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STATE OF THE UNION WITH CANDY CROWLEY
Quarantined Nurse's First TV Interview; Fauci Warns Of Quarantines and Unintended Consequences; Obama Doing Enough To Stop Ebola; Feinstein: Police And Military Need To Be Guard
Aired October 26, 2014 - 12:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CANDY CROWLEY, CNN HOST: Good morning from Washington. I'm Candy Crowley.
New York, New Jersey, and Illinois abruptly imposed mandatory 21-day quarantines on all health care workers returning from West Africa. The first person to be quarantined a nurse who wrote in the Dallas morning news of her concern for other workers returning to the U.S., "I am scared that like me they will arrive and see a frenzy of disorganization, fear and most frightening, a quarantine." We also heard more from one of the governors that imposed that quarantine, Chris Christie, the governor of New Jersey this morning defending that 21-day quarantine.
(BEGIN VIDEO CLIP)
GOV. CHRIS CHRISTIE (R), NEW JERSEY: The fact of the matter is that I don't believe that when you are dealing with something as serious as this, that we can count on a voluntary system. This is government's job. If anything else, the government's job is to protect the safety and the health of the citizens, and so we have taken this action. And I absolutely have no second-thoughts about it.
I believe that the folks who want to take this step and willing to volunteer also understand that it is in their interests, and in the public health interest to have a 21-day period thereafter if they have been directly exposed to people with the virus. And as we saw with what happened with some of the health care workers in Texas, with the CDC shifting protocols, we had people who are infected from that type of contact, and we just can't have that in the New York/New Jersey area. And that is why Governor Cuomo and I agree on this, and now you can see that they agree in Chicago as well. I think this is a policy that will become a national policy sooner rather than later.
(END VIDEO CLIP)
CROWLEY: Joining us now on the phone, that nurse, Kaci Hickox, the nurse in quarantine now in New Jersey.
Kaci, thank you so much for joining us. I just want you to -- I know, a couple of days to get from Sierra Leone. You had been there with Doctors Without Borders helping to treat and fight Ebola. Tell us what happened once you landed at Newark.
KACI HICKOX, NURSE UNDER MANDATORY QUARANTINE IN NEW JERSEY (via telephone): That is correct, Candy.
I spent a month in Sierra Leone and when I arrived at the airport in Newark, I of course, presented my paperwork to the immigration official, and told him that I had been in Sierra Leone. So, I verbally declared it myself as well as writing it in the documentation. And he was very nice and said, OK, well, they will have a couple of questions.
First there were many people that asked me questions. No one seemed to be leading or coordinating the effort. A lot of the questions were repetitive. And as an epidemiologist, I was surprised that, you know, I saw people writing in the margins of their paperwork, which just showed that obviously they were not prepared to really capture all of the information they thought they needed. Obviously, I was there for many hours. My plane landed at 12:30, and I only left for the isolation center around 6:00 (ph) p.m.
CROWLEY: Kaci, let me ask you something. Let me interrupt you for a second, because I want to know, did this, the questioning -- by my tally you were there five or six hours at the airport. Is that correct? And were you surprised by this? Did you know that there had been a quarantine put in place for all health care workers from the three affected countries including Sierra Leone?
HICKOX: As far as I know -- you are right, I was at the airport for five or six hours, and before I arrived, I had heard the news that a doctor from Doctors Without Borders living in New York City had tested positive. So I assumed that there would be maybe further questioning than before.
But as far as I knew when I landed, there had been no official quarantine order for either the state of New Jersey or New York, and we are currently looking into that detail, but of course, I don't have that information at that time.
CROWLEY: And so once you got to the hospital, what happened?
HICKOX: Once I got to the hospital, they of course tested my blood. They asked me a few more questions. I do want to say that everyone here all of the doctors and the nurses that have been caring for me and EMS workers have been fantastic. So supportive. You know, they have offered to give me books and to bring me Pizza Huts, and they are fantastic. They have gotten caught up in a political mess. So I don't envy them.
