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Anderson Cooper 360 Degrees

CDC Changing Ebola Procedures; Dallas Nurse's Friend Speaks Out; Nurses' Union: "No Protocols" At Texas Hospital; CDC On Ebola: New Team To Help Hospitals

Aired October 14, 2014 - 20:00   ET

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

ANDERSON COOPER, CNN ANCHOR: And good evening. Thanks for joining us.

We begin tonight here live in Dallas with breaking news on several fronts in the growing Ebola crisis and the CDC's plan for how it's going to deal with new cases from now on.

As I said we are in Dallas tonight where a nurse who contracted the disease said in a statement today that she is doing well. We'll have the latest on her condition in just a moment. I'll also be speaking to one of her childhood friends who knows her very well to find out more about her and her life.

But first, breaking news, sobering and new numbers from the World Health Organization. Shocking numbers which is now projecting -- listen to this -- that within the next two months number of new Ebola cases in Guinea, Liberia and Sierra Leone could skyrocket to up to 10,000 a week.

Currently there are about a thousand new cases a week. They're saying by December it could be 10,000 a week. Now keep in mind, there have been just under 9,000 Ebola cases total so far in West Africa. So that is an ominous warning.

The World Health Organization, the WHO, also said today that the mortality rate in this outbreak is now at about 70 percent, which is up from earlier estimates of about 50 percent when it started.

Outside of West Africa, a U.N. worker who is being treated in Germany has now died. He contracted Ebola while working in Liberia, but clearly the problem has spread just beyond the hot zone in West Africa.

Here, in the United States, good news from the University of Kansas hospital where a medic who worked on the ship off the coast of Africa has been in isolation since yesterday. Preliminary lab tests show he does not have Ebola. But more extensive testing will be done to try and confirm that.

Now also today, there's more breaking news from the head of the CDC who we're going to talk to on this program shortly who said it's putting together a response team to be able to handle any new confirmed cases at any hospital in the country. He said a team like that might have prevented a nurse here in Dallas from contracting the disease.

Now I spoke with CDC director just a short time ago and as I said, going to be bring you that interview in a moment. But first the latest from our senior medical correspondent, Elizabeth Cohen, who is also here with me in Dallas.

What is the latest on Nina Pham's condition?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: She was upgraded from stable to good. So that's wonderful and it really speaks, Anderson, to when you get quick treatment for Ebola it really helps. She was hospitalized within 90 minutes of feeling sick, within two days she got a blood transfusion from Dr. Kent Brantly. That's all terrific.

COOPER: And that's really critical. I mean, we've known that for a long time, from the way patients in Africa were treated. We've heard that from Doctors Without Borders who said all along if you get to the patients early that's critical.

COHEN: Absolutely. That really is critical, and that unfortunately was not the case with Thomas Eric Duncan and he passed away.

COOPER: Do we know for a fact that this blood transfusion that she got from Dr. Brantly, that that is what's contributed to her doing well? Or we can't say for sure?

COHEN: We can't say for sure because no one has done clinical trials or studies on these blood transfusions. But the World Health Organization does, you know, tell hospitals that they can do this. They instruct them how to do it. Doctors I've talked to were very confident that it works. But we really can't know for sure.

COOPER: And Dr. Brantly has done it for two other patients before Nina Pham.

COHEN: Right. That's right.

COOPER: Nina Pham actually made a statement through the hospital today.

COHEN: She did. She made this statement. She said, "I'm doing well and want to thank everyone for their wishes and prayers. I am blessed by the support of family and friends and am blessed to be cared for by the best team of doctors and nurses in the world here at Texas Health Presbyterian Hospital in Dallas."

COOPER: All right. Elizabeth Cohen, appreciate the update. Thanks very much.

There is a lot to get to in this hour, as I mentioned. CDC director Tom Frieden said today that he wished that there was an Ebola response team on the ground the day that Thomas Eric Duncan was diagnosed but there will be a team like that from now on as soon as patients are diagnosed, as testing positive if there are any more cases in the United States. We have a lot to discuss with the director. I spoke to him a short

time ago. Here is that interview.

(BEGIN VIDEOTAPE)

COOPER: Dr. Frieden, when we learned that Nina Pham had contracted Ebola, you first said it was because of a breach of protocol. Do you know right now exactly how she was infected?

DR. THOMAS FRIEDEN, CDC DIRECTOR: We're not sure how she was infected. We're intensively looking at that. But we're not waiting for the results of our investigation. We're immediately changing any procedure that we think can be improved to increase the safety of those caring for her.

COOPER: So what procedures needed in this hospital to be improved? Because I know you've -- President Obama has talked about a surge of personnel coming to this hospital now from the CDC. You put in new protocols in place. Specifically what are you improving?

FRIEDEN: There are three major things and then there are lots of details. The first is putting in a site manager. Someone who oversees and makes sure that everyone puts on and takes off their protective equipment correctly and monitors everything going on. The second is --

(CROSSTALK)

COOPER: There was no one doing that at the hospital previously?

