Dallas. And we know the CDC wants to track down each and every one of those people to talk to them. What is that process like? What kinds of questions would the CDC be asking?

MARY SCHIAVO, CNN AVIATION ANALYST: Well, and this is an absolute outrage, which is why travel should have been banned while it was containable, while 150 people from three countries in Africa now have endangered by traveling.

BALDWIN: One hundred and fifty.

SCHIAVO: One hundred and fifty each day. And now we have this problem. And so the problem is the CDC is going to be asking these people about symptoms and telling them to check their temperatures, et cetera. But Sanjay said it right, there is no mechanism by which, unless you actually do a quarantine order, these people have rights unless they've been ordered under quarantine, and people can travel. It's in the Constitution. And so now we have a situation where the CDC is backtracking, trying to find people and is going to have people all over the country monitoring their temperature because if people aren't just from Cleveland, Atlanta and Dallas. And this is a huge problem because we really don't have these procedures in place at airlines and there's no law that sets them forth.

BALDWIN: There isn't.

SCHIAVO: No.

BALDWIN: And then the next thing is, you know they're trying to talk to all those people on board that plane. I mean I was just on a plane coming back here from Louisville, Kentucky, last night on a shoot for work and I was like sitting there asking the flight attendant to help me scrub off part of the tray table, right, because somebody had left some of their -- some of their ick.

SCHIAVO: Yes.

BALDWIN: And I started to think, OK, what if it's not just the plane -- the people on board the plane that she was on. What about the next person or the next person who sat in her very seat? I mean how thorough does this need to be? SCHIAVO: Well that's the crazy thing about cleaning planes. You know,

there is no Federal Aviation regulation on standards for cleaning aircraft. Why? Because the Federal Aviation regulations deal with safety and security of flying. That's left to the various health authorities as are things like food kitchens and cleaning the bathroom, et cetera. And now yesterday we saw right on CNN the CDC says that the fluids can live, if dried for several hours and if wet for several days. There's no current plane cleaning protocols that take care of that. Most flights they don't even wipe off the tray tables. There just isn't time. Why? Because aviation's fast. That's why we like it.

BALDWIN: And we (INAUDIBLE) the lines and we want to go, go, go and get on our plane to get to where we're going.

SCHIAVO: That's right.

BALDWIN: I mean, my goodness.

SCHIAVO: That's right.

BALDWIN: And then -- and then, Sanjay, with the symptoms, I mean I know she didn't report any symptoms, at least this is according to the CDC and apparently the crew on Frontier Air said, you know, they didn't see anything either. She was part of the group self-monitoring. Apparently she did take her temperature. This is when she came back to Dallas, had a 99.5 degree fever. Would that be enough to make her contagious for passengers on that return flight home or it wouldn't quite meet that -- meet that point?

GUPTA: Well, it's a -- it's a good question. So if she had a 99.5 temperature before getting on the flight and she reported that, you know, this is one of those areas now where it gets to be a little bit of a gray area. Here's why. Typically what the protocol calls for is 100.4 temperature. This is not an exact science, Brooke. It's not to say that 100.4 is a magic number or that 100.5 or whatever it is. But the fact that she had a fever at all, whether or not somebody would look at that and say, well, she had contact with somebody with Ebola, pretty intensive contact it sounds like. Now she's had a bit of a fever. Maybe we should ground her or do something to sort of isolate her wherever she is at that point. I don't know. You know, some of this, I think, is a little bit of a judgment call based on how suspicious you think it is.

But I think given the fact that she shouldn't have been on the plane in the first place, that sort of becomes the -- everything else is dwarfed by that very thing. She should have been in Dallas monitoring her temperature and then been able to quickly get into isolation as soon as she started -- that temperature to go up.

BALDWIN: Mary, I see that look in your eye, did you want to jump in?

SCHIAVO: Well, you know, here's another example of double speak out of the CDC. They say, you know, it's 104. Duncan's temperature was 103 and he died. So even the CDC's own messages on -- the problem why the American public is reacting so strongly to this, and they should, because it's a deadly disease and we haven't gotten consistent, reliable information from the government. So what's going to happen? People who don't have to fly won't and those of us like me, who have to fly every week for work, we'll get on board but we'll take our own precautions.

BALDWIN: Right, right, right.

GUPTA: Just to clarify, Brooke, really quick. I agree with what Mary said. It's 100.4, though, that they say is the guideline at which you start to become concerned about Ebola.