But, yes, they tested my blood (INAUDIBLE) it is negative. He (ph) also confirmed that it was negative. And I know that there have been reports of me having a fever in the airport, but I truly believe that it is an instrument error. They were using the forehead scanner and I was obviously distressed and a bit upset. And so my cheeks were flushed and I think there had been some evidence that that machine is not very accurate in these kinds of situations. So, when I arrived in the isolation unit they took my temperature orally and it was completely normal. And since --
CROWLEY: And does it remained completely normal? HICKOX: Yes, it has also been completely normal.
I heard from my mother last night who called me concerned and said, that Governor Christie just said in an interview that you were, "obviously ill." And this is so frustrating to me.
First of all, I don't think he is a doctor and secondly he has never laid eyes on me. And thirdly, I have been asymptomatic since I have been here. I feel physically completely strong and emotionally completely exhausted. But for him to say I am obviously ill which is even a strange statement. What does that mean? Someone define that for me because I think I don't quite understand what "obviously ill" means, but I am here to tell you that I am completely fine physically. And being held here is just -- I just don't (ph) (INAUDIBLE).
CROWLEY: And what is your understanding about how long you will -- what have they told you about tomorrow and the day after that and the day after that?
HICKOX: This is the other concern that I have. I have not been communicated a clear plan. My quarantine order was written by the New Jersey health commissioner and even to this day, no one has told me what it means or what's the plan. No one has told me how long it will last. I don't know if I'm going to be retested, and if so, why I would be retested, (INAUDIBLE) asymptomatic and the test is not even accurate if you don't have symptoms.
And yesterday I spoke with the assistant health commissioner Christopher, I believe is his name, and I told him one thing, I said, the only thing I have to the say to you is I want an answer for what is my clear plan. No one has communicated with me. You have put me in an isolation unit without communicating medically or public health, you know, scientifically, logical chain of events that need to happen next. And this to me is just completely unacceptable. I spoke with him at 6:00 p.m. last night, and now it is 11:00 a.m., and I still have not heard to anyone as to what the plan is next for me.
CROWLEY: As far as we know, and this certainly does not relate specifically to your case, that it is a 21-day quarantine. Can you describe to me like where you are right now? What does it look like? Are you in the hospital in a room? Are you -- what's happening?
HICKOX: I am outside of the university hospital, itself. In a different building, I believe. Although I can only say what I can see from my tent. I am in (INAUDIBLE) within the building. And I - you know, it's just a basic tent structure. There is a hospital bed (INAUDIBLE). They bring me food. I have kind of a port-a-potty type restroom, no shower facilities and no connection with the outside world except my iPhone which I insisted that I brought with me when I arrived late Friday night.
CROWLEY: So, let me ask you this from a different point of view, you have been over in Sierra Leone, I think everyone would salute someone who really does put their life on the line to go over and help others. And we have heard over and over again while you have been away how vital it is for all countries to send workers, doctors, nurses, other health care workers to fight this disease where it is. In order to, you know, save those countries as well as protect the rest of the world. But understanding that the doctor who is now in quarantine in New York City was home seven or eight days before he spiked a bit of a fever and then was put into isolation. Do you understand the need of governors whether from New Jersey or New York or Illinois to say, we can't take this risk that somebody is out there with the fever, or will spike a fever eight or nine days after they arrive. We need to make sure that they are in isolation until we know they are past the danger zone. Do you understand that psyche?
HICKOX: I completely don't understand it. I really -- it is completely not understandable to me. It is not based on any clear public health evidence, and it is not the recommendation of public health and medical experts at this point.
You know, I think we have to be very careful about letting politicians make medical and public health decisions. And all of the evidence about Ebola shows that if you are not symptomatic, you are not infectious.
So, for instance when I arrived, I was not symptomatic, and that Friday (INAUDIBLE) they tested my blood, and I am negative. So I did not have symptoms, and the blood is negative for Ebola there's no way I can be contagious. And (ph) for anyone to tell me that I need to be isolated (ph) and be under a quarantine is just completely unacceptable, and I believe, you know, imposing --
CROWLEY: You know, perhaps because you have been gone I know, again, for so long, in the United States, there had been what appears to be missteps by the CDC, certainly by a hospital in Dallas which got an Ebola patient someone who was certainly ill from it, and clearly had a -- you know, was communicable at that point. And so, there has been lots of --
HICKOX: And I would like to remind you that he was not an aid worker.
