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The Lead with Jake Tapper

Ebola Cases Escalating?; ISIS Advancing; Fear, Confusion Spread in Wake of Outbreak

Aired October 14, 2014 - 16:00   ET

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

JAKE TAPPER, CNN ANCHOR: There could soon be as many Ebola cases per week as we have seen during this entire outbreak so far. Is anyone listening to this World Health Organization warning?

I'm Jake Tapper. This is THE LEAD.

The national lead. That nurse who caught Ebola while trying to save Thomas Duncan's life, she sends a message from isolation, thanking her colleagues, while we wait to hear the fate of another new patient who had close contact with her, all this as another victim in Europe dies.

The world lead. Defending their Stone Age sexual fantasies under the guise of a twisted interpretation of Islam, ISIS justifying slavery and rape in a magazine you probably will not find on the checkout line.

And the buried lead. My colonial ancestors were on the wrong side. In Philadelphia, born and raised on the playground was where I spent most of my days, yours truly tracing his roots for CNN and finding out I have colonial ties, ones that may not go over that well with Ben Franklin and company.

Good afternoon, everyone. Welcome to THE LEAD.

We are going to begin with the national lead.

Faced with a horrible Ebola diagnosis, and from inside isolation, she is showing the spirit that made her, by all accounts, a great and dedicated nurse. Just a short time ago, we heard for the first time from Nina Pham, the nurse battling Ebola in Dallas, saying -- quote -- "I am doing well and want to thank everyone for their kind wishes and prayers. I'm blessed by the support of family and friends and I'm blessed to be cared for by the best team of doctors and nurses in the world here at Texas Health Presbyterian Hospital Dallas."

Pham of course became the first person to contract Ebola inside the United States after she treated Thomas Duncan, the Liberian national who died of this merciless virus last week. Pham's condition is now being described as clinically stable after she received a transfusion from Dr. Kent Brantly. You might remember him. He beat Ebola.

He has some of the most valuable blood in the world right now because it contains antibodies against the disease. We're also waiting to hear the results of tests on another patient now in isolation for possible exposure to Ebola after having had close contact with Nina Pham.

The CDC says this patient is the only contact Pham had while possibly contagious. Meanwhile, there has been another Ebola death in the West. A 53-year-old United Nations worker who was working in Liberia, he died from Ebola in a hospital in Germany overnight.

Of the 16 cases treated outside the Ebola hot zone in West Africa, he is the fourth person to die.

CNN senior medical correspondent Elizabeth Cohen joins us live now from outside the hospital of where Nina Pham is being treated.

Elizabeth, the head of the CDC just wrapped up a press conference. He says it's unlikely that any of the original 48 contacts who had contact with Thomas Duncan, the first U.S. patient to die of Ebola, he said it's unlikely they will contract the disease. So what is Dr. Frieden worried about?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right.

He says enough time has passed that Duncan's family, et cetera, it's unlikely they will get Ebola. What they are really worried about now are 76 health care workers, doctors, nurses, janitors, you name it, who may have come in contact with Duncan while he was at this hospital from September 28 to October 8.

In the beginning, the CDC kind of let the hospital take over and they let the hospital follow those contacts. Now the CDC is actively following those contacts as well.

TAPPER: Elizabeth, in hindsight, what would Dr. Frieden have done differently in Dallas, if anything?

COHEN: You know, he was really quite frank in his press conference. He said that he wishes that he had sent a larger team in when Duncan was first diagnosed.

He sent a smaller team, Jake, that really focused on keeping Ebola from spreading in the community, in the outside world here in Dallas. What he was basically saying was he had wished he had spent more time focusing on the hospital. Now there are Emory nurses and CDC staffers who are training folks here at Texas Presbyterian to not to get anyone else sick.

He was saying that he wishes he had sent those kind of people earlier and he even said, if he had done that, then Nina Pham might not have been infected.

TAPPER: Is it practical to keep sending teams if this disease continues to spread throughout the country?

