Return to Transcripts main page

Anderson Cooper 360 Degrees

Details on Second Nurse with Ebola; Nurse with Ebola Travels to Maryland for Care; Nurse Blasts Hospital over Ebola Response; CDC: Ebola Patient May Have Been Ill As Early As Friday

Aired October 16, 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, everyone. Thanks for joining us tonight from Dallas.

Tonight, many breaking developments on Ebola and according to every expert you're going to hear from in the next two hours that we're on the air, there is one lifesaving bottom line. More than anything else, knowledge stops this virus. The lack of it kills. The lack of knowledge, the lack of transparency, the lack of accountability.

More than high-tech equipment or experimental drugs, simply knowing what to do, knowing how to do it, doing it well, doing it right is what really saves lives. Owning up to shortcomings and fixing them is a big part of that and we have not seen that from this hospital.

Surprising it is really hard, and our breaking news is proof of that.

Breaking item number one tonight, late-word that Nurse Amber Vinson may have already been showing symptoms when she boarded that flight from Dallas to go home to Ohio on Friday. That's three days before, we were told, she was symptomatic just yesterday and countless other people were possibly exposed. That's being investigated.

Now if it's true, the question is why did she, a nurse, think she was OK to fly? How many people was she in contact with and why on Monday, on the way home, when she phoned into the CDC, with the fever of 99.5 saying that she'd been treating an Ebola patient who died, did the person on the other end of the line at the CDC not tell her to stay off that airliner?

Breaking item number two tonight, Nurse Nine Pham seen here leaving Texas Health Presbyterian a short time ago in Dallas, being cheered on by colleagues at the hospital where she and Nurse Vinson became infected from the now deceased Thomas Duncan. At Love Field, she stepped out of an ambulance in a full hazmat suit and walked with some assistance to the aircraft.

We got a live shot of it on the tarmac now waiting for takeoff. She is being flown to the Washington, D.C. area for treatment at the National Institutes of Health in Bethesda, Maryland.

Both she and nurse Vinson worked under conditions that were self- evidently not sufficient to protect them. And the Dallas hospital in turn was working with inadequate CDC guidelines. Now in a moment you're going to hear from a nurse at Texas Health

Presbyterian Hospital who paints an incredibly troubling picture of the treatment that Thomas Duncan received. The lack of training that staffers had in dealing with him and the lack of transparency from the hospital. And she's taking a great risk in speaking out. She could lose her job.

Listen to some of what she has to say.

(BEGIN VIDEO CLIP)

BRIANA AGUIRRE, TEXAS HEALTH PRESBYTERIAN NURSE: I feel like if you're in there with an Ebola patient and your life is on the line and your family's safety is at risk you should have the number to anyone. You should have the number to Obama administration to get you whatever it need -- you need to perform that job safely. And I'm not satisfied with any answer that the hospital has to offer at all.

(END VIDEO CLIP)

COOPER: At the -- at the very least, those nurses should have had the right protective gear. She herself was told to just slap some tape to cover her neck, the skin that was exposed to her neck. The one-inch medical tape, to just tape it up as best she could.

There is a lot to get to tonight. And you're going to hear a lot more from her in the next two hours but we start with senior medical correspondent Elizabeth Cohen.

Let's talk about Amber Vinson getting on that plane, possibly already starting to show some symptoms on Friday. We're talking not about the plane back to Dallas. We're talking about from Dallas to Cleveland.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right, at that time the CDC was really paying attention to the community. Let's make sure this doesn't get out into the community. They kind of let these workers monitor themselves and they kind of let the hospital sort of take care of it.

COOPER: How are they now saying that she may have been symptomatic? Is that based on contact interviews they've done?

COHEN: Based on interviewing her again. I'm sure interviewing her family, interviewing her friends. You know, she was in Ohio to prepare for a wedding. Did she fully participate? And all those activities or maybe she felt a little sick and stayed home. You know, we don't know.

COOPER: So the question is, why would a nurse who has just been treating an Ebola patient who died and she didn't have great protective gear, why would she get on a plane if she is starting to feel sick?

COHEN: You know, we don't know the answer to that. We would have to be in her head. But I will tell you, Anderson, the denial is a very powerful thing. Even if you're a doctor, even if you're a nurse you might feel something and thin, I have a little headache, I have headaches all the time. You know, so my stomach is sort of upset, my stomach has been upset before.

COOPER: I mean, she clearly must have not believed she really was sick because she went to visit her family. So --

COHEN: Right.

COOPER: I mean, she wouldn't have consciously wanted to endanger her family, obviously.