BALDWIN: Got it. Got it. It's interesting you say this is the gray area. I feel like so much of this story we are living and covering and reporting in massive gray area.

SCHIAVO: It's terrible.

BALDWIN: Dr. Sanjay Gupta, Mary Schiavo, I thank you so much here.

And as we talk about travel in airports (INAUDIBLE) it is being called an Ebola fighter and demand for this machine, as you can imagine, huge. It's been used in airports and hospitals and to clean one of the infected nurse's apartments in Dallas. And he will show me how this thing works.

Plus, explosive new allegations involving the care for Thomas Eric Duncan. Hear what the nurses were told to wear when touching the patient and how Duncan was allowed to be around other patients exposed. Lots of questions on this one. Stay with me. You're watching CNN's special live coverage.

(COMMERCIAL BREAK)

BALDWIN: All right, more on our breaking news in this story of Ebola. We know the second patient, this second nurse from Dallas who has Ebola, returned from a flight from Cleveland just this past Monday. So now we're hearing from the Cleveland mayor responding to all of this. Cleveland Mayor Frank Jackson. Take a listen.

(BEGIN VIDEO CLIP)

MAYOR FRANK JACKSON, CLEVELAND: Today we were notified by Frontier Airlines and the CDC that an airplane at Hopkins transported a person now diagnosed with Ebola. Now the CDC is handling that situation and is really on top of that. However, we are taking additional steps in abundance of caution.

Now, it's important to note at this point, to the best of our knowledge, we have not had any cases of Ebola in the city of Cleveland. Just the same, this is a very important public health issue and it is important that we all stay focused on the facts and sharing the information so that we can protect the interest of the public and the public is aware of what they should do and when they should do it and have an understanding of the nature of this virus.

Now, I'll introduce to you Director Perilla (ph) from our public health department who will discuss --

(END VIDEO CLIP)

BALDWIN: Pull away. We're going to pull away from this. Just -- that was pretty short and sweet. Cleveland Mayor Frank Jackson obviously watching the situation very closely now that we know that this 29- year-old nurse, this second nurse from this Dallas hospital, has contracted Ebola. We've got much more on that.

But let me talk about this weapon, this piece of machinery being used in the fight against Ebola here in the United States. And apparently it's working so well the demand for it is huge. Take a look at it. Let me show you a picture. Here you go. Just in this guy's hand. This is called Touch Point Healthy Infection Control System. It is developed by Emist Innovations. That is a Fort Worth, Texas, basis company. And so this misting -- you see the mist coming out of this thing. This mist helps decontaminate surfaces with Ebola exposure precisely. In fact, hazmat crews used this product to clean the Dallas apartment of that first nurse who was exposed and who contracted Ebola, Nina Pham. Again, the first person to contracting Ebola in the U.S., This was the primary nurse for the late Ebola victim Thomas Eric Duncan.

So, let me bring in the man who has come up with this piece of technology, this CEO of E-Mist Innovations, Mr. George Robertson.

George, welcome.

GEORGE ROBERTSON, CEO, EMIST INNOVATIONS: Thank you very much. Thank you for having me today.

BALDWIN: I can only imagine you are getting call after call after call from people, not just in Texas, but all across the country. But let me just begin with how this is being used to disinfect airports. How so?

ROBERTSON: Well, currently at this time we are not using it to disinfect any airports. The technology has been around for a long time. We've been in development for several years. And just now, this year, have brought this to commercialization and full production. So it's not only about Ebola, but infection-control, because the mister that we have here will help to prevent going forward in all kinds of situations, not only hospitals, airports, airplanes, daycare centers, it's very effective in chemicals --

BALDWIN: OK.

ROBERTSON: Yes.

BALDWIN: Well, no, no, I just -- forgive the assumption. I just -- with, you know, people being screened coming in from different parts of the world --

ROBERTSON: Right.

BALDWIN: Assuming that you have been called from airports. My guess is going to be, you will be. And let me (INAUDIBLE), probably so. But on the science, I mean, what kind of -- what kind of scientific proof or evidence do you have that once you spray this mist on, you know, on table tops, lap -- you know, tray tables in airplanes, that that will kill any kind of Ebola?

ROBERTSON: Well, first of all, our machine is the delivering device, it's not the actual chemical. I mean you can use a multitude of chemicals. But from the scientific, it's electrostatically charged. And what the droplets are, they're positively charged. And then when they go, attract to a negative charge, like on a table, any surface, they will wraparound that, go underneath that, cover any touch point where anybody else would touch.