FRIEDEN: There wasn't a single individual accountable for that. That's a critical role and that's there now. The second is training, retraining and support for staff. And we brought two nurses from Emory, as well as our own staff to do that. And the third is limiting the number of staff who go into those who are -- necessary to go into the isolation area.

COOPER: You said this afternoon that you wish you would put more what you call robust hospital infection control team on the ground here in Dallas and been more hands on with the hospital from the first day that Thomas Duncan was diagnosed. Why didn't that happen?

FRIEDEN: We sent out the same night a large public health response team, including people to help with contact tracing so we helped identify all of those 48 people who have not developed fever or Ebola and are now mostly through their risk period, we helped to make sure that there was a systemic process in place to manage the response. And we sent some infection control expertise, but 20/20 hindsight, I wish we had sent more.

COOPER: Why wasn't Nurse Pham considered to be at increased risk for infection? I would have assumed all the personnel in the hospital who had direct contact in Duncan's treatment would have been assumed to be at increased risk. She wasn't being monitored by officials. She was just taking basically her own temperature. FRIEDEN: The system there was to make sure that she was monitored and

she was. As soon as she developed fever and symptoms she notified people. She came in. In fact she came in before her fever went up very high. So she had at most one person who she exposed because of that monitoring system. 48 in the case of Mr. Duncan. One in her case.

COOPER: I know you're looking at the protocols and you're constantly revamping them.

Our Dr. Sanjay Gupta, our chief medical correspondent, last night on our broadcast he showed us how to put on and remove the personal protective equipment according to CDC protocols from the Web site, the gowns, the mask, the gloves, that health care workers, you know, wear while treating an Ebola patient.

And he was surprised the guidelines don't require workers to be covered head to toe, no skin showing. It talks about from the neck to the knees. It doesn't even have covering, suggest that they have covering for their feet which they do in West Africa.

Why isn't that part of the recommendations? Do those need to be updated?

FRIEDEN: What we're looking at is making sure that it depends on a situation. So if you're going into a patient who's having vomiting and diarrhea, that would be a very different set of protective equipment you would need, someone who's not having those symptoms. But in any case, we know that what protected is preventing any contact, and that can be done with meticulous infection control and a variety of types of personal protective equipment.

COOPER: But shouldn't every part of the skin on the body be covered?

FRIEDEN: We've looked at that question. We've taken care of many patients with Ebola without having every piece of the skin covered. But that's something that we'll look at.

COOPER: Were you surprised when you learned that some 76 personnel inside this hospital here in Dallas may have had some form of contact or handling some fluids of Thomas Eric Duncan. That seems like an extraordinarily high number of people with such an infectious patient?

FRIEDEN: He went through very complex care in his final days, intubation, dialysis, so a lot of people were needed for that care. But as you may recall the very first day before we knew the number one of our immediate recommendations was limit to the absolute minimum the number of people who go in. You want to provide effective care but you don't want to have more people than necessary go in, both to reduce the potentially exposed number and so that those people get more comfortable and confident and effective at putting on, taking off and working in protective equipment.

COOPER: Dr. Thomas Frieden, appreciate your time, thank you.

FRIEDEN: Thank you very much. (END VIDEOTAPE)

COOPER: Well, as the director of the CDC just mentioned it is still unclear exactly how Nina Pham was infected with Ebola. And that's critical. We've been reporting that CDC disease detectives interviewed her and thought that there were some inconsistencies in the protective gear that she wore in the process she used to put it on and perhaps most importantly to take it off.

I just want to show you again that demonstration by Dr. Sanjay Gupta because it really brings home just how easily contamination could occur when you're taking off these suits.

(BEGIN VIDEO CLIP)

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: I want to show you how I'm going to take this protective equipment off and I'm also going to put a little chocolate sauce in my hand which could represent a possible Ebola contamination. Take a look.

This is the mask I put on. So here's would be the most likely contaminated area, would be my gloves and maybe the front of my gown a bit like this. OK. Now I got to -- I got to treat this as if I'm potentially contaminated. I come out, what I'm going to do with this particular gown, I'm going to rip it all off together and everything is going to come off simultaneously.

But if a part of the glove sort of brushed against my hand, my arm there, that could potential be an exposure. If the glove didn't come off properly I would reach underneath here as best I could. And yet underneath there, but perhaps if I didn't do it exactly right there could be another potential exposure there.

I'm reaching behind now as well as I can, but let's say the side of my face shield was contaminated and I touched here, that could potentially be an exposure. Same thing here now with the face mask.

So now take a look. Right there, see a little bit of chocolate sauce. One possible exposure and over here on my neck, one possible exposure.

(END VIDEO CLIP)

COOPER: And Sanjay joins me now, along with Dr. Seema Yasmin, staff writer at the "Dallas Morning News," also professor of public health at the University of Texas in Dallas, and a former CDC disease detective.