COHEN: That's right. I think it's very easy to convince yourself that it's something else. The first signs of Ebola look like so many other things. And especially if no -- at that time she was not getting phone calls, she wasn't getting visits from officials, she was told to sort of monitor herself.

COOPER: And I just want to show our viewers what you're watching. This is the plane carrying the nurse to Bethesda, to the NIH. This is Nina Pham is on board that in a full tieback suit, full gear, as are other people obviously who have gone with her that is taking off from here in Dallas. She left this hospital just a short time ago.

Elizabeth, as we watched these images, I mean it really is an admission by this hospital that they need time. I mean, maybe they just don't want any Ebola patients here at all because they're losing all their other patients here. A lot of other patients are not wanting to come to this hospital. And they clearly need time to get their act together.

COHEN: Right, I think we can see that two things are going on. In their press release, they said they wanted her to be transferred because they wanted to be able to prepare for whatever might come next. That makes you wonder, are they anticipating the other employees, when people are going to come here.

The other thing is, is that I learned from a CDC doctor who is inside this hospital, they are two thirds empty.

COOPER: Two thirds, wow.

COHEN: Two thirds. They're -- people are scared to come here. This is now known as the hospital with the Ebola patients. You can't operate for long that way.

COOPER: And in terms of what the CDC now has to do, they need to now try to contact people on the aircraft that -- from Dallas, I guess, to Ohio. They need to figure out exactly who she came in contact with while she was in Ohio.

COHEN: Right, exactly. They need to establish when did she truly start feeling sick. I mean, they really need to nail that down. And then who did she see during that time period. For example, with Nina Pham, they were very lucky. I mean, we're told that the minute she felt sick, she alerted people. She only had one contact.

COOPER: Right.

COHEN: It appears that this one is going to have many, many more than that. That is a difficult thing to do. Now they're doing contract tracing in two cities. And the CDC doesn't have an unlimited number of disease detectives.

COOPER: A troubling development, no doubt about. This occurred just a short time ago.

Elizabeth, thanks.

We have more breaking news. Shortly before air time President Obama spoke on the issue. He covered a lot of ground. He said he did not rule out appointing a so-called Ebola czar, if need be. He also talked about growing calls to restrict travel to the United States from Western Africa.

Take a look.

(BEGIN VIDEO CLIP)

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: I don't have a philosophical objection necessarily to a travel ban if that is the thing that is going to keep the American people safe. The problem is, is that in all the discussions I've had thus far with experts in the field, experts in infectious disease, is that a travel ban is less effective than the measures that we are currently instituting.

(END VIDEO CLIP)

COOPER: And again, to our viewers, if you're just joining us, what you're seeing, the aircraft carrying Nurse Nina Pham to the Washington, D.C. area. She's going to be taken care of at the NIH, the National Institutes of Health at the Bethesda, Maryland, a specialized unit that they have ready and waiting for her.

I want to bring in chief medical correspondent Dr. Sanjay Gupta. Also joining us tonight Dr. Joseph McCormick, dean of the University of Texas School of Public of Health and co-author of "Level 4: Virus Hunters", and Dr. Seema Yasmin, staff writer for the "Dallas Morning News," former CDC disease detective, and professor of public health at the University of Texas at Dallas. And of course, Elizabeth Cohen is with us as well.

Sanjay, the fact that Amber Vinson could have been sick as far back as last Friday that would potentially have put her into contact with a lot more people it would mean that it wasn't only the people on the flight back to Texas that could have been exposed but also people on that flight to Ohio.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: That is exactly right. I mean, obviously, you do want to figure out what those symptoms were specifically. And you know, keep in mind again, at the time that apparently if everything that we're hearing is true, at the time that she was getting on the plane back to Dallas she did call the CDC, said she had a temperature of 99.5, so low grade fever. If her symptoms were more minimal than that prior to that flight over

the weekend, more minimal symptoms, the important question, how infectious, how contagious would she be, it would still be pretty minimal. So, you know, you've got to be balance this, obviously, you want to go find people that she may have come in contact with. Talk to those people. And you're asking them, as well.

What did you notice in Amber? How sick was she when you were talking to her? The contacts that she had. And really, really nail down the story. But again, I think the threat to the general public still minimal given that by the time she got on the flight back to Dallas still just a low-grade temperature at that time -- Anderson.

COOPER: Dr. McCormick, as we watch the plane taxiing, getting ready to take off with Nina Pham to take her to NIH, I think it bears repeating. You know, I've talked about this a number of times over the last couple of days. I mean, you have experienced on the ground dealing with Ebola patients in very difficult circumstances. Very rugged situations in Africa early on in other Ebola outbreaks.

