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The Lead with Jake Tapper

Will Ebola Patient Be Prosecuted?; White House Update On Ebola Response

Aired October 03, 2014 - 16:30   ET

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

JAKE TAPPER, CNN HOST: Welcome back to THE LEAD. I'm Jake Tapper. Continuing with our World Lead. Health officials now closely monitoring 50 of the people who came in contact with Thomas Eric Duncan since he arrived on American soil, many still wondering how did he make it through all the screening?

Each person leaving Liberia must fill out this health questionnaire. According to officials there, Duncan lied on his form, specifically to this question, have you taken care of an Ebola patient? Tom Duncan checked no.

But we have learned that he provided care for a pregnant woman with the virus. Liberian President Ellen Johnson Sirleaf told Canadian public broadcaster, CBC, the fact that Duncan knew he'd been exposed to the virus and left the country is unpardonable, she said.

Now Liberia says it may take action against him. Joining me now to discuss is the Liberian ambassador to the United States, Jeremiah Sulunteh. Mr. Ambassador, is Liberia going to prosecute Thomas Eric Duncan for what he wrote on that health form?

JEREMIAH SULUNTEH, LIBERIAN AMBASSADOR TO THE U.S.: I'm very happy to be here at this time. Our hearts are broken to be able to witness this reckless behavior on the part of Duncan, the fact that he lied to airport authority, that he lied that he'd ever got in touch with anybody infected with Ebola is just a shame.

And the government is taking it very seriously. The government has come out to say that he violated the public health law and it's punishable. But we want to say on behalf of Liberia and the Liberian people that we are truly sorry for this kind of behavior.

That such a person would be able to infiltrate and bring this to a country that has been helping us, that has been there all the way for us.

TAPPER: Have you spoken to Mr. Duncan? Does he have an explanation at all?

SULUNTEH: No, I haven't been able to get in touch with him or any of his family.

TAPPER: What do you say to those who might say you're blaming a victim here, he is suffering from this life-threatening disease and you're talking about prosecuting him?

SULUNTEH: Well, I think we should be honest with ourselves. The government has come out and declared a state of emergency and informed everyone that if you have any feeling of fever, report yourself to a containment center, go to the hospital or identify yourself to be treated.

And knowing that he has interacted with an Ebola patient and decided to travel, not only that, filling in the form at the airport, he denied ever getting contact with an Ebola patient, it's just shameful.

TAPPER: There are some in this country who say that travel from Western Africa from these countries affected, Liberia, Sierra Leone, et cetera, should be cut off until this crisis is over. The U.S. government has said it has no intention of doing that.

I know Liberia opposes it. What more steps, if any, do you think Liberia and Sierra Leone and the other countries affected need to take to make sure that this virus does not spread outside Western Africa?

SULUNTEH: Well, Jake, we want to, again, appreciate the international community, I want to appreciate the U.U. government and the friendly people of the U.S. for the support for us even before the Ebola, the American people are always been there for Liberia and we truly appreciate what they are doing.

We have been advocating that we can isolate Ebola, but you cannot isolate a country that's affected. I think what needs to be done is a tighter effort on the part of this government to make sure --

TAPPER: Part of the United States or part of --

SULUNTEH: No, Liberia. The Liberian government or any other place that is affected.

TAPPER: Do you think people -- your country screens individuals to see if they have a fever. You put a thermometer up to her heads to see if there's any fever. We do not do that with people arriving from Liberia. Do you think we should be?

SULUNTEH: Well, I think the first thing is the source of the disease should be the primary area to start the process. If we can do our homework and do it very well, if Duncan had not lied, this thing would not have happened.

TAPPER: Mr. Ambassador, thank you so much. We do have some breaking news we want to report right now.

SULUNTEH: Thank you very much.

TAPPER: Breaking news, I wish it was good news, but it's horrific news in our world lead just minutes ago, the terrorist of ISIS released a video that appears to show the execution of yet another western hostage, British aid worker, Alan Henning.

The video also directly mentions President Obama bombing in Syria. This would be the fourth known hostage to be executed by ISIS and the terror group is threatening that an American is next, an American is next.