Sanjay, I mean, I just think it's so instrumental watching you take that stuff off. When you hear the CDC director say well, look, it depends what kind of patient you're dealing with, with what kind of suit you wear, do you think -- I mean, does one size fit all? Should all skin be covered?

GUPTA: You know, I really do think so. And I'd be curious what situation Dr. Frieden was specifically referring to. We know in West Africa that the standard is to cover up all parts of the skin. We know at Emory, for example, when they brought Dr. Brantly and Miss Writebol, I suited up with those guys, they covered all parts of the skin.

There is a trade off, the more garb you put on, the harder it is to do your job, to draw blood, to take care of patients, you just have more things on. And you also have more chances for making it more difficult to work on things, and there is a potential error every time you add another step. But this basic idea that Ebola is so infectious that even a small amount of it on your skin anywhere can cause an infection, it sounds like the answer is sort of obvious. Cover up the skin.

And, you know, Anderson, I made this point last night. I'll just say it again. Doctors Without Borders, they've been taking care of patients with Ebola in really, really tough conditions in Central and West Africa for decades. Up until this year they never had a case of a patient transmitting the virus to a health care provider.

The United States has had the first patient diagnosed with Ebola ever in the United States and that patient transmitted -- one patient transmitted the virus to a health care provider. So you can look at what works and what doesn't work. And I think there's some real lessons to be learned here.

COOPER: Yes, and I mean, even though on the CDC Web site it doesn't specify that the shoes need to be covered. You would think that would be something that could easily get contaminated.

Were you also surprised to find out that this hospital, they didn't have a site manager actually responsible for kind of, you know, standing back and watching the procedures being done, which now the CDC has put a site manager in place? Were you surprised that wasn't already in place?

DR. SEEMA YASMIN, FORMER CDC DISEASE DETECTIVE: That is surprising, Anderson, because so many hospitals across the country have this key person. An infection control nurse or a doctor or epidemiologist. They're really a central figure in making sure the infections don't occur in the hospital. And asking those crucial questions like, does it really take 76 people to care for this patient? We know he's very sick. Is there any way we can reduce that number?

COOPER: Right. It seems obvious that -- and this is now something the CDC is doing, trying to limit the number of people attending to a patient. But to have 76 people, potentially, I supposed, that's a huge number.

YASMIN: It's a really big number. And we can underestimate. When a patient is that sick and in the intensive care unit, certainly it does take very many people to look after them. Think about all the different types of specialists they have. Intensive care doctors, kidney specialists, all the types of nurses, pharmacists, people that would do ultrasounds and other imaging. It really does add up.

But having that site manager say, is there any way we can reduce this is so key. COOPER: Yes. Sanjay, when you talked to the director of the CDC,

obviously, look, he doesn't want to bask this hospital. He's got to work with them. Important thing is, you know, that they all work together and that they're all on one team here. But it is important to point out things that worked and things that didn't work with this hospital. Because it does -- it's kind of a test case for other hospitals throughout the United States, isn't it?

GUPTA: Yes, from step one, from when this patient first arrived to the hospital with some symptoms and this travel history from West Africa. Doesn't mean that he had Ebola for sure, but the fact that it was not investigated at that time obviously was a huge problem.

What exactly transpired now with Nurse Pham getting a -- getting infected, how exactly that happened, that's obviously a huge problem. And again, these are -- you know, as much as we talk about vaccine trials and experimental medications and the blood transfusions, what we're describing here is the basics. That's the 101 sort of stuff. And you know it just -- it just didn't work here.

If there's any good news here, Anderson, to your point, it's that other places hopefully can learn from this mistake and this won't happen again.

COOPER: Yes, well, we certainly hope. We're watching carefully.

Sanjay Gupta, thank you. Dr. Seema Yasmin.

A quick reminder. Make sure you set your DVR so you can watch 360 whenever you want.

Coming up in this hour, a 360 exclusive, one of Nina Pham's best friends who actually talked to her today joins us to tell us about how she's doing and what she's doing to help Nina and her family, and also just what kind of person Nina is.

Also coming up, as we've reporting there are really only four facilities in the United States that are fully equipped to deal with Ebola. You're going to be surprised to learn just how many beds or perhaps I should say how few beds are actually available to treat patients in those facilities.

Drew Griffin investigates ahead.

(COMMERCIAL BREAK)

COOPER: Hey, welcome back. We are live in Dallas, now a 360 exclusive, where one of Nina Pham's best friends.

We got these picture from Sarah Strittmatter who has been friends with Nina since the third grade. They're very close, obviously. They went to high school together. And for Sarah and for Nina's other family and friends, what's happening here in Dallas is not just another Ebola case, of course, even though her case has the attention of the whole country. For them, it is their friend, their loved one who is sick.

Sarah has set up a fundraising site for her friend Nina. That's at gofundme.com/ninaphamdallas.