You have said repeatedly that it's not necessarily that at the NIH they have magic wands or, you know, it's not just that they have high- tech equipment, it's that they have practiced, and they have protocols in place that they rigorously adhere to. That's what's critical in treating this. And any hospital should be able to do that if they practice, practice, practice.

DR. JUSTIN MCCORMICK, CO-AUTHOR, "LEVEL 4: VIRUS HUNTERS": Absolutely, Anderson. This is a very disappointing failure also of surveillance. I am just astounded at the fact that she was under self-surveillance. This should have never happened.

And secondly, you cannot replace good training, solid technique, good protocols with all the technology in the world. Because it will eventually break down, as well, if the staff are not well trained. And I think you have to have a staff right down to the nurses. And listening to the comments of the nurse previously, you have to have nurses who buy into this. Who are part of the team. Not just doing a job because somebody told them to do it.

And it is clear from the top to the bottom that this hospital just had major problems in how it was organized for this. And I'm just wondering if a lot of people wonder whether this hospital is competent for a lot of other things. Because this should not have been this complicated. It was made so by the lack of training of their staff and a lack of preparation.

COOPER: Yes --

MCCORMICK: I think the other thing is that --

(CROSSTALK)

COOPER: Doctor --

MCCORMICK: It also gives a disturbing message to the rest of the world and to other hospitals in the United States.

COOPER: Yes, about how the United States can deal with this.

Dr. Yasmin, I mean, you worked at the CDC in contact tracing. How does that actually work? What is actually now going on in relation to Nurse Amber Vinson, tracing all the people she came in contact with? How does that actually work.

DR. SEEMA YASMIN, FORMER CDC DISEASE DETECTIVE: I tell you, Anderson, it's really hard work. You have to take a good history from the index patient. You have to ask them, when did you actually start having symptoms. You count back to that day number one and for that particular day you say who did you have contact that day, where did you go? You do the same for the next, say, they had symptoms, and so on. And then you have to contact all of those people.

The fact that she may have now had symptoms earlier than the CDC have been means the CDC really has their work cut out for them. They have to cast that net much wider, they have to perhaps do contact tracing back in Ohio. So it's very difficult work that will probably become a lot harder.

COOPER: And Elizabeth Cohen, the fact that the hospital -- I mean, we've talked a lot about the lack of transparency from this hospital. They've really said nothing. They put out now a few statements. They apologized in a general sense. But the fact you have this whistle- blower nurse who we're going to hear more from tonight, who this morning was talking on "Today" show, leveling some very detailed descriptions of what was going on, and the lack of preparation. They've really responded not at all to what she has said. They have remained completely silent.

COHEN: That's not surprising to me.

COOPER: Just stunning.

COHEN: It's stunning but it's not surprising. They have responded to almost nothing. For example, the initial mistake where they let him go home instead of admitting him, they first said it was a flaw in the medical records. They blamed the medical record. Then they said no, there was a flaw. I mean, they just haven't come forward with what exactly is happening inside those walls.

COOPER: And I mean, you know, to any hospital management who's watching, look, I know they're all concerned about lawsuits, obviously, but the most important thing is getting accurate information to other hospitals out there to know what worked and to know what did not work. Most importantly what did not work in this hospital. And this hospital keeps talking about wanting to share information to help other hospitals.

They haven't been sharing information with the public at all about what really went on. And it's just -- it's pretty outrageous, it's a complete lack of transparency.

As always, we're going to have a lot of reporting on this throughout this hour. We're also live at the 9:00 hour tonight. Make sure you set your DVR, you can watch 360 whenever you want.

Coming up next, my interview with the whistleblower nurse, my conversation with the nurse who saw firsthand just how ill-prepared this Dallas hospital was to deal with Ebola. And she said how little they told staffers, who were putting their lives, nurses putting their lives on the line, every moment every day.

(BEGIN VIDEO CLIP)

AGUIRRE: Why? What explanation can you give me or anyone about why we would be in the second week of an Ebola crisis in our hospital and we don't even have the same equipment or protection that is given to sanitation workers that have no contact with patients at all.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

COOPER: Welcome back. We have breaking news tonight on a number of fronts.

First, Amber Vinson, the second nurse who contracted Ebola after caring for Thomas Eric Duncan. We reported last night she was running a fever when she flew from Ohio back to Dallas.

