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Quarantined Nurse Released; Child Hospitalized in NY With Possible Ebola Symptoms; Kaci Hockox Will Challenge NJ's Mandatory Quarantine in Court; Joint Chiefs Considering 21-Day Quarantine for Returning Troops

Aired October 27, 2014 - 11:00   ET

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

JOHN BERMAN, CNN CO-ANCHOR: She is getting out. The nurse in a tent in with no fever is being allowed to leave. So what happens now? Will Ebola fears chase her north?

MICHAELA PEREIRA, CNN CO-ANCHOR: Heartbreaking news. Another victim of the Washington state school shooting has died, this as we learn new details about the shooter. Two of five students he shot are his cousins.

Plus, a teacher who is now being hailed a hero for trying to stop that shooting.

BERMAN: And the battle against ISIS, an American veteran goes inside Syria, breaking the law to take on terrorists. Our Ivan Watson followed him there.

Hello there, everyone. I'm John Berman.

PEREIRA: And I'm Michaela Pereira. I trust you behaved while I was gone. We have those stories and so much more ahead @THISHOUR.

We are watching to see just when nurse Kaci Hickox will be released from quarantine in New Jersey. She of course had been quarantined at University Hospital in Newark since Friday when she returned from treating Ebola patients in Sierra Leone. She was subjected to the state's tough new controversial guidelines for Ebola.

BERMAN: The governor's office in a statement said Hickox had been symptom-free for 24 hours. In truth, she never had Ebola symptoms at all. She had one test with a fever but every other test said she had no fever. She will now be sent home to Maine by private carrier.

Our Elizabeth Cohen joins us now to talk about this. And, Elizabeth, you know, scientists say there was no reason to keep her inside the tent. So, is there any development causing he release?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: No. I imagine it's more of a political development. That's what I would guess.

She never had any symptoms. She had apparently one, high-fever read with one thermal scanners but she was flushed, she was upset, the blood was going to her face. And I was talked to a guy who investigated these thermometers. He said yeah, it's going to be high.

PEREIRA: Most of us in the airport would feel the same way.

COHEN: If we'd been held at the airport for seven hours. Yeah, she was upset and every ... this is really pretty simple stuff.

Those thermometers are not as good as oral thermometers. Every oral thermometers she's had have been normal. She's tested negative for Ebola twice. She doesn't have symptoms of Ebola, so time for her to go home.

PEREIRA: So now she goes home. What more details do we know? We read and know that she's going to be transported via sort of private transport. She's not going to be on mass transit.

COHEN: Right, right, right.

PEREIRA: I think the point is being made there. What else do we know?

COHEN: Right, I think so. So apparently what we know now is that they proposed an ambulance perhaps taking her, and she said no, I don't want an ambulance, I want something more comfortable.

I don't know what that means. It seems like it would be an incredible waste of money to have an ambulance.

BERMAN: She could take a rental Toyota.

COHEN: Exactly. Why would you want to have an ambulance? That's so expensive.

Plus she lives way up in northern Maine at the Canadian border. I mean, from here to there, that's a long ride.

PEREIRA: Are they ready for her there? Again, she's going to have to self-quarantine and monitor then, right?

COHEN: Maine will have to decide what they want to do with her, right? She won't necessarily be quarantined. They don't have quarantine orders in Maine.

So they may just tell her to take her temperature twice a day and check her symptoms. They may have health workers come and knock on her door and visit her. They may quarantine them. It's really up to them what they want do.

BERMAN: Elizabeth, they've really gone further with her than they have with most patients. She has been tested for Ebola twice now with no signs.

But does that mean that it couldn't develop in a few days or week or two weeks?

COHEN: Absolutely. It absolutely could develop because she's probably had her last exposure a couple days ago. She's got many days where she could develop the disease. That's why you want to watch these folks, and that's why you want to tell them the minute, the second that you feel ill, you need to let someone know because you need to isolate yourself.

BERMAN: All, in Maine's hands right now. Elizabeth Cohen, thank you so much. Appreciate it.

PEREIRA: Thank you. Good to have you with us too.

BERMAN: Two other developments on Ebola. Just a short time ago the Pentagon told CNN that an army major general and about ten other personnel are in something called controlled monitoring in Italy.

They arrived there over the weekend from West Africa where they had been helping set up the U.S. military response in the region. They will now be watched for 21 days. There's no evidence that any one of them has the virus.

There are a lot of questions about why they're doing this. Did something happen? Did they have exposure to patients that has caused this extra concern? Our Barbara Starr will have more details later @THISHOUR.

PEREIRA: Also, we're watching also the case of a five year old -- a five-year-old little boy in New York City. He is now in isolation at Bellevue Hospital, the very same medical facility where Dr. Craig Spencer is being treated and monitored for Ebola symptoms.