I'll be tweeting that out, will put that on our Web site also.

Sarah joins me now live and exclusive.

Thanks so much for being with us.

SARAH STRITTMATTER, NINA PHAM'S FRIEND: Absolutely.

COOPER: What is Nina like?

STRITTMATTER: Nina is an absolutely incredible young woman. She is a woman of great heart and incredible spirit.

COOPER: It's so cool that you've been friends since third grade.

STRITTMATTER: Third grade.

COOPER: There's not many people who, you know, remain friends with that long.

STRITTMATTER: We've been very close and she's kind of that person that you're always striving to be. She is that person that has got infectious laugh. In eighth grade, she was --

COOPER: I'm partial to anyone with strange laughs so.

STRITTMATTER: She's got a wonderful laugh.

COOPER: OK.

STRITTMATTER: A wonderful laugh. She laughs even when your jokes are not that funny.

COOPER: Is that right?

STRITTMATTER: Mm-hmm. Always.

COOPER: Yes, I heard you said that she laughs just because you think the joke is funny.

STRITTMATTER: Yes.

COOPER: And she sort of wants to make you feel good.

STRITTMATTER: Yes. She's --

COOPER: You also said she's not very good at being mean to people, right?

STRITTMATTER: No. She's terrible.

(LAUGHTER)

STRITTMATTER: She's also terrible at being sarcastic. Sorry, Nina. But she's an incredibly kind and selfless person. COOPER: Did she always want to be a nurse? I understand during a

career day when you were in high school she was a -- she was a nurse.

STRITTMATTER: Well, she had some first and second grade dreams of being a fashion designer, I think, but when we came down to it in fourth grade and we had to pick careers, she came as a nurse in the third grade.

COOPER: Fourth grade you're --

STRITTMATTER: Fourth grade. That was in fourth grade that we had the career day.

COOPER: So for that long?

STRITTMATTER: That long.

COOPER: So it didn't surprise you that she actually did become a nurse?

STRITTMATTER: She is a people person.

COOPER: You're also very close to her family?

STRITTMATTER: Yes.

COOPER: They have helped you in tough times as well.

STRITTMATTER: Absolutely, any time that my family has struggled with a death in the family or any tough times. One time we came out on the porch and there was an entire ham on our porch. But they're always talking to us and making sure that we're doing OK and they're there to support us.

COOPER: There's been a lot of reports about her dog and how important her dog is to her. And the reason I wonder, is we've been reporting is because, you know, you don't want people who might be infected with Ebola feeling that their dog is going to be killed if they come forward. So her dog is being taken care of. But you kind of know the history of this dog.

STRITTMATTER: A little bit. And I hope I do him justice. His name is Bentley. She calls him Bentley Boo. He's adorable. And --

COOPER: He's a rescue dog.

STRITTMATTER: He is a rescue dog. So Nina, her entire life, had been looking forward to moving out just so she could kind of have her own dog and Bentley was that dog. And Bentley was part of a litter of dogs -- I just call them litter. Pack of dogs that was rescued from a puppy mill.

COOPER: Wow.

STRITTMATTER: And there were a lot of puppies and to save them from euthanasia, and Nina said, sign me up. I want one of those dogs. COOPER: So this dog is important to her, no doubt.

STRITTMATTER: Extremely important to her. Yes.

COOPER: And, you know, obviously, I talked to the mayor of Dallas, who was saying that, you know, the family is obviously for them, this is a very private matter but they also are aware of -- there's a lot of interest in this and obviously a lot of attention. What --

STRITTMATTER: Yes.

COOPER: Is there anything else you want people to know about your friend?

STRITTMATTER: I want them to know that she is that best friend that you have in that whole life -- your whole life, you're trying to live up to be like her. To be that caring and loving and selfless and there for you. She is that person, she is not just another news story, that she is somebody's best friend and --

COOPER: Your best friend.

STRITTMATTER: My best friend.

COOPER: And I remember -- I heard you saying also that she is very meticulous.

STRITTMATTER: Yes.

COOPER: She's very -- and has always been?

STRITTMATTER: Yes, and in middle school we always needed things that were handwritten for the class, (INAUDIBLE), I mean, anything that we were doing it was always Nina that we went to, to do that.

COOPER: Are you --

STRITTMATTER: She's just so organized.

COOPER: And have you talked to her? Is she doing -- I mean, I know that she's --

STRITTMATTER: I personally, and I wanted to make sure that I said this. I personally have not been in contact, like physical contact with Nina for four months.

COOPER: OK.

STRITTMATTER: I have not seen Nina since June. We have spoken since then, though, and so -- I mean, what I know is pretty much what everybody knows right now.

COOPER: Right. Well, certainly everybody's thoughts and prayers are with her and her family, and with you.

Thank you so much. STRITTMATTER: Thank you.

COOPER: I really appreciate you being with us.

And also, if you're interested in the gofundme page, again, we're going to have that more on our Web site. I'll also tweet that out.