Tonight, we're learning she was showing symptoms apparently before she went to Ohio for the weekend. That's three days earlier that she was symptomatic. Three days of coming into contact with any number of people both on the ground in Ohio and the on the flight there. The CDC is investigating more on that to nail that down and figure out exactly who she came in contact with.

Also happening now, Nurse Nina Pham, on board a plane, in the air from Texas Health Presbyterian Hospital, here in Dallas, to that special facility at the National Institutes of Health. According to officials they have the kind of expertise in training that simply doesn't exist at this hospital where she works and was infected.

And Nurse Briana Aguirre also works at Texas Health Presbyterian, though her future there now is uncertain. That is because she is speaking out about what she says she saw there. The chaos, the lack of training, the confusing protocols from the CDC, and the risk that she says the hospital exposed nurses to in the isolation ward where Thomas Eric Duncan was treated.

Now we spoke a short time ago along with her attorney, Bob Kelly. And we want to apologize for the background noise. There was a helicopter circling overhead.

(BEGIN VIDEOTAPE)

COOPER: Sabrina, we have been told that for months the CDC was sending out hospitals, bulletins, guidelines, how to deal with Ebola. And I'm wondering if any of that trickled down to your level as a nurse. Did you receive any special training? Did you have mandatory classes? Was there discussion from higher-ups at the hospital about how to deal with an Ebola patient before Thomas Eric Duncan arrived?

AGUIRRE: No one ever spoke to me about Ebola. No one ever spoke to -- I never witnessed any other discussions going on among my colleagues about, you know, what to look for. How to be prepared. There were no classes offered. There were no training offered. There was a -- a seminar, a one-time seminar offered to doctors and nurses. Just --, if you were interested you could take it, go to it. And basically it was offered one time. And it was not suggested that we go. It was just -- here is what we're offering here.

COOPER: You were involved in the treatment of Nina Pham. What was that like? What was the protective gear that you yourself wore?

AGUIRRE: On the day that I took care of her, it was my first time being involved. And the care of any potential or confirmed Ebola case in the hospital, and you know, they asked me if I had been in there -- if I had been trained. I said no, I have not. They said we need someone in there that has been trained. That someone who's been a part of this. Someone who was going to know what to do more.

And they asked for -- who has been trained and the whole room of nurses was silent, indicating that none of them were either going to come forward or none of them were going to admit they had been trained so that they were put in there. And then after that they said we're going to need a volunteer to care. And it was not just Nina, there were other patients that day. We're going to need a nurse to volunteer to care for patients in that area.

Who is going to volunteer? And I said I will. You know.

COOPER: And what was the gear that they gave you?

AGUIRRE: So I went over there in the Infectious Disease Department and I had the -- some representative from the CDC there. Telling us what to put on. And they were going over the different changes they made because, you know, they -- before they were putting on three pairs of gloves, now they're putting on two. And they were saying this is the system we've moved to now.

And it was -- it was a tie-back suit, a white tie-back suit, what I assume was a hazmat suit. It was only available in one size so it didn't fit us all. And other people were given yellow Dupont suits. And I'm not sure which one is superior to another. They were not exactly designed the same. But depending on your size, you know, you had to pick which one -- you know, get one would fit you.

And so we had that suit on. A pair of surgical boot covers that, you know, just cover your shoes. And then a taller pair of surgical boot covers that go up to either mid-calf or almost to my knee. And then we had on a pair of long nitro gloves about to here taped to that tie- back suit. And then another pair of long nitrile gloves on over the top of that so a total of two.

We had had a hood on over our head, both types of suit had a hood on and it just went around here. And it came to a zip at the base of our necks. And we had on a paper machine, which is a form of airborne isolation that is a machine you hook around your waist. It leads by a tube up to a hood that sits on the base -- you know, the crown of your head and those covers your face with a shield and goes under your chin.

And then because the zipper of the suit was a source of you know, contamination we had an apron on, covering that zipper so that no, you know, bodily fluids or anything could penetrate that and go to our under layer of clothing.

COOPER: But your neck -- was your neck exposed?

AGUIRRE: Absolutely, yes. There is a --

COOPER: What part of your neck?

AGUIRRE: Well, the zipper ended about here on me and the hood ended about here on me. And you know, this part right here made a triangle that was open. It was completely open. And the very first time that they were instructing me how to put this on is exactly the very point when I said, why would my neck be exposed? Why would I have on two pairs of gloves, tape, a plastic suit covering my whole body, two hoods.

A total of three pairs of booties, including the one on my tie-back suit, an apron, and my entire body is covered in at least two to three layers of plastic and my neck is hanging out. And I just -- I told them, why would an area so close to my mouth and nose, why would that be exposed?