Jim Acosta is at the White House briefing room where they are preparing for an Ebola press conference. But obviously, Jim, it's one crisis to another, even though the president wants to talk about good economic news.

Now we have an Ebola press conference that might be upstaged by this horrific news of another beheading of a British hostage with an American being threatened next -- Jim.

JIM ACOSTA, CNN SENIOR WHITE HOUSE CORRESPONDENT: That's right, Jake. And we should point out that Lisa Monica, who is the president's counterterrorism and homeland security adviser, she's going to be leading this news conference here in just a few minutes here in the White House briefing room.

The president, as you know, is in Indiana right now. She was slated to talk about the Ebola response here in the U.S. and what's happening in West Africa. She's going to be joined by the Health and Human Services Secretary Sylvia Matthews Burwell and the head of the NIH, Dr. Fauci.

But Jake, obviously because this is a news conference and reporters will be asking questions, I think it's quite likely that Lisa Monica will be asked this question about this apparent beheading video. And obviously this is going to be another challenge for this administration.

Because with an American being threatened next, the president just can't seem to be able to escape what is a very, very serious foreign policy challenge and that is ISIS apparently, despite about a month of bombings in Iraq and now in Syria, is still doing what it has been doing for several months and that is terrorizing Americans with this kind of horrific violence.

TAPPER: This would be -- here we have the authorities -- the White House officials. They're going to be addressing the U.S. government response, the Obama administration response to the Ebola crisis.

LISA MONACO, ASSISTANT TO THE PRESIDENT OF HOMELAND SECURITY AND COUNTERTERRORISM: Good afternoon, everyone. Thank you for joining us here this afternoon. As you all can see, I'm joined here by a number of senior leaders in the United States government addressing this response. Let me take a minute to introduce them.

With me this afternoon is the Secretary of Health and Human Services, Silvia Burwell. Also with me is Dr. Anthony Fauci, from the National Institute of Health, Administrator Raj Shah from the U.S. agency for International Development and finally General David Rodriguez who is a commander of U.S. forces, Africa Command.

As the president has said, we are not facing just a health crisis, we are facing a national security priority and it's one that he has instructed his team is as important as any threat we're facing. Since this outbreak began in March, the president has directed that we scale up our response both here at home and in the countries affected in West Africa. And that's exactly what we've done.

Most recently by deploying United States military members to Liberia and to the region to support civilian efforts on the ground. Today, we are using a whole of government approach and response to control this epidemic at its source.

And that's evidenced by the people who are here with me today at the podium. We're doing a number of things to address this epidemic. At its source in West Africa, first and foremost. We are also enhancing our domestic preparedness and ability to respond to isolated cases here in the United States.

And as importantly, we are rallying the international community to contribute to this response. And that was seen most recently when the president spoke at the United Nations last week and when we had an unprecedented vote in the U.N. Security Council to contribute and to show galvanizing forces of the international community to contribute to this response.

The strategy of the United States is executing has four key goals -- to control the epidemic at its source in West Africa, to mitigate the second-order impacts of this epidemic, to lead a coordinated international response and to build a robust global health security infrastructure so we are prepared over the long run to confront epidemics such as the one we're facing today.

I think it's very important to remind the American people that the United States has the most capable health care infrastructure and the best doctors in the world, bar none and it's why people travel from all over the world to receive medical care here in the United States.

Finally, I want to emphasize that the United States is prepared to deal with this crisis, both at home and in the region. Every Ebola outbreak over the past 40 years has been stopped. We know how to do this and we will do it again.

With America's leadership, I'm confident and President Obama is confident that this epidemic will also be stopped. So with that, let me turn the podium over to Secretary Burwell.

SYLVIA BURWELL, SECRETARY, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES: Thank you, Lisa. Since the outbreak began, the United States government has been engaged in preparation both at home and abroad to protect our homeland and stop the epidemic at its source.

We've been working for many months to ensure that the United States is protected. CDC sent out our first guidance to state and local officials on July 28th and it's been followed with six additional sets of guidance and the latest was just issued yesterday.

In addition, we have enhanced our surveillance and laboratory testing capacity in states to make sure they're able to detect cases. Been in regular and repeated contact with state officials and health departments, including developing guidance and tools for departments to conduct public health investigations.