CROWLEY: Sure, no, no. Absolutely. And I just - all I was going to say was that there was this feeling that the federal government and the doctors who advised the federal government don't actually know how to contain this, and I think it is out of that concern from the public thinking, wait a second, they told us it could not come here, they told us we could deal with it, and it hasn't always come to be so. They have had to change a, you know, some of their protocols in dealing with for health care workers et cetera. And so I think that is somewhat pushing this drive.
So, you know, do you -- having said that, you landed without knowing about a quarantine, and it seems to me, in one of the things that you wrote was, I'm scared talking about other workers coming back, that they will arrive and see a frenzy of disorganization et cetera, et cetera, and most frightening a quarantine. Can you tell me why the quarantine of the fear that you certainly must felt thinking, what are these people up to? Getting, you know, a police are ride with sirens and everything to the hospital. So I understand that fear and not knowing what's going on. But tell me what is frightening about a quarantine? HICKOX: You know, for me, it is two things. And I have experienced
it. So unfortunately, I think I can say these two things pretty confidently.
And the first is (INAUDIBLE). You know, for instance, all of the health care workers that are taking care of me (INAUDIBLE). They are seeing me in their PPE, and then going home to their families. So, the quarantine doesn't (ph) and (ph) it's (ph) you know, how it is being carried out, it does not make (INAUDIBLE) sense. It is not evidence-based.
And the second thing is it's really inhumane. I just came back from one of the most difficult months of my life, and I am completely (INAUDIBLE) -- and no one knows - no one can predict if I will develop Ebola or not in the next 21 days. And most aid workers (INAUDIBLE) come back will not (INAUDIBLE) Ebola. So, to quarantine everyone in case, you know, when you cannot predict who may develop Ebola or not, and to make me stay for 21 days to not be with my family, to put me through this emotional and physical stress is completely unacceptable.
CROWLEY: You know, Kaci, one of the things we have learned from talking to experts through (ph) all (ph) these (ph) many (ph) weeks is that there is no such thing as no risk, but you can get pretty close. And you -- I think would concede as a health care worker that, sure, there is a low risk that perhaps you might be carrying - you might at some point be carrying the Ebola virus that has not yet manifested in your body, is it worth it to keep New Jerseyans out of any kind of risk to keep you 21 days in quarantine?
HICKOX: You know, I think one of the frustrating things about this policy is it is obviously poorly planned out. The policy states that health care workers will be quarantined, but what about other people traveling from these regions as well.
And you are right, there is no such thing as no risk, but I think when considering this issue, we also have to balance what you're putting the health care workers through, and how evidence-based your approach is. So for instance, are you then going to quarantine all of the health care workers that are looking after the health care workers who have been to an Ebola affected area? (INAUDIBLE) couldn't it be said that they also have some level of a risk since they're taking care of a possible Ebola contact.
So, I think it's just a slippery slope. And my frustration is that it's really (INAUDIBLE) well thought out and it's not (INAUDIBLE). It is not a sound public health decision. And I think many experts in the field have come out to agree with me. So I think we need to stress the fact that we don't need politicians to make these kinds of decisions. We need public health experts to make these decisions. And there always needs to be a balance, because I also want to be treated with compassion and humanity.
HICKOX: And I don't feel like I have been treated that way in the past three days. CROWLEY: Sure.
And one of the things that Governor Christie said recently as this morning is that he is sorry that this has been an inconvenience to you, but that he is trying to protect a public that he feels particularly in densely populated areas has not been property protected by the CDC and this administration.
I want to give you this chance to talk to Governor Christie, what would you say to him?
HICKOX: You know, the first thing I would say to Governor Christie is that I wish that he would be more careful about his statements related to my medical condition. I am not as he said, "obviously ill." I am completely healthy and with no symptoms. And if he knew anything about Ebola, he would know that asymptomatic people are not infectious.
I understand that people feel like they have a risk, and I think that we can have a conversation about what further measures might look like, but I think this is an extreme that is really unacceptable. And I feel like my basic human rights have been violated, and I hope that he will also consider me.