COOPER: And what did they say?

AGUIRRE: And they didn't have an answer.

(END VIDEOTAPE)

COOPER: They didn't have an answer.

Briana and her attorney had much more to say about what clearly became a nightmarish experience for her. That's next.

And in our next hour, our panel of experts are also going to answer your Ebola questions, tweet them with a hashtag Ebolaqanda.

We'll be right back.

(COMMERCIAL BREAK)

COOPER: Well, before the break you heard Nurse Briana Aguirre describe the chaos, the lack of training and now the lack of transparency at Texas Health Presbyterian Hospital. It's a place she says that she loves, she loves her job there, yet she also says that if she ever comes down with Ebola she would do everything and anything -- her words -- not to be a patient there.

Here is part two of our conversation.

(BEGIN VIDEOTAPE)

COOPER: Did they have a lot of this gear? Or was there any follow-up when you raised objections to, I mean, what is clearly a ridiculous situation, a dangerous situation?

AGUIRRE: I immediately felt like it was ridiculous. And I immediately posed the same question that you are posing to me, you know, asking me right now. I said why, why -- what explanation can you give me or anyone about why we would be in the second week of an Ebola crisis in our hospital and we don't even have the same equipment or protection that is given to sanitation workers that have no contact with patients at all?

And they said we know, we've ordered it. We've ordered -- I mean, I talked to charge nurses, I talked to supervisors. I talked to house supervisors. I talked to the CDC about it. I talked to infectious disease about it. I raised a stink with anyone and everyone. And I said there is no explanation why we don't have it. If -- we're a part of an organization of hospitals.

They could have gone to another one of our THR hospitals and said we have nurses with their necks exposed dealing with a very, very dangerous situation and we will now need your supply to get them in the right hands. And they chose not to do that.

COOPER: I can't believe their response was well, we've ordered it. That is inexcusable.

AGUIRRE: Two weeks? I mean, not to be taken lightly, but I'm sure, I could have ordered that on Amazon Prime and had it in two days. I'm sure I could have at least a box of them or something. I mean, if you can't get them to another hospital, go to a sanitation department that has them and buy them from them and give them to us.

It is just outrageous, and the most outrageous part of it is that every time I think about the facts that I'm saying right now, I just know that the nurses that have been infected -- they were dealing with the same equipment while they were dealing with so much more than I dealt with personally.

They were dealing with an Ebola-positive patient with copious secretions of diarrhea, vomiting, continuous dialysis, mechanical ventilation, all of these dangerous, dangerous medical procedures, and they put their lives on the line without the proper equipment. And there is nothing --

COOPER: You believe Nurse Pham was wearing that kind of equipment when she was exposed?

AGUIRRE: I know she was because the equipment we needed was still on order.

(END VIDEOTAPE)

COOPER: Well, the hospital has not responded specifically to Brianna's accusations, but earlier today they did respond to the broader allegations from that union, National Nurses United.

Now, the hospital says when Mr. Duncan returned to the hospital the second time he was moved directly to a private room and placed in isolation. They also say nurses who interact with Mr. Duncan wore protective equipment consistent with the CDC guidelines at that time.

Joining me again are chief medical correspondent, Dr. Sanjay Gupta, and also Dr. Seema Yasmin, the staff writer for the "Dallas Morning News" and a former CDC disease detective.

Sanjay, what Brianna is saying there, the lack of training, the protective gear with the neck open, and told to put one-inch medical tape on their necks. It is not like hospitals in the United States didn't know Ebola was out there.

And hadn't seen what "Doctors Without Borders" and others were doing to deal with it in terms of protective gear, shouldn't they have been prepared?

GUPTA: No question, Anderson. There are several problems obviously that she outlined really well, two big ones, first of all, the gear itself, what was available, what was not available, the training, putting it on and off. It's not easy. It looks simple, but there are many steps to it that should be trained and drilled.

But the second part of it is that even if you followed the CDC guidelines on Ebola, it left a lot of exposed skin, and that is quite concerning. We've talked about this, Anderson. I think we have a picture. I want to show you.

I got an exclusive look inside what Emory uses to basically try and protect their doctors versus what she was just describing. Take a look. I mean, this is the lead man on the five-member team that has been taking care of patients here at Emory.

They go above and beyond what the CDC recommends. But you can't see his whole body there, but take a look specifically at the neck, take a look at the hood, the face shield. That is the point. You don't want anything exposed.