Now this five year old returned with his family from Guinea Saturday reportedly with a 103-degree fever and had been vomiting before he was take on the hospital.

I had the opportunity to speak to a hospital official about this case a little earlier today on "NEW DAY."

(BEGIN VIDEO CLIP)

DR. RAM RAJU, PRESIDENT & CEO, NYC HEALTH & HOSPITALS CORPORATION: We are at the present time evaluating a five-year-old kid with travel history and fever at Bellevue Hospital pediatric emergency department.

And he's undergoing an evaluation together with the Department of Health and Mental Hygiene of New York City. And we will be probably making some decisions in the next few hours.

PEREIRA: Observation or being tested?

RAJU: We don't know yet. The evaluation is still going on.

(END VIDEO CLIP)

BERMAN: Let's bring in Dr. Seem Yasmin. She is a public health professor. She joins us from Texas. And Frank Esper joins us as well. He's an infectious disease specialist.

Seema, I want to start with Nurse Hickox here. She is said to be released. She is set to be transported to Maine. What concerns do you have about her and whether she will develop Ebola symptoms?

DR. SEEMA YASMIN, PROFESSOR OF PUBLIC HEALTH, UNIVERSITY OF TEXAS AT DALLAS: It's reassuring that the policy is aligning. She does not have any symptoms, so she can go through the procedure that was agreed between her and the organization, Doctors Without Borders, which is that for 21 days after she returns home she should stay home and monitor her symptoms at least twice a day.

We know from speaking to other doctors in reality they're monitoring very many times in a day. Some take their temperature every hour, every two hours. She know she has to be checked for 21 days, perhaps stay at home.

There's a possibility that Ebola could develop. We know it doesn't always develop, and we hope she stays healthy. It's important about being able to stay at home, having dignity, and self-monitor and stay in contact with health officials is observed.

PEREIRA: Self-monitor and this idea of dignity, we really get that. But I think, Dr. Esper, one of the things at least from the outside view, there may be people who say, look, do these home quarantines work?

We saw what happened with Dr. Spencer. He was going to a meatball shop, taking the subway, and going for a jog. We also look at Dr. Nancy Snyder man who returned from West Africa with her NBC team and didn't fulfill her quarantine obligations.

I know those are two cases, and I know the vast majority of medical professionals will say, "I'll do what I need do and I'll stay put." Bottom line, do they work?

DR. FRANK ESPER, INFECTIOUS DISEASE SPECIALIST: The answer is yes, they do work. And this has been used to control epidemics not just here in the United States when we're dealing with very few amount of Ebola exposures and Ebola patients, but all across in other areas around the world as well as in Africa itself.

You have to understand that the infectiousness of this germ grows as you get sicker. And so while you're still up and about and walking around, you don't have a lot of virus in you. You don't have a lot of virus to give to other people. You are not very contagious.

It is when you get very, very sick. When you become bed-bound is when you become the most contagious to other individuals, which is why when we actually look at the individuals who have Ebola here that we've been treating for the United States, returning missionaries, returning physicians, or nurses who are in direct contact with individuals who are very, very sick with Ebola.

Those are the people you worry about developing the disease, not the casual contacts of individuals.

BERMAN: Dr. Yasmin, there is a debate about how to treat the public health professionals who come back through the three West African nations, what should they go through when they get here. What happened in New Jersey, though -- even if you fall on the side of these need to be quarantined for 21 days -- is a tent with no shower and a portable toilet, is that the right way to do it?

YASMIN: This really sent a message to the public health community and the medical community that they could be quite frightened when they return home from West Africa that this is how they could be treated.

And nurse Kaci Hickox was outspoken about how she felt being in this tent. She hasn't been able to shower since she landed. She asked for showering facilities and they gave her a basin of warm water.

So the public health community in New York said it's really important that they have a heads up, that they're able to prepare, so that if there is a policy where you want to quarantine returning troops, returning health-care personnel, you can do so in an appropriate manner.

You can treat them with respect, with dignity, and make sure they're comfortable. That really helps people maintain the quarantine situation if you give them provisions and make them comfortable.

PEREIRA: I want to turn, Dr. Esper, to the five-year-old at Bellevue, the little one that returned with his family from Guinea, developed a fever, 103. And we were told earlier that he was being monitored. But we know now the child has been tested.

Can you help us understand why testing isn't done almost immediately? Is it painful? Is it risky? Is it --

BERMAN: Expensive?

PEREIRA: Is it expensive? What is the concern?

Because it seems to me that the first thing you would want to do is to say, OK, we have a negative here, carry on.