COHEN: You know, the kind of team the size that Dr. Frieden is talking about, I think it's a concern. If you have just one in Dallas, that's manageable, but let's say you have many, many other cases through the United States in the future. Can you keep sending large teams from the CDC to help those hospitals out? It's not clear that you can. And that's why some experts have said, look, we ought to just have a few hospitals that are really well-trained and really, really know what they are doing that drill at this. We ought to have just a few hospitals treating these patients rather than just leaving it up to whatever hospital the patient walked into.

TAPPER: Elizabeth, Nina Pham treated Thomas Duncan and she's now a patient at the same hospital where he died. Have any changes been put into place in reaction to his case, ones that might give her a better chance of survival?

COHEN: Well, the hospital is, from all accounts, being much more aggressive in her care than they were in Duncan's care.

I was on the phone with Duncan's nephew and he said that he begged for one of these blood transfusions from the very day that Duncan went into the hospital. And we know that the hospital didn't reach out to Nancy Writebol, a potential donor, until six days into his hospitalization. It's great that Nina Pham, she got her transfusion 48 hours or even less upon arrival at the hospital. So they seem to be being much more aggressive with her.

TAPPER: Elizabeth Cohen, thank you so much.

Nurses are a rare breed of people, the kind of people that can keep you smiling even while approaching you with a needle. No one works closer with the sick and dying on a day-to-day basis.

But now many nurses and other health care workers are afraid that they may turn out like Nina Pham, who was in protective gear when she contracted Ebola.

Today, the CDC vowed that their health would be his top priority.

(BEGIN VIDEO CLIP)

DR. THOMAS FRIEDEN, CDC DIRECTOR: I have been hearing loud and clear from health care workers from around the country that they're worried, that they don't feel prepared to take care of a patient with Ebola, that they're very distressed that one of our colleagues now has contracted Ebola and is fighting the infection in Dallas.

A single infection in a health care worker is unacceptable.

(END VIDEO CLIP)

TAPPER: Step one in that, according to many critics, might be changing the instructions on the CDC's own Web site.

(BEGIN VIDEOTAPE)

TAPPER (voice-over): Head to toe, tape to tie, protective suits like these have become the symbol of Ebola danger and prevention worldwide. Investigators are currently looking into whether the infected Texas nurse followed all the protocols.

FRIEDEN: What we're doing at this point is being looking at every aspect of prevention of infection in the Dallas hospital.

TAPPER: For those on the front lines of the crisis, learning how to properly dress and disrobe for new patients is crucial. The CDC's current guidelines do come with a disclaimer, noting that they will -- quote -- "vary based on the level of precautions required."

The problem is, according to one expert, the Centers for Disease Control guidelines on its Web site don't offer fully accurate instructions on this subject for health care workers, a troubling glitch at a time are desperate for guidance.

DR. GAVIN MACGREGOR-SKINNER, PENN STATE UNIVERSITY: They are downloading this. They're not getting something that is going to protect them 100 percent from Ebola and it's going to lead to more mistakes.

TAPPER: Infectious disease expert Dr. Gavin Macgregor-Skinner has suited up himself on the front lines of outbreaks in Africa. He says these diagrams on the CDC's Web site show personal protective equipment, or PPE, procedures that are just wrong.

MACGREGOR-SKINNER: When you have direct contact with an Ebola patient, no skin should be exposed. No part of the body should be exposed and that's not what the guidance shows.

TAPPER: The inconsistencies between this instructive diagram and this reality are more than minor procedural differences, Macgregor-Skinner says. They could be the difference between life and death.

MACGREGOR-SKINNER: We have seen this on TV now for months. And this is not new information. And it's something that has to be corrected immediately.

TAPPER: Yesterday, the center's director assured the public that protective procedures were evolving and improving with each new case.

FRIEDEN: And really it's an ongoing process. We are already today implementing some new procedures to make it safer and easier.

TAPPER: But for now it seems those on the front lines are all dressed up with no place to guide them.