And I obviously, you know, all I want is to go home to my partner who is completely happy to have me home and is not scared at all, because he knows that I know more about Ebola than most people in the U.S. And if I were the unlucky person like Dr. Spencer to develop symptoms after returning home, I would be smart and do the right thing and contact the local health department and be safe in going to a facility, and being isolated and tested, but this is just an extreme that we have to fight against.
CROWLEY: Kaci Hickox, first I want to thank you so much for your time. Our wish for you is that you remain symptom-free.
HICKOX: Thank you.
CROWLEY: And our the second wish is that somehow you can work this out to a point where you no longer feel that you are being threatened, you know, by just having to stay in quarantine and that you get back to your life as soon as you can.
Thank you so much for your time this morning.
HICKOX: Thank you, Candy.
CROWLEY: We did ask Governor Christie's office and the state of New Jersey for a reaction to some of what Kaci had to say. The Department of Health did respond to Kaci's statement that she didn't know exactly what was going on, no one had presented her with a plan, et cetera, et cetera, and from the director of the office of communications of the New Jersey health department, " the patient was given a copy of the quarantine order on Friday and is receiving regular updated information." I want to bring in CNN's senior medical correspondent, Elizabeth Cohen. She is outside Bellevue Hospital in New York. That is where Dr. Craig Spencer is. He is the latest person in the U.S. to have officially the Ebola virus. He is being treated.
Let me just start with his condition, Elizabeth, what do you know?
ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: We are told right now that he has moved into, "the next phase of his illness." We were told that he is now having gastrointestinal symptoms. They didn't specify but usually that means diarrhea and vomiting. This is not unexpected, Candy. This is what happens to Ebola patients. We are also told that he is getting an antiviral drug and that he is already receiving a plasma transfusion from Nancy Writebol who is an Ebola survivor who was treated at Emory.
CROWLEY: And let's talk now, Elizabeth, about Kaci Hickox. I know that you've been following her and as I understand that have also spoken with her earlier.
In the end we have heard doctor like Dr. Fauci at the NIH say, you know, this quarantine just really - isn't necessary and yet no one can argue that it does not lower that infinitesimal risk if that is what it is. From a medical point of view what are you hearing about this quarantine from the three states?
I mean, certainly I have not spoken to a single public health or medical expert who supports this quarantine. They think that it's not worth it. And here (ph) - they think it's actually hurtful, and here is why.
So, maybe there's a tiny infinitesimal risk that someone who is healthy comes back and all of the sudden starts feeling sick when they are out. Well, they are not going to be transmitting Ebola the minute they feel ill. The minute they feel ill, they should isolate themselves. They really don't feel that there is a risk that anyone like Kaci Hickox could transmit Ebola.
But on the other side they see a huge risk of quarantining people like her. When see that she has been quarantined, other aid workers who want to go and help they're not going to go. Many of them I talked to say, there is no way they're going to go to. They can't spend a month in Africa and then three weeks being quarantine, especially, are they going to get stuck in a tent like she is? Are they not being allowed to go home even though they are perfectly healthy?
I mean, Kaci related to me that is staring at the walls. They didn't give her television. The hospital didn't give her reading material or books, or anything. And so when you hear that that's certainly discourages you from going to help. And if the Ebola outbreak gets worse than - worse than West Africa that it is going to be worse here. The worse it is there the worse it is here. We live in a small world.
CROWLEY: Certainly, one of the things Kaci said when I asked her directly, if you had known, which she said she didn't that a mandatory quarantine was in effect when she landed in Newark. If she had known that was coming, would she have gone, and she said, truthfully I, would have gone anyway even though she thinks the quarantine is unjustified.
Elizabeth, from your talking with her, I got the sense that it was the abruptness of the feeling that she didn't know what was going on particularly in those early five or six hours when she was at the airport, you know, the siren, you know, police cars and ambulances and such taking her to the hospital. That she seemed more upset with not knowing what they were doing than the quarantine, itself. I mean, she's upset with it but I also got this feeling that she - she said a couple of times, well, you know, I think we should talk about this or what is the plan.
COHEN: Right. I think she is upset with both.
I think that you are right, Candy. And she told me that the quarantine order does not have an end date to it. It's just a quarantine order. I haven't seen a copy of it myself. You know, we've asked the state of New Jersey for it, we don't have it. So, it seems like she doesn't - she doesn't have an end date. And I think that that's, you know, a particularly difficult thing. You're perfectly healthy, you're stuck in a hospital in Newark, and you don't know when you're going to get out.