It's like when you were a kid and you took a balloon and rubbed it on your hair and it created electrostatic and would stick to the wall. Same thing for the affluent that we use in the system. It makes it more affordable for the health care worker to be able to apply disinfectants much quicker. You can disinfect a hospital room within minutes compared to other technologies that's been available. And our product has not been around for use for -- until just recently.

BALDWIN: You bring up health care workers and ease of use for them, but what about Nina Pham, this first nurse who contracted Ebola. I understand your company was the one that got the phone call to go to her apartment, to go to her apartment complex there in Dallas and clean it.

ROBERTSON: Right. We partnered with another clean up company and they did use our device there. And, you know, again, not knowing exactly how the breach and protocol was there with Nina, things that we possibly could have done if the device was in the hospital, possibly sprayed down the clinician prior to them taking off their protective gear.

BALDWIN: Well, would have, could have, should have, I guess, but hopefully you can be used in the future. George Robertson, CEO of Emist Innovations, thank you so much. I really appreciate it.

ROBERTSON: Thank you.

BALDWIN: You got.

Explosive allegations against the hospital in charge of Thomas Eric Duncan. Hear how nurses were apparently told to cover up their skin around this Ebola patient, the patient who died last week.

Plus, Duncan was allowed to be around other patients. We'll bring Dr. Sanjay Gupta back live on this major observation he made trying on this personal protective equipment. This is CNN's special coverage.

(COMMERCIAL BREAK)

BALDWIN: You are watching CNN. I'm Brooke Baldwin.

Live pictures here as we are watching and waiting for this White House daily briefing to begin, presumably hearing a bit more on Ebola specifically. We know the president has cancelled his campaign trips both to New Jersey and Connecticut today to stay put, stay at the White House, meeting with some cabinet agencies, those responding. The government's response to Ebola. So watching and waiting for that there.

Also, we are seeing this picture, guys throw it up here, this -- here she is. This is this second nurse from Dallas. This is 29-year-old Amber Vinson who has now also contracted Ebola. She is the one who also helped treat Thomas Eric Duncan when -- before he passed away last Wednesday morning. She is the one who took that plane. A lot of people asking questions about the travel choices and if she even knew that that was a breach in CDC protocol. But again, this is the second nurse who was en route to Atlanta to be treated at Emory Hospital there.

And then this. You have Frontier Airlines. They have pulled the plane that this young woman flew on just a day before her temperature spiked. According to the CDC, she should not have flown, as I mentioned just a mention ago, according to protocol for those who have cared for Ebola patients.

And you have to think, with another one of their own sick, the colleagues of nurse Amber Vinson are also more worried than ever for their own health. And if you believe the National Nurse's United union, some nurses at this Dallas hospital, Texas Health Presbyterian, they fear something else, retaliation. And that is why this union says no nurse from the hospital would even show their face or use their own voice as they sat on this teleconference on Tuesday, but they shared a lot through this union.

So according to union representatives who were speaking for these different nurses at this Dallas hospital, none of whom are in the union, by the way, let me just make that clear, they revealed mistake after mistake after mistake involving the care of this man, Thomas Eric Duncan, the first Ebola victim in the United States. Here is just one of the nurses' allegations.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: There was no one to pick up hazardous waste as it piled to the ceiling. They did not have access to proper supplies and observed the infection control department and the CDC themselves violate basic principles of infection control, including cross- contaminating between patients. In the end, the nurses strongly feel unsupported, unprepared, lied to, and deserted to handle their own situation.

(END VIDEO CLIP)

BALDWIN: Lied to. Pretty strong words here from these nurses. Joining me now, infectious disease specialty doctor Celine Gounder.

Dr. Gounder, welcome back.

We have a lot to talk to as far as these allegations go from these different nurses. And so we actually heard that from Dr. Frieden, the head of the CDC. He also said and he understood. Listen, out of anxiety, a lot of these nurses and doctors were like piling on the gloves, two, three pairs of gloves, you know, multiple layers. But in actuality it backfires. It makes you more open to the virus.

DR. CELINE GOUNDER, INFECTIOUS DISEASES AND PUBLIC HEALTH SPECIALIST: Right. So as we've discussed before on the show, the real high-risk moment is when you're take off the protective equipment. And so if you're putting on multiple layers, that makes it more difficult to take it off and so your risk of contamination is higher. Now, one thing I would point out is that initially the hospital protocol -- now I'm not saying the CDC protocol, what the hospital was instructing the staff to do was very minimal in terms of protective gear.