(END VIDEOTAPE)

TAPPER: It has been two-and-a-half months since the first American infected with Ebola landed in the United States. From the beginning, the CDC has sounded confident in its ability to handle this epidemic.

Why are we just now hearing that more training and new protocols should be put into place?

Dr. Robert Haley is the former president of the Dallas County Medical Society. He joins us now. Dr. Haley, thanks for joining us.

You have written isolation protocol for the CDC in the past. Let's take a look at the CDC guidelines for personal protective gear. If you look there, it doesn't have any mention of head cover. It says one pair of gloves, not two. Boots are recommended, but not required.

Now, according to Gavin, who we just heard from, that is not enough. If you were going to go into a room with an Ebola patient, would you have a head cover and would you have a shield for your eyes and would you wear two pairs of gloves? Would you wear a guard for your shoes?

DR. ROBERT HALEY, FORMER PRESIDENT, DALLAS COUNTY MEDICAL SOCIETY: You know, I think the main point here is what was the Presbyterian Hospital staff doing here?

And we have had some briefings all the way through the care of that first patient from the hospital staff. And I can tell you, from hearing that, they did a terrific job of caring for Mr. Duncan, and protecting their employees. They were in contact daily with the Emory people who had taken care of the first case.

Dr. Ed Goodman, who is head of the infection control program, has been a leader in infection control in Dallas and to some extent in the nation for 40 years. This group had been having drills even to one week before this patient came in. They were very well-prepared and they were carrying out the procedures and everybody was confident that there would not be a case of employees.

(CROSSTALK)

HALEY: The fact that we have had a case is disturbing and suggests that it's not the personal effort or the preparation or the advice that they were getting, because they were getting the best advice from Emory.

It's the fact that we have some things to learn about isolation and protection of our employees. And that's why what is going on right now, we need to focus on that as a positive. What is going on right now is the hospital people who are right in the middle of this and are very well-qualified along with the state health department and the CDC consultants -- by the way, the CDC are consultants here

They're not the primary mover. But they are now working on what the problems were and see if they can identify some problems and make recommendations to all of the hospital personnel in the country to try to shore up those guidelines so that everybody will be safe and we can take care of these other individual hospitals.

(CROSSTALK)

TAPPER: All right, now, Dr. Haley, obviously, these are first- responders. Nobody is doubting the motivation of the doctors or nurses or health care professionals, whether at the CDC or at the hospital. They are trying to save lives. That's a given. But obviously they

didn't do a great job at the hospital because one of their nurses has Ebola and it's possible that she may have infected somebody else. So what you said just isn't true. They didn't do a great job.

A great job is when you treat an Ebola patient and he survives, not you turn him away from the hospital and then he actually gets worse and then he comes back and then you treat him and then he dies. And no one else on staff gets Ebola. So I don't want to be...

(CROSSTALK)

HALEY: Let me take issue with you.

The mortality of this disease is anywhere from 60 to 70 percent. And it's unclear how many people can be saved. So, the fact that this patient died is not a failure. In fact, he was doing pretty well until the very end.

(CROSSTALK)

TAPPER: Well, it's not a success. And turning him away from the hospital when he had a 103-degree fever seems to indicate that they were not prepared, at least in those initial days.

HALEY: You know, all the facts on that are not out.

And my understanding is, there are some extenuating circumstances that may ultimately clarify that. But, yes, you're right. That seems like a problem. But since that patient was admitted, I believe that the care that person received and the care and the expertise shown by the Presbyterian Hospital staff were exemplary.

And the problem is not with the personnel or how well they did. The problem is with the protocols. And as Dr. Frieden well pointed out, these are the first several patients that we have seen in this country in our hospitals, and we have got a lot to learn.

(CROSSTALK)

HALEY: And so the wonderful thing is that we're learning that.