Sarah Strittmatter, I appreciate you being with us.

STRITTMATTER: No problem.

COOPER: Thanks very much.

STRITTMATTER: Is it OK? I wanted to thank everybody that has donated so far.

COOPER: OK.

STRITTMATTER: For their contributions.

COOPER: All right. Cool. You can also find it at CNN "Impact Your World" at CNN.com/impact and the Gofundme page is gofundme.com/ninapham -- what's the last word?

STRITTMATTER: Dallas. NinaphamDallas.

COOPER: Dallas. NinaphamDallas. All right. Thank you so much. Appreciate it.

STRITTMATTER: Thank you.

COOPER: There is a lot more ahead in this hour to tell you about. A lot more on the Ebola case.

As always you can find more on this story and others at CNN.com.

Growing concerns that most U.S. hospitals are unprepared to safely treat Ebola patients. We're going to have more on that and a reality check on how many beds are actually available at this specialized facilities called biocontainment units. We'll be right back.

(COMMERCIAL BREAK)

COOPER: There is more breaking news tonight. We have just gotten a statement from the president of an organization, the National Nurses United, saying when Ebola patient Thomas Eric Duncan was here at Texas Health Presbyterian Hospital, quote, "The guidelines were constantly changing and there were no protocols."

Now the union's co-president also says the protective gear that nurses wore at first left their necks exposed. The troubling claim, now that the nurse has been tested positive for Ebola. And frankly the same outfit that Sanjay wore in that demonstration the neck was exposed.

That official says the information is coming from nurses at the hospital. But the union is not saying who those nurses are. The Ebola scare here in Dallas obviously put a stark fact in sharp relief.

Across the United States there are precious few facilities that are specially equipped to safely treat Ebola patients. They're called biocontainment units. Hospitals like this one with designated rooms and areas to treat highly infectious patients like the one we're showing you right there. Not the one here in Dallas.

There are just four of these centers in the United States and here they are. There is a facility in Missoula, Montana, there's one in Atlanta, one in Bethesda, Maryland and another in Omaha, Nebraska. So there's four clinics in total but if you're thinking that these are hospitals with dozens or hundreds of beds each and that they can handle a real outbreak, well, we're learning something far different.

Our Drew Griffin has been looking into that and he joins us now.

Drew, what about -- what have you learned?

DREW GRIFFIN, CNN INVESTIGATIVE CORRESPONDENT: Drew -- I mean, Anderson, it's 19 beds. That's the number of beds in those four facilities total that you just showed on that map. Nineteen. Three beds in Atlanta. Three in Missoula, Montana. Three we believe at the National Institutes of Health but their staff couldn't count them today, believe it or not. And the big center in Omaha, in Nebraska Medical Center, they have 10 beds.

But, Anderson, even that's deceiving because the center director in Omaha says his staff could only realistically handle no more than two Ebola patients at a time. That is because of the danger, the staffing, and the waste removal necessary when you're treating any Ebola patient.

COOPER: So then realistically we're talking about really 11 beds for the entire country out of all four of these -- of these units?

GRIFFIN: Yes, exactly right, 11 beds for the entire country.

COOPER: I mean, that is surprising to me, certainly. You have been reporting since last week that even though other hospitals may have the equipment, even isolation rooms to handle Ebola patients, they really aren't prepared to the point that they would feel comfortable actually accepting them, right?

GRIFFIN: Yes, they won't admit that, of course, on camera, but I can tell you, the hospitals across the country are scrambling now to figure out what to do and the changing policies from the CDC are not helping.

They're calling on infectious disease experts who are rushing to these hospitals, trying to review these emergency procedures. A lot of the hospitals are not sure they're ready. I'll give you an example of that and the demand for information, OK?

The CDC held this seminar today over the phone. A phone conference for hospitals and emergency room workers who just wanted to learn from the experiences that we've already had, how to do handle Ebola patient treatment. How to do that safely? Listen to what happened when we tried to dial in, Anderson.

(BEGIN VIDEO CLIP)

OPERATOR: The conference you're attempting to join has momentarily reached capacity.

(END VIDEO CLIP)

GRIFFIN: We tried a few more times. We never did get through. I'm telling you these hospitals are desperate for information.

COOPER: And we're talking about just regular hospitals trying to prepare for the possibility of an Ebola patient walking into the door, right?

GRIFFIN: Yes, they don't know if they're ready. And the reason they don't know if they're ready even though they have all the gizmos and everything that they may think will help them is because of what happened where you are in Dallas.

Anderson, what happened at Texas Presbyterian is a failure, I mean, I don't know how else you could look at it. Thomas Eric Duncan walks in. He is not identified right away. He's sent home. Thomas Eric Duncan comes back in, he dies.

Now, Ebola kills a lot of people, but he dies in an American hospital getting treatment and now you have a nurse who was treating him gets Ebola. This was not supposed to happen. So these hospitals are scrambling.