We're continuing to provide guidance for flight crews, emergency medical service units at airports and Customs and Border Patrol officers about reporting ill travelers to the CDC.

And we're continuing to work with hospitals and health care workers around the country to prepare most effectively both in terms of detecting symptoms and then responding appropriately.

As we saw just a few months ago, almost two months ago, in Carolina's Medical Center in Charlotte, North Carolina, and at Mount Sinai in New York, hospitals and health care systems reacted and took appropriate steps.

Fortunately in those cases, the cases were not positive. We saw Emory's ability to handle the first cases that returned from West Africa followed by the Nebraska Medical Center's ability to do the same.

In Dallas, the public health system is now handling the case with the protocols that we know control this disease. We recognize the concern that even a single case of Ebola creates on our shores.

But we have the public health systems and the public health providers in place to contain the spread of this disease. We've taken a number of precautions to prevent the spread.

We've instituted exit screening procedures in West Africa to prevent those who have been exposed to Ebola or are sick with Ebola from traveling. The Department of Homeland Security is in the process of advising all travelers returning to the U.S. from countries with Ebola outbreaks in West Africa to monitor their health for 21 days and to immediately seek medical help if any symptoms do develop.

The Centers for Disease Control stands ready as it has in Dallas to deploy expert teams when needed. Finally, our scientists at the Food and Drug Administration and the National Institutes of Health are working tirelessly to develop new vaccines and treatments for Ebola.

We remain focused on working with our partners on the ground to stop the epidemic at its source and we're continuing to take the necessary precautions across the United States government to prevent the epidemic from spreading further.

And I'd like to now turn to Dr. Tony Fauci, who is the director of the National Institute of Allergy and Infectious Diseases at the NIH to talk a little bit about epidemiology.

DR. ANTHONY FAUCI, NATIONAL INSTITUTES OF HEALTH: Thank you very much, Secretary Burwell. I'd like to provide some basic, but important facts about Ebola and its transmission. Although Ebola is an extremely serious viral disease with a high fatality rate, it is not easily transmitted.

Specifically the Ebola virus is not easily spread like a cold or influenza. You must come into direct contact with the bodily fluids of a sick person or through exposure to objects that have been contaminated with infected bodily fluids.

Ebola is not a respiratory disease like the flu so it is not transmitted through the air. This is important. Individuals who are not symptomatic are not contagious. In order for the virus to be transmitted, an individual would have to have direct contact with an individual who has experiencing symptoms or who has died of the disease.

We have considerable experience in dealing with Ebola both in controlling and in preventing outbreaks. This is based on experience with almost two dozen outbreaks in Central Africa since the virus was first isolated in 1976.

The key elements to that control and the prevention of outbreaks when Ebola rises in a community is to first identify cases, isolate them, care for them under conditions that protect the health care workers and importantly perform contact tracing.

People in direct contact with a sick Ebola patient should be monitored for symptoms for at least 21 days. If no symptoms arise, the individual is cleared. If symptoms arise, the person is appropriately isolated and cared for. This formula has worked very well over many years.

The situation in West Africa has been very difficult largely due to the lack of an adequate health care infrastructure to deal with the outbreak. And so I want to reiterate what the secretary said. Our health care infrastructure in the United States is well-equipped to stop Ebola in its tracks.

As the secretary said, in addition to managing the issues associated with containing the situation in Dallas as it exists today and addressing the very dire situation as it exists in Africa today, we are working very aggressively and energetically to develop and test a vaccine to prevent Ebola and therapeutics to treat it.

And now I'd like to introduce Dr. Raj Shah, the administrator of USAID.

DR. RAJ SHAH, ADMINSTRATOR, USAID: Thank you, Dr. Fauci. I'd like to take a moment to describe the effort in West Africa, which as has been noted includes a major effort to control the disease, includes specific actions to deal with the secondary impacts of the crisis in several West African countries.

Including making food, water and government support more available and the effort to build out an international coalition as Lisa previously discussed.