TAPPER: Well, that's what I started off by asking you. Would you go into the room of an Ebola patient only going by what the CDC says, as opposed to going by what our expert who has treated Ebola patients on the front lines in Africa and advises U.S. hospitals says, which is, you should be wearing -- there should be no part of your body, no part of your body that is exposed, as to opposed to what the CDC guidelines are?

Shouldn't those guidelines be updated if we're going to continue to try to save the lives of doctors and nurses and people on the front lines?

HALEY: Well, let me say, what I would do today is a little bit different than what I would have done last week, before we knew there was...

(CROSSTALK)

HALEY: ... an employee that has been infected.

TAPPER: So what would you do today? So what would you do today?

HALEY: Well, here's what I would do. And I think this is really important.

I would have my infection control staff in the hospital, and if it was in Presbyterian, it would be one of the best infection control teams in the country. I would have them meeting with the CDC consultants, our state health department, our local health department people.

And we would work out our own best set of procedures based on what we know now and what all -- everybody is recommending. We would change things a little bit to try to shore up what might have gone wrong.

And -- but we would know that we're just hopefully in a higher state of performance than we were before.

TAPPER: OK.

HALEY: But we would never be assured.

But, you know, we have been taking care of infectious diseases in our hospitals. Every hospital in the country is prepared to take care of contagious diseases and have been doing it for -- since there were hospitals.

And CDC has been extremely important in the leadership for the last 40 years in developing these isolation protocols, providing training ideas.

TAPPER: Right.

HALEY: But it's unrealistic to think that they could be sending people at a time to prevent infection to an employee. They just -- you know, with cut backs in funding, CDC doesn't have the personnel for that.

TAPPER: OK. Dr. Robert --

HALEY: So, it's up to our hospitals to do it.

TAPPER: Dr. Robert Haley, we thank you so much. I'm sorry, we have to leave it there. We have to move on to the next segment.

Health care workers are not the only ones dealing with different guidelines, of course, in how to protect themselves. Even politicians and celebrities are spreading false information from one governor telling the public that water is enough to kill Ebola, to singer Chris Brown suggesting the deadly virus is a form of population control. The fiction versus the reality, that's coming up next.

(COMMERCIAL BREAK)

TAPPER: Welcome back to THE LEAD.

The world lead now -- the latest Ebola predictions released by the World Health Organization are grim and they are staggering. If the outbreak is not contained within the next two months, officials say we could see close to 10,000 new cases a week in West Africa. That's more than the current number of Ebola cases since the outbreak began, not to mention the fact that the majority of these new cases will likely be fatal.

According to the World Health Organization, what will help to contain this crisis is an aggressive and strategic response from the international medical community, but what will not help is the conspiracy theories and misinformation that is being put out about Ebola, which often seem to resonate more than the cold, hard facts.

(BEGIN VIDEOTAPE)

TAPPER (voice-over): Ebola is not yet airborne but misinformation about Ebola sure is.

Nathan Deal, the governor of Georgia, the state that houses the Centers for Disease Control, told "The Marietta Daily Journal" that the commissioner of the Georgia Department of Public Health told him "water kills the Ebola virus. Her advice was, wash your hands."

Yes, that's not right, Governor. Chlorine kills Ebola, bleach, but not water alone, not ever.

Then there was R&B singer Chris Brown who tweeted to his 13.7 million followers on Monday, "I don't know, but I think this Ebola epidemic is a form of population control. Blank is getting crazy bruh." Actually, Chris, the only crazy thing going on is people pushing nonsensical conspiracy theories like that one, bro.

Speaking of wild conservative theories, conservative talk radio host Michael Savidge, who has one of the biggest radio audiences in the country, has even been suggesting that this is all some Obama blot to purposefully infect the nation.

MICHAEL SAVIDGE, CONSERVATIVE TALK RADIO HOST: There is not a sane reason to send 3, 4,000 troops into a hot Ebola zone without expecting at least one of them to come back without Ebola, unless you want to infect a nation with Ebola.