ESPER: The answer is it's not risky, painful, or even expensive. The problem is, though, that you need do it right. And in order to make sure that we want to have the most effective as well as accurate testing, there's only certain ways that we will test that we have already made sure they are accurate, that they are valid, and that they're very sensitive.

And sometimes that requires those tests to be done some will be on site at the actual emergency departments and at the hospitals, but also to be -- ensure that they are confirmed by the state labs or the Centers for Disease Control themselves.

The testing themselves is a blood test. Most of the tests that they would do early on is going to be -- and I don't want to go half Latin, but it's going to be PCR, which basically is looking for the virus itself and tells us you have any of this virus in your blood or not.

If it's not -- or you have any of the antibodies to that virus in your blood or not. Those are very, very sensitive tests, but only -- but anything can be negative. And so they have to make sure that they are accurate and that they are sensitive enough in addition to the symptoms.

I will tell you a five-year-old with fever and vomiting, well, welcome to my world.

PEREIRA: Exactly!

BERMAN: Come to my house on Tuesday, any Tuesday.

PEREIRA: You make a very good point. You make a very good point.

I love this team with us. You guys get to the bottom of so many questions that nag at both John and I. We appreciate it. Dr. Esper and Dr. Yasmin. Thanks so much.

BERMAN: Ahead for us @THISHOUR, she is being released, but was quarantining Kaci Hickox legal? Her lawyer has said he's filing a civil suit against the state.

Let us know what you think. Should states quarantine those traveling from Ebola hot zones?

(COMMERCIAL BREAK)

GOV. CHRIS CHRISTIE (R), NEW JERSEY: I know she didn't want to be there. No one ever wants to be in the hospital, I suspect. I understand that.

The fact is I have a much greater, bigger responsibility to the people and the public. So I think when she has time to reflect, she'll understand that as well.

PEREIRA: New Jersey Governor Chris Christie there talking about the nurse, Kaci Hickox, who's now being discharged from the hospital in New Jersey and heading to Maine. And talking about the fact that likely she didn't want to be there, he understands that, but he had to protect the public of New Jersey.

This, though, as an attorney for Nurse Hickox, says he's going to take the matter to court, claiming New Jersey's mandatory quarantine guidelines are unconstitutional. Take a listen.

(BEGIN VIDEO CLIP)

NORMAN SIEGAL, CIVIL LIBERTIES ATTORNEY: We believe that, medically speaking, there's no reason for the state of New Jersey to keep her quarantined. We believe that that policy infringes on the constitutional liberty interests of Miss Hickox, and we think that the policy is overly broad, and what I mean by that, it sweeps in people who do not meet the criteria for being quarantined.

(END VIDEO CLIP)

BERMAN: So what does the law say about this? Page Pate is an attorney and an expert on constitutional law. Paige, thanks for being with us. Is the law clear here? I mean, a governor can take actions for the public health, can't he?

PAGE PATE, CRIMINAL DEFENSE ATTORNEY: Absolutely. New Jersey, like several other states and the federal government, has a law that authorizes their health department or their director of public health to institute a quarantine. But the problem is, when does he do it? Because the law allows him to do it whenever he deems it necessary. So you're creating a huge lack of uniformity and the ability to arbitrarily determine a quarantine. And that's what this lawyer is going to challenge.

PEREIRA: I guess it's that whole conversation, Page, that we've been thinking about since Ebola first broke here in the United States. And we're going to be seeing, probably, more of this. The rights of the individual versus the rights of the public, right?

PATE: That's exactly right. And in the past, we really haven't had anybody challenge these quarantine laws. And if you read them from the books, you can tell that although there's a lot of authority vested in these state health officials, there's really no guidance given to them. I mean, they have to make their individual determination that this person is too sick to go anywhere so we're going to lock them up or keep them in a tent or whatever it may be. And in the past, no one has really challenged that, because I don't think we've seen it applied as broadly as we're about to see in the Ebola situation.

BERMAN: You said quarantine them, keep them in a tent, whatever may be. But is it really whatever may be? Is there any kind of legal guidance on what you can do with them and where you can put these people? Again, is this tent, with no shower and a portable toilet, is that lawful?

PATE: There's absolutely no legal guidance on how you can set somebody apart, isolate them, quarantine them. It's left up to the discretion of the public health officials. So we're going to see a lot of different states, and even the military has a different policy about how we treat people who, No. 1, have Ebola, and No. 2, are suspected to have Ebola, so I think some guidance from the federal government would be very helpful here. They have the authority to step in and create some uniformity, because if we have one quarantine policy in New Jersey, a totally different one in New York, and then none in Maine at all, we don't really have any quarantine policy at all.