It is not a respiratory virus so you don't need respirators, but you need what he is wearing there. They have it here. That's what they are wearing and it sounds like she did not.

COOPER: Dr. Yasmin, what do you make of what -- some of what Brianna has said?

DR. SEEMA YASMIN, STAFF WRITER, "DALLAS MORNING NEWS": I think she is a brave woman because she is really speaking on behalf of many health care workers here in the U.S. We've heard from so many that they asked, why are we looking at doctors in West Africa, who were treating patients of Ebola, and we don't see any exposed skin?

They're wearing completely covered body suits. They were wearing hoods and face shields, but yet in the U.S., the guidelines are very piece meal, you put on a mask, a pair of gloves, a gown, and then you may or may not put on a different pair of gloves and the booty. So we're seeing very different guidelines being instituted in different hospital across the U.S.

COOPER: Sanjay, when the head of the CDC was visiting in West Africa, he was not wearing what the nurses in this hospital were wearing. He was wearing that pull protective suit, correct?

GUPTA: Correct. And you know he was doing what all the doctors do there. I should point out that sometimes you hear we're making a distinction. If you have direct contact with the patient, you are actively taking care of it.

It is a different level of protection as opposed to if you're just in the room. Keep in mind, when he was wearing that full content, he was touring in Ebola word. He wasn't actually actively taking care of patients and yet you're just in the room.

Keep in mind when he was wearing the full protective gear, he was touring and yet fully covered head to toe. There is this double standard there. To be fair that may have been the only equipment they had there where he was in West Africa. They may not have had the other options.

But still this is not that complicated if this can transfer through the skin, bodily fluid that's infected get on your skin, you get the infection, you cover your skin taking care of a patient. It sounds silly almost saying this over and over again.

COOPER: And Dr. Yasmin, these nurses, if you're a nurse. Nurses want to help people. You're in a room with a patient, who starts projectile vomiting or you know, diarrhea. They are going to want to try help and the idea that everybody have the same level of protection if they're in the room with the patient seems bizarre to me.

YASMIN: Absolutely. Anderson, they are some of the most hard working people in the hospital and some of the most under-appreciated. They are absolutely there to serve. They want to care for patients and make sure the hospital has their back and they will be safe while they to do their job.

COOPER: And we are going to hear more from Brianna in our next hour on 330. She is worried about keeping her job and we are going to try to get a response from the hospital on that.

Just ahead, what we now know went on inside that hospital and what we now know about nurse, Amber Vinson's trip to Ohio and back right before she was diagnosed with Ebola.

Just this past Saturday, she was planning her wedding in her Ohio hometown. She -- and she flew back Monday, went in the hospital the next day. The latest from Ohio next.

(COMMERCIAL BREAK)

COOPER: Welcome back to breaking news tonight, the 29-year-old nurse who was the most recent person to contract Ebola in the United States might have been having symptoms as far back as Friday.

Tonight, we are also learning more about what she was doing just before she was in fact diagnosed. We know that Amber Vinson lives and works in Dallas, but very recently flew to Ohio where she grew up to visit family and take care of some planning for her upcoming wedding.

She flew back to Dallas just this past Monday. Now, Susan Candiotti joins me now live from Ohio with more on the trip. So you spoke to the owner of a bridal shop that Amber went to last weekend. What did she tell you?

SUSAN CANDIOTTI, CNN NATIONAL CORRESPONDENT: You know, she said, Anderson, that when the bridal party came in, they were there for a fitting for the bridesmaids. And she said that Amber and the group that was with her, Amber Vinson, that they were having a great time.

They were there for three and a half hours and that she showed no signs of being sick at all. So she was really surprised when she heard about this.

COOPER: And I understand she called the health department. What did they instruct her to do?

CANDIOTTI: You know, that is the thing she said that she was the one that first called the health department when one of her co-workers saw this on the news yesterday. And she called the health department first to say what is going on.

But a health department official is saying tonight that they called her first. So there is definitely a disconnect there. She said that she is really unsettled, really, about how the health department had been in touch with her. And they were -- she felt, could have given her better and more advice about what she was supposed to do.

She said that her staff is actually a bit more worried about what might happen next than she actually is. But she wanted to close the shop as a precaution. And Anderson, she told me just a little while ago by text that the health department just left her house and took her temperature for the first time.

Left a thermometer with her, she is supposed to take her temperature twice a day, and Anderson, that they had her walk through exactly what Amber Vinson did with her and where she was in the bridal shop when she was there on Saturday -- Anderson.