TAPPER: It's hard to know where to start with that one, the idea that the president wants to infect soldiers and then Americans? It's so unhinged we should probably not bother dignifying it with fact checking.

These theories are, as of now, not impacting the American health community's response to threat Ebola. But, unfortunately, in Africa, misinformation has impacted the spread of the virus.

BRUCE AYLWARD, WORLD HEALTH ORGANIZATION: The disease continues to expand geographically. There are more district, counties, and prefecture that actually have disease than here would have been a month ago.

TAPPER: UNICEF reports that in Nigeria, many think Ebola doesn't exist. The city of Lagos in Nigeria has even appointed a rumor manager to knock down untruths. Health workers in Liberia are combating the belief that you're immune if you kiss a person who has died from the virus.

Controlling the deadly virus has been a global struggle. Controlling the misinformation, nearly impossible.

(END VIDEOTAPE)

TAPPER: Joining me now to help sort out Ebola fact from Ebola fiction is Dr. Alexander Van Tulleken. He's a senior fellow of the Institute for International Humanitarian Affairs at Fordham University.

Good to see you, Doc. What's the biggest single misconception that people have about Ebola that you want to dispel right now?

DR. ALEXANDER VAN TULLEKEN, FORDHAM UNIVERSITY: I think that it's very easy to catch it. And this is the really difficult thing is we have health care workers like Nina Pham who caught it even though she was wearing protective gear. So, it's a very tricky distinction to make between contagious and infectious. It's highly contagious, just a single drop of infected body fluids of Ebola, but it's not very contagious to it because most of the people exposed to it don't catch it.

That's the really difficult thing. It's very, very hard message to communicate because there is still a risk, and if you get it, it's dangerous.

TAPPER: Right. And also, you want to communicate that while at the same time you want people to take it seriously and those messages sometimes almost seem in conflict. It's, of course, easy to laugh off some of the wilder conspiracy theories but we've seen how misinformation, especially in West Africa, has had deadly consequences.

VAN TULLEKEN: I've worked in a lot of these rural African communities, and it's really, really difficult to do even basic public health messaging, like telling people to wash their hands, with communities that have totally spiritual model of medicine, either to do with religious beliefs or to do with curses, those kinds of ideas, rather than a germ-theory disease which we're more used to.

So, they've got a real uphill battle to change people's minds. We see how hard it is to change doctors' minds in the U.S. or in the west about new therapies, let alone rural villages in Africa.

TAPPER: What should the medical community here in the United States and abroad in Africa be saying to win the confidence of people? Are they two different challenges in the two different continents? VAN TULLEKEN: I think they are different challenges. I think in

Africa, the main thing we have to do is deliver high enough standard of care that people believe -- that people will see that there are survivors from the hospital and not everyone who goes to the hospital dies, and that there need to be hospitals available. That's the main way of change behavior. That's why it's so important to change this virus in Africa. And that is the only way we won't have more Ebola in America, is containing it over there.

Here, I think we actually have to be more straightforward. We've had a lot of dogma about saying, you can't -- you can only catch it this way. It's very difficult to catch and so on. And it turns out a lot of that stuff.

So, I actually think here, it will be nice to see more honesty in saying it's a virus that we don't understand that well. We're working terribly hard to learn more about it and we're going to try to take more precautions.

And the moment, I think the public health messaging has leaned towards dogma, that means when you get a case like Nina Pham, they say it's all lies and it's all nonsense. And it isn't. It's a different difficult set of messaging that Tom Frieden has got in his hands. But it needs to be a bit more ne nuanced, I think.

TAPPER: Interesting. Dr. Alexander Van Tulleken, thank you so much. Appreciate it.

Coming up, they've slaughtered women and children and brutally beheaded aide workers and journalists. And now, ISIS is bragging about taking sex slaves and the terrorists are, of course, trying to justify it by using Sharia.

Plus, guess who is back? New photos, supposedly, of Kim Jong-un out and about in North Korea today. They, of course, are raising more questions about his health.

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