PEREIRA: And also, you just brought up a good point, because things will have started overseas then come to New Jersey where she was quarantined, this nurse I'm speaking of, and now she's going to Maine, who knows how things will be handled there, but it does talk about that cross-border and state border issues. I'm curious how you think this is going to end? Do you think they're going to drop the suit or do you think this will carry on?

PATE: I think they'll drop the suit, because now that she's out of New Jersey, she's no longer subject to the New Jersey quarantine protocol. I think this lawyer, and perhaps other civil rights lawyers, will be looking for the next case, because you have to have someone withstanding, someone who's actually aggrieved by this particular protocol, someone who's in the tent, for them to be able to have a viable lawsuit.

BERMAN: So people like that would be, for instance, the people who were in Dallas, you know, kept in that house or locked in an apartment first, and then put into a house? It would have to be someone in the moment?

PATE: Exactly. To have the base case going forward, you need someone who's suffering from a quarantine restriction for them to bring a claim in court saying hey, I need to get out of here, and they're holding me against my will, and they're doing it unlawfully. That needs to be the best challenge.

PEREIRA: Page Pate, always good to have a conversation with you. Thanks for your legal mind, we appreciate it.

PATE: Thank you.

BERMAN: Ahead for us @THISHOUR, he shot his own cousins and his friends. New details about the Washington school shooter, plus the teacher who, today, is being hailed as a hero.

(COMMERCIAL BREAK)

BERMAN: Alright, we do have breaking news. CNN has learned that the joint chiefs of staff are considering a recommendation about all troops that return from those three West African countries, the Ebola hot zone. They're considering whether to recommend that all the returning troops get quarantine for 21 days. That reporting is from our Barbara Starr who is at the Pentagon. She joins us right now.

Barbara, we're talking, when all is said and done here, thousands of troops. Several thousand troops here. They're considering quarantining all of them for 21 days?

BARBARA STARR, CNN PENTAGON CORRESPONDENT: Well, this is what the Pentagon is struggling with, you know, they have made a commitment to send up to 4,000 troops to help with the Ebola situation in West Africa. There are already more than 700 on the ground. What do you do about those troops coming home? Some of them are going back to their home bases in Europe, most of them are coming back to the United States. Their families are concerned, their communities are concerned.

The way it had been working right now is there is a 21-day period of monitoring. Taking your temperature, as we have talked about, all of us, for so many weeks now, taking your temperature twice a day and if you're asymptomatic, being able to return to work, return to your home, return to your families. But the joint chiefs now looking at this, we are told, are expanding their thinking a bit and thinking, at least no final decisions, about whether to recommend a mandatory quarantine. That is going to be massive disruption for hundreds, if not thousands, of military families. An awful lot of concern about where all of this is headed.

PEREIRA: This was one of the very conversations we had initially when they were talking about deploying those troops there is, what do you do, in terms of monitoring after the fact? Also news, Barbara, of 10 other military personnel in so-called controlled monitored situation in Italy. They had just returned from West Africa. Tell us more about his.

STARR: Yeah, and I think that we are beginning to see the very beginning of this debate now about military troops. Let me tell you, the Pentagon wants to call it "controlled monitoring." I think the rest of us would understand it as a quarantine. The Pentagon doesn't want to call it that, but what you are talking about now, two-star Army Major General, Darryl Williams, and about 10 of his team came back from West Africa after a 30-day deployment this weekend. They were met on the ground in Italy, their home base, by Italian authorities in protection, in infection control gear, and they are now at a separate place, separate building, in Vicenza, Italy. They will remain there for 21 days.

We are told, at this point, they cannot go home, they cannot, see their families, have direct contact with their families at this point. They will stay in this building. They'll do work, but this is not, you know, anywhere near normal routine, which is what the military procedure calls for if no one has any symptoms. No reason to believe, at this point, General Williams, who has been all over West Africa in the last 30 days, and this team, no reason to believe any of them have any symptoms.

Pentagon calling it "abundance of caution," but look, there's some military politics, small 'p,' in all of this. The Italians are very concerned. There are other countries taking U.S. troops back, Spain and Germany, and they are also very concerned. The U.S. has to make sure it can get all these troops home.

BERMAN: Yeah, one thing that is clear from this reporting from you right now, Barbara Starr, is that the military now involved in very serious high-level discussions about what to do with all of these people who are trying to help in Africa fight Ebola, but some decisions could be coming soon. Barbara Starr, great reporting. Thanks for being with us. Appreciate it.

PEREIRA: Goes back to that conversation, who do you quarantine? Who do you monitor? Who is self-monitored? Who is monitored under more stringent circumstances? We're going to take a short break. We'll be right back.

(COMMERCIAL BREAK)