She said she did get a visit from a New Jersey health department official yesterday and she asked him, when am I getting out of here? And he said, I will check on that and get back to you. And they have not gotten back to her yet.
And I think, Candy, it is an interesting question, if she is being quarantined what about the nurses and the doctors inside this hospital? They're taking care of a known Ebola patient. (INAUDIBLE) Ebola. They are taking care of someone who has Ebola, who is actively ill. Should they be quarantined? I mean, as far as we know they are not quarantined. Should the nurses and doctors taking care of Kaci be quarantined? After all they are obviously suspicious that she might have Ebola or they would not have her there. So, it just raised these questions that I think have not been answered.
CROWLEY: Sure. And also we have lots of questions with different answers. So to be continued. Elizabeth Cohen, thank you so much. I appreciate it.
CROWLEY: There are fears the quarantine move by states might hurt U.S. efforts to the Ebola fight.
Dr. Anthony Fauci from the National Institutes of Health tells us what he thinks next.
CROWLEY: So far the White House continues to resist calls for a travel ban to combat Ebola, and now a new question, should the federal government follow the states in implementing a quarantine? Here now joining me Dr. Anthony Fauci, is long time director of the National Institute of Allergy and Infectious Diseases. You let go one of the nurses from Dallas this week.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASE: Right.
CROWLEY: Cured of Ebola. So, I know that is a big relief to you.
CROWLEY: We now have a doctor quarantined up in New York, and that is apparently what prompted these new rules from New York, from Illinois, and from New Jersey. What do you think of them?
FAUCI: Well, I think there are two principles we need to stick with.
One, protecting the American people is paramount, but to that --
CROWLEY: I agree with you on that.
FAUCI: Yes. You have got to make your decisions and your policies based on the scientific data. And the scientific data and the evidence tell us that people who are not ill, who don't have symptoms, who -- with whom you don't come into contact with bodily fluids they are not a threat. They are not going to spread it. So we have to be careful when we make the policy that we don't have unintended consequences where you group everyone in the same category, that just because you came back from there, that therefore, you are in this category.
We do have stratification of risks, and stratification of monitoring. That's critical based on scientific data. I'm concerned of the disincentive for the health care workers. And it's interesting I think people lose that the best way to protect us is to stop it in Africa. And one of the really best ways to stop it in Africa is to get health workers who are going there and helping them with the problem. When they come back, they need to be treated in a way that does not disincentivize them from going there.
CROWLEY: Sure. And I think this nurse sounded like she was surprised by this as was everybody else. But if a health care worker goes to West Africa, deals with the Ebola patients and knows when they come back, they'll be in a 21-day quarantine.
FAUCI: Right. Right.
CROWLEY: What is the harm with that?
FAUCI: Well, the harm is that it is totally disruptive of their life if you put even a person who is no risk to anyone else --
CROWLEY: Well, (INAUDIBLE) is going to West Africa to treat Ebola patients is one thing.
FAUCI: Well, exactly, but we want them to go because they are helping us to protect America by being over there. What I think people need to understand is the scientific evidence tells you that you are not going to transmit it. We don't want to be cavalier, Candy. There are ways to monitoring people. There's passive monitoring. There's active monitoring where you take your temperature .
CROWLEY: There is monitoring now in the airport -- right.
FAUCI: Yes, but I'm talking about when they come home, and in their home. If in fact they are at a certain risk, they will then be actively monitored in the sense of someone taking your temperature, asking you if you have symptoms. There is a big, big difference between completely confining somebody that can't even get outside and doing the appropriate monitoring based on scientific evidence.
CROWLEY: But this is - it was based I think on a doctor who came back, had been treating patients in Guinea, he comes home, he's fine for four or five or six or seven days.
CROWLEY: All of the sudden begins to feel tired. The night before he comes down with the fever, he is out bowling --
FAUCI: Right. Right.
CROWLEY: -- and eating dinner and doing ordinary things, and then obviously gets a fever and reports himself --
CROWLEY: -- and they come get him. You would eliminate a lot of that.
CROWLEY: You would not be worried about --