COOPER: OK, Susan, thanks very much. Again, this is coming from the CDC based on more interviews they have done with family members and with Amber Vinson. Apparently, these were earlier reports that she may have felt sick or showing some symptoms when she flew to Ohio.

They are trying to follow up more on that. We knew she took a plane to get to Cleveland and then back to Dallas and that certainly now raising questions about the risks of getting Ebola on flights. A lot of people fly.

We're not trying to spread fear. We're trying to spread information and give you accurate information as much as we know. CNN's Dan Simon has some answers for us tonight about that angle.

(BEGIN VIDEOTAPE)

DAN SIMON, CNN CORRESPONDENT (voice-over): Dr. Suzanne Donovan is an expert on Ebola. She recently completed a month-long stint in Sierra Leone, treating Ebola victims.

(on camera): What made you volunteer?

DR. SUZANNE DONOVAN, OLIVE VIEW UCLA MEDICAL CENTER: Well, this is what I do. You know, I'm an infectious disease physician.

SIMON (voice-over): She has come with us aboard a 767 jetliner, now out of service to discuss the risk Ebola could have to the American flying public.

(on camera): So let's say somebody has Ebola and is showing symptoms and you're sting next to them, any chance you can get it?

DONOVAN: I can understand passengers' concern about being exposed, but this is something that is transmitted with direct contact of body fluids.

SIMON: If saliva or bodily fluids gets either on a tray or arm rest and you touch it and then touch your nose or mouth?

DONOVAN: You're bringing out very rare scenarios. I would say you're at a greater risk of driving to the airport and getting in a car accident than being infected with Ebola by being on an airplane.

SIMON (voice-over): Dr. Donovan says Americans have little to worry about, from temperature and symptoms screenings in many African airports to the low risk of coming into direct contact with body fluids of an infected patient.

(on camera): Now let's assume a worst case scenario for a moment. That there is an infected person on board and that person is also showing symptoms. You're the unlucky passenger sitting right next to them.

Even with those circumstances, Dr. Donovan says the risk of you getting the disease is still very low. What about just the fabric on the airplane, say for instance, bodily fluids get on the fabric and seats, what is the probability of you getting it that way?

DONOVAN: It is very susceptible to cleaning agents. So even soap in water in Africa, we use bleach solutions frequently. But even washing your hands with soap and water will kill the virus.

SIMON (voice-over): Ebola is not an airborne virus, so unlike the flue, there is little concern about getting it from someone who coughs or sneezes on an airplane. But the U.N. Ebola chief raises the possibility, however remote that the virus could mutate and become airborne.

DONOVAN: Well, that would be a game changer. SIMON: A game changer because Ebola could become much more infectious, transmitted just like the flu.

DONOVAN: I have seen some of those concerns raised and clearly any virus that became airborne with this type of lethality rate would be concerning.

SIMON: Until then, there seems to be no reason to alter flying habits. Dan Simon, CNN, Victorville, California.

(END VIDEOTAPE)

COOPER: We're going to have more on that whole airborne question because most of the experts I talked to said that is highly unlikely the virus would mutate in that form. We're going to talk about more about that coming up.

As always you can find out more on that specific story at cnn.com. Coming up, just ahead, the type of protective gear that's been keeping so many health workers safe in West Africa. Not what the CDC recommended for health workers in Dallas.

Tonight, somebody who warned the CDC that its guidelines were seriously flawed is speaking out on this program. You will hear from him next.

(COMMERCIAL BREAK)

COOPER: Welcome back. Tonight's breaking news, moments ago, I talked to Briana Aguirre, a nurse at Texas Health Presbyterian Hospital, who is bravely speaking out about what she says are dangerous conditions that she and her co-workers faced for two weeks after Thomas Eric Duncan was admitted with Ebola.

She is not talking about things those first couple of days she is talking about two weeks later. Ms. Aguirre actually volunteered to help care for the fellow nurse, Nina Pham, and she described how the protective gear the hospital provided left her neck exposed.

(BEGIN VIDEO CLIP)

AGUIRRE: The hood was right here, this part made a triangle that was open. It was completely open and they said that what they're doing, and what they have been advising people to do is to go ahead and put however many pieces of tape it takes to cover that hole, to cover that vulnerable spot.

(END VIDEO CLIP)

COOPER: And that is what she did, she used medical tape, one-inch medical tape just to cover that spot. We're going to talk to her more in the next hour.

But now the hospital has said that it followed CDC guidelines and the CDC has acknowledged that those guidelines were inadequate. They updated them actually two days ago. Take a look, on the left side of your screen you can see what the actual guidelines called for. You can see the neck is exposed. On the right, you can see what has been added, a hood that covers the next, a second layer of gloves and leg and shoe coverings.