And as we've seen there is no way this country could handle an Ebola outbreak. Now, we're told there could not be an Ebola outbreak, but the worst case scenario, I think you have to come to the conclusion that experts tell us we're really not prepared.

COOPER: And certainly we've seen the CDC ramping up their procedures, changing their procedures yesterday. Drew Griffin, thanks for that.

They are worrying no doubt about it. Many public health experts have cited a litany of missteps made by Texas Health Presbyterian Hospital, as Drew mentioned, starting with that decision to send Duncan home when he first showed up to the ER. The fact that Nina Pham became infected while caring for Mr. Duncan has only fuelled a criticism.

Joining me now Dr. Joseph McCormick, the dean at the University of Texas School of Public Health and also co-author of "Level Four, Virus Hunters of the CDC." He helped to investigate the very first Ebola outbreak in Central Africa when he worked at the CDC.

Dr. McCormick, thanks so much for being with us. You got a lot of experience with Ebola. You're critical of the way the Dallas hospital handled Mr. Duncan's case, particularly the contact staff had with infectious substances, how so?

DR. JOSEPH MCCORMICK, UNIVERSITY OF TEXAS SCHOOL OF PUBLIC HEALTH: Well, I mean, clearly the contact with the patient and with the initial patient was -- had a lot of flaws, a lot of flaws. And as you pointed out sending him home was terribly flawed. But I want to point out that even the -- the scenario that I saw with Dr. Gupta has its own flaws.

We ran a program for 15 years taking care of patients in Sierra Leone with lots of fever, which spreads exactly like Ebola and under the most rudimentary circumstances. And we never had but one over the years of transmission in the hospital.

COOPER: What do you attribute that to?

MCCORMICK: Well, I attribute it to very careful procedures by the staff and experience is worth a lot and I think that's one of the things that we are seeing here. I think, Anderson, we may be over -- having more technology than we need.

We had a gown, a cloth gown, a cloth mask, and a pair of surgical gloves. That is what people wore to take care of patients. When they came out, first of all their washed their hands with the surgical gloves, that is the first thing they did, in Clorox, in bleach and then they took off their gown.

Now, if somebody had as much stuff as I saw in the gown of Dr. Gupta, then we would spray it with bleach. Then we would take our gloves off and put those in bleach. And by the way, we reused our gloves because we didn't have the material to --

COOPER: Wow, so you were reusing gloves.

MCCORMICK: Exactly, and masks, exactly. So my point is this can be done. It is not that complicated. I would also say that we don't have to have, and we've proven it over and over again. We do not have to have these high-tech facilities to treat patients with Ebola.

We have had patients with lots of fever in the United States. We treated them successfully. Indeed we intubated one of them. So I think we may be looking --

COOPER: I understand there was an incident where you were in Central Africa, if I read it correctly, basically drawing blood from I think about ten people who had been infected with Ebola in very low light conditions. They were on the floor, 12 people, and you were able to do that safely. I mean, that is an extraordinary thing.

MCCORMICK: That is correct. It was in Sudan, not only then, I centrifuged all the blood so that I could send them back to the CDC and also take off some of the serum. So we know that --

COOPER: So the key is just observing, it is not necessarily going high tech, the key though is just training, training, training?

MCCORMICK: It is training, training, training and having a protocol. I think my biggest criticism of the Dallas situation is apparently there were no protocols. They didn't have a protocol for what they were going to do when they saw somebody in the emergency room or any other place. They didn't have a protocol for how they were going to handle the patient when they picked him up. They clearly didn't have a protocol for how they were going to decontaminate his surroundings. They didn't have a protocol for putting their staff who took care of him under active surveillance.

I think all of those were missteps and those -- I think this is a learning process. And I will say that -- and I've said this before, we can make mistakes in this country because of what we have, the facilities we have and still not produce an epidemic.

We're not going to have an epidemic of Ebola. Will we have some secondary cases? Possibly, but we're certainly not going to create an epidemic of Ebola, even with some missteps as we've seen in Dallas.

COOPER: And that is an important message to get across tonight and every night frankly. Dr. Joseph McCormick, I appreciate your expertise. Thank you. It's our pleasure to talk to you.

MCCORMICK: Thank you very much.

COOPER: Up next, we have more on the breaking news we told you about just a minutes ago. The president of the National Nurses United is speaking about the changing guidelines when Ebola patient, Thomas Eric Duncan, was here in the hospital in Dallas, and quote, "no protocols."

Dr. Sanjay Gupta has new information. He will join us after the break.

(COMMERCIAL BREAK)

COOPER: And welcome back, breaking news here in Dallas, some explosive claims now being made from the president of the National Nurses United who represents the nurses of this hospital says when Ebola patient, Thomas Eric Duncan, was here at Texas Health Presbyterian Hospital, quote, "The guidelines were constantly changing and there were no protocols."

And that is just the beginning of their claims. Dr. Sanjay Gupta who was just on that press call, he is back with us now. Before we get into what are incredibly troubling claims, I do want to point out that CNN just reached out to Texas Health Presbyterian Hospital for comment on these allegations, we have not yet heard back on that.

Sanjay, what did you learn on this call? What is the organization claiming happened inside this hospital?

GUPTA: They are making some pretty startling claims, Anderson, as you mentioned, from anonymous nurses within the hospital that do not wish to be identified. But some of these things so important with regard to possible other infections.

They say that Mr. Duncan was left for several hours not in isolation, but in other areas where other patients were present, up to seven patients they say, and even after a nursing supervisor demanded that he'd be put in isolation. They say it was met with opposition from hospital authorities. Also the laboratory samples, the blood samples, typically, when we say there is a concern about infectious diseases, they're taken straight to the lab.

Instead they say this was transported to the hospital tube system, which is a tube system where all sorts of samples are sent. A lot of people have access to it.

They are worried that the entire system there could potentially be contaminated. This one really was quite surprising to me, apparently nurses expressed concern about the fact that their necks were not covered taking care of a patient with Ebola.

They were told to wrap medical tape around their necks as an alternative. I mean, it is really outrageous, medical tape is incredibly --

COOPER: Have you ever heard of that?

GUPTA: I have never heard of that. I've never heard of anybody ever suggesting that someone wrap anything around their neck, period, let alone medical tape as a type of precautionary measure against Ebola. It is almost outlandish.

They also make the point that people were going in and out of isolation areas without personal protective equipment. We have also reached out to the hospital, Anderson. We obviously want to hear how they respond to this.

But if this is true again from anonymous nurses here making these claims to the nurse's union essentially, it is just staggering. And I think adds a whole other dimension to the lack of protocol, lack of leadership and lack of being able to take care of this patient.

COOPER: I also understand because you and I were talking right before we went on air, you were kind of briefing me about this call during the commercial break that they were also making claims about medical waste?

GUPTA: Yes, you know, you were talking to Louise a few days ago about the apartment, this is about again a hospital where they say and I'm reading this quote now, "There was no one to pick up hazardous waste as it piled up nearly to the ceiling."

You know, they didn't have a plan apparently for the hazardous waste so they just kept piling it up in this one area to the ceiling not knowing what to do with it. So again, speaks to exactly what kind of plans if any were in place to be able to take care of Mr. Duncan, the patient with Ebola.

COOPER: And again, it really re-emphasizes what Dr. McCormick was saying, the doctor who has treated fevers and viruses like this in Central Africa including Ebola, and done it safely many times, was saying that it is all about training, training, training, and having protocols in place. Sounds like what this nurse's union is saying, again, these are allegations. The hospital has not had time to respond, we've not heard back from them. But again it sounds as though they did not have protocols in place, again, according to this nurses' union. Sanjay, thanks.

We'll keep trying to get a response from the hospital tonight. Here in Dallas, certainly the disease could continue to spread. There are fears all across the country. We're trying as much as possible to give you a realistic picture of this virus.

And give you all the information that we have because frankly we think the more information you have, the better. An update on Nurse Nina Pham's dog, tonight we have new information where he is, how he is being taken care of.

It's not just important to her family, the reason we report on this a lot of people may wonder why is because there is concern among health workers and even officials from the CDC and elsewhere.

That if people believe if their dog is going to be put down if they come forward or they believe their dog will be put down, they may not come forward in a timely manner.

So if there is concern about how the dog is being taken care of, we'll have more on that ahead.

(COMMERCIAL BREAK)

COOPER: As we reported, the head of the CDC today is putting together a response team to handle any new confirmed new Ebola cases at any hospital in the country.

They say a team like that might have prevented the nurse here in Dallas from contracting the disease. Nina Pham is the first person to contract the Ebola in the U.S. and that has many people fearing the same faith. CNN's Gary Tuchman reports.

(BEGIN VIDEOTAPE)

GARY TUCHMAN, CNN NATIONAL CORRESPONDENT (voice-over): Inside the neighborhood medical center in Dallas, Kisha Bell has come in with abdominal pains. She also has come in with a daughter, grandson and a question for Dr. Martin McElya, which she is asking because of what so many in Dallas are talking about.

UNIDENTIFIED FEMALE: The Ebola, can you tell me -- like what the symptoms --

DR. MARTIN MCELYA, URGENT CARE PHYSICIAN: Usually pretty significant fever, over 101, 102, somewhere in that range. A lot of abdominal pain, nausea and vomiting, feeling really crummy, really lousy, fatigue, and symptoms that don't get really better with medication, don't get better in time.

TUCHMAN (on camera): Before this first Ebola case surfaced in Dallas, how many times have you been asked about Ebola?

MCELYA: Never.

TUCHMAN (voice-over): But now Dr. McElya says many patients ask about Ebola and he works to make people feel more at ease.