By the way, that is what groups like "Doctors Without Borders" and others have been using for a long, long time. Sean Kaufman is the president of the Behavioral-Based Improvement Solutions.

He oversaw the infection control at Emory University Hospital where Dr. Kent Brantly and Nancy Writebol were being treated successfully there. No one who cared for them got infected.

Mr. Kaufman is now training health workers in Liberia. I spoke to him a short time ago.

(BEGIN VIDEOTAPE)

COOPER: Sean, I heard you said that earlier that the earlier CDC guidelines were quote, "absolutely irresponsible and dead wrong." Explain exactly what you were talking about.

SEAN KAUFMAN, PRESIDENT, BEHAVIORAL-BASED IMPROVEMENT SOLUTIONS (via telephone): Well, I think it is fair to say Ebola is a virus and there are two ways to look at it. Number one, we interact with it in a laboratory environment and in the other way we interact with it today in a clinical setting.

At CDC, when laboratory scientists worked with Ebola in a very predictable way, there are millions of dollars spent on laboratory equipment and thousands of dollars spent on personal protective equipment.

While the CDC, on the other hand, recommending that we work with patients who are sick with Ebola really recommended that we wear minimum protection, minimum protection in an environment where if a patient is sick, they could have diarrhea and vomiting and bleeding out at any time in unpredictable situations.

And so putting the doctors and nurses in clinical situations with very little PPE is in my opinion, irresponsible and dead wrong.

COOPER: There have been nurses here in Dallas who talked about how their necks were exposed. And Sanjay Gupta put on what the CDC protocol was, the outfit and the protective gear. His neck was exposed.

And in taking it off, too, he ended up with material on his arm and on his neck. So it is not just the limit limitations of the protective gear that they were recommending, but also the guidelines for taking it on and off.

KAUFMAN: If you do not take your personal protective equipment off properly, it will be as if you never wore the personal protective equipment at all.

COOPER: And having somebody watching you, monitor you is critical. I mean, you are teaching that right now at the Samaritans personnel.

KAUFMAN: Exactly. What I'm teaching is not only the proper steps for putting on and taking off the personal protective equipment, but also the fact that look, nurses and doctors are very patient driven. They are focus on the patient.

And if someone is not watching the nurse or the doctor meaning if someone is not watching out for the nurses or the doctors, they can get so focused on focusing on the patient that they forget about themselves.

COOPER: I understand you actually warned the CDC about their guidelines. What was their response?

KAUFMAN: Well, I warned them via e-mail and initially was very well received. They forwarded it I think to the final person where it needed to go and really, CDC just -- they kind of defended what they were doing. They stated that they felt that the protocols were acceptable.

COOPER: And the nurse from Texas Presbyterian or one nurse at least now says that there was no discussion of Ebola protocol before the first patient came in and one optional informational seminar to go to.

If that is true, that to me is pretty unbelievable because, I mean, CDC was warning about this back in August. And obviously, we have been watching this outbreak now for a long time in West Africa.

KAUFMAN: What you're saying to me is the equivalent to saying to a child who does not know how to swim. I'm going to teach you how to swim with a PowerPoint and then simply throwing them in the swimming pool and leaving them by themselves.

They are going to drown. That is not setting your staff up or your hospital up for success. It is a failure in leadership and it is a failure in work force preparedness.

COOPER: We've also gotten reports. I talked to Dr. McCormick who talked to another hospital in Texas and some of the nurses there say they were just shown YouTube videos about protocols. Not actual hands-on training, which again, to your analogy, it is pretty stunning.

KAUFMAN: Yes, Michael Phelps, if he could teach us how to swim with a video then by all means let's train with videos, but the reality is this, Emory University was a complete success in a lot of ways, but primarily because they not only trained and prepared for this event. But they had somebody making sure everybody was doing what they needed to do.

COOPER: Well, Sean, I appreciate what you're doing. You're on the ground there at great risk and I appreciate all your advice and help. Thank you so much.

KAUFMAN: Well, thank you very much.

(END VIDEOTAPE)

COOPER: We're going to have much more on the Ebola crisis in the next hour of 360. We are live all through the next hour. Our breaking news, Nina Pham, the first Dallas nurse diagnosed with Ebola is on a flight right now headed for the National Institutes of Health facility in Bethesda, Maryland.

We expect her to arrive there soon. We'll bring that to you when it happens. Stick around. We'll be right back.

(COMMERCIAL BREAK)