MCELYA: I make sure you say you're not going to get it from somebody who sneezes across the room or because you're sharing an air space, it requires more of an intimate contact and people seem relieved by that fact.

TUCHMAN: Some medical supply stores in Dallas say they have seen a spike in sales.

UNIDENTIFIED FEMALE: They just want to put them on --

TUCHMAN: Jennifer Wilson of One Source Medical Solutions puts on three big sellers, goggles, gloves, and an isolation gown.

JENNIFER WILSON, ONE SOURCE MEDICAL SOLUTIONS: Typically, we only have purchases from clinicians, you know, medical professionals --

TUCHMAN (on camera): It is like everyday person coming in and saying I want protection --

WILSON: We do. We have every day people coming in saying I want to have them just in case, just as added protection. And I think they're just concerned. Percentage-wise in personal protection items we've seen about a 75 percent spike.

MCELYA: Well, it makes the pain worse.

UNIDENTIFIED FEMALE: I think if I have something spicy --

MCELYA: OK, got it. What makes the pain better, anything?

UNIDENTIFIED FEMALE: No.

TUCHMAN (voice-over): Kesha will have further testing for a possible gall bladder condition, but the doctor told her this is nothing to do with Ebola.

MCELYA: People just want reassurance.

TUCHMAN: And these days in Dallas, there is never too much of that.

(END VIDEOTAPE)

COOPER: Gary joins me now. Are doctors seeing a lot of anxiety?

TUCHMAN: Frankly there is a lot of anxiety here in Dallas, Anderson. This is a big international and national story, but it's also a uniquely local story. This first diagnosis in the United States could have happened in any city, from Alaska to Maine and Florida.

But it happened here in Dallas and people take it very personally. But if we can go days or weeks or months without another diagnosis, it will do wonders.

COOPER: All right, Gary, thanks very much. Appreciate that.

As we mentioned earlier on top of everything else Nurse Nina Pham, is worried about her dog, Bentley, a King Charles spaniel, a dog that she rescued. Tonight, we have an update from city officials. The dog has been moved to the naval air base where he will be monitored for Ebola in the next few weeks.

Dallas Animal Services will oversee his care. City officials say he has been given bedding, toys and other items to make him feel at home. This is a concern for health officials, obviously, dogs can be infected with Ebola without showing symptoms, although there are no known cases of dogs actually transmitting Ebola to human beings.

Twenty five years ago, this week, disaster struck the San Francisco area. It's hard to believe it's so long ago. A massive earthquake, extensive damage, dozens of people killed.

It's the focus of a special report that airs at the top of the hour on CNN, Randi Kaye joins me with a preview next.

(COMMERCIAL BREAK)

COOPER: Well, it is 25 years ago this week that a massive earthquake tore through the San Francisco bay area, just minutes before the start of the World Series at Candlestick Park, 63 people were killed in magnitude 6.9 quake, many of them in cars on a double decker freeway that collapsed.

Massive fires also ripped through some neighborhoods and homes were turned into rubble. The bay area has, of course, rebuilt, but the stories live on from that terrifying night in 1989.

And in just minutes, Randi Kaye, brings us a special report, "San Francisco Shaken 25 Years After the Quake." I spoke to her earlier, but first, here is a preview.

(BEGIN VIDEOTAPE)

RANDI KAYE, CNN INVESTIGATIVE CORRESPONDENT (voice-over): Bill and Janet Ray are still trapped under rubble. Firefighters are now inside what's left of their building.

BILL RAY, EARTHQUAKE SURVIVOR: They said, don't worry, we're going to get you out of there, and I could sense that there's desperation. This fellow, who I've never met, was working so hard to get the chainsaw started.

KAYE: The firefighter tries an axe instead.

RAY: Once they got the hole cut out, a gloved hand came through the hole. I grabbed his hand. The only thing that separated me and them was two inches of subfloor.

KAYE: They're so close, but incredibly, debris is no longer the main obstacle to their rescue. Bill and Janet realize their building is on fire.

RAY: It was during the axe chopping that the smoke started to roll in to the floor that we were on and I could smell it. That was a big concern to Janet.

KAYE (on camera): Do you remember what she said to you?

RAY: "We're not going to get out of here."

(END VIDEOTAPE)

COOPER: Such a terrifying story. We'll have to watch the documentary to find out what happens. What other stories are a part of this?

KAYE: Well, I would say Bill and Janet's story was incredible. He was trapped with his wife, it felt like a coffin. They were in an area that was 2x2 feet.

We also share the story of a couple of people who were trapped on the Cypress Freeway, which is the freeway that had pancaked down. One woman told us that her car had been pancaked to about four inches in the front. Her dashboard was at her ankles.

COOPER: My gosh. All right, Randi, thanks very much. We look forward to this.

Well, that does it for us. We'll see you again at 11:00 p.m. for another edition of 360. "San Francisco Shaken 25 Years After The Quake" starts now.