Our response in West Africa started in the spring and accelerated dramatically over the summer. This coordinated civilian response included the largest-ever disaster assistance response team from USAID, the largest-ever more than 100-person centers for disease control disease control capability deployed to Liberia, Sierra Leone, Guinea and countries throughout the region. And efforts partnering with our Department of Defense colleagues to more than double the laboratory and diagnostic capacity in West Africa to ensure that cases could be identified and positively confirmed.

Since that time, we've helped deliver more than 120,000 sets of personal protective equipment, built out Ebola treatment units, provide technical assistance for airport screening throughout the region and increased the basic capacity of what has been a weak existing health care infrastructure to deal with this disease.

As the president noted in his comments at the Centers for Disease Control a few weeks ago, our strategy now is clear. First, we're investing in a strong incident command system at the national and local level throughout the region to identify cases and trace contacts.

Second, we're building out Ebola treatment units so that enough bed capacity exists for as many positively identified patients as possible to receive isolation and treatment. We are on path to put in place the WHO plan of more than 2,800 beds in Liberia, according to their time line.

And just in the last ten days, have seen significant new Ebola treatment capability come online, including the largest Ebola treatment unit in Liberia, the New Island Clinic, which we helped build and staff.

Third, we're engaging in an extensive community care strategy that includes 10 to 20-bed community care center units that are placed throughout rural communities in particular to help isolate patients in those communities and support the distribution of hygiene and protective equipment kits so families can protect their patients and their families.

We've distributed more than 9,000 of those kits together with UNICEF and the World Health Organization and are on path to have about 10,000 arrive in country and be distributed through Liberia on a weekly basis.

In recent days, we've been successful in scaling up the effort to reach -- identify, reach and in a safe and dignified manner deal with bodies of patients who are deceased from Ebola.

We now have more than 50 safe burial teams with full protective equipment and careful protocols in place. And we're noting that more than three-quarters of all bodies in Liberia of positively identified patients are now being cleared safely within the 24-hour period.

This is critically important because that is an important existing mode of transmission. I'd further note that the scale-up of Centers for Disease Control and USAID efforts through June and August was quite significant.

But the complexity of building out Ebola treatment units and providing the logistics support in terms of protective equipment and medicines required the significant additional resources brought by the Department of Defense and announced by President Obama.

So I'm pleased to introduce General David Rodriguez, the commander of Africa Command to describe those specific efforts. Thank you.

GENERAL DAVID M. RODRIGUEZ, COMMANDER, UNITED STATES AFRICA COMMAND: Thanks, administrator. As we deploy America's sons and daughters to support the comprehensive United States government effort led by the United States Agency for International Development, we'll do everything in our power to address and mitigate any potential risk to our service members, civilian employees and their families.

As Administrator Shah mentioned, the areas that we're focusing on are command and control and that is to help support and coordinate the efforts of both USAID and the international community. We are also working on training, training the people who man and manage the Ebola treatment units.

We're supporting the engineering efforts to build out the Ebola treatment units and we're also doing an effort in the area of logistics, which this is a tremendous logistics effort, as the administrator pointed out.

For our soldiers prior to deployment, we'll provide them the best equipment and training that we can. We're assessing risks based on the service members' missions, activities and execution of their operations.

We're implementing procedures to reduce or eliminate the risk of transmission as service members go about their daily missions, including the use of personal protective equipment, hygiene protocols and monitoring.

Prior to redeploying service members back home, we will screen and identify anyone who faced an elevated risk of exposure. We will take all necessary steps to minimize any potential transmission in accordance with the international standards that our medical professionals have given us.

In the end, our equipment, training, procedures and most of all the discipline of our leaders and our force will help us to ensure that our team accomplishes its mission without posing a risk to our nation and our fellow citizens. Thank you.

MONACO: Thanks very much, General Rodriguez. First, I want to thank the folks who are with me at the podium. But most importantly, the dedicated military, medical and development professionals that they represent and who are working so hard in this problem. I think with that, we're happy to take your questions.

UNIDENTIFIED MALE: Talking about giving -- why not do some more active screening like ask people, have you had a fever, have you been in contact with people? That's been done in some countries in other circumstances. You would think it's a reasonable thing to do.

MONACO: I think this goes directly to what Dr. Fauci talked about, which is this -- we are taking steps to address the source -- people coming from the source countries. We think those are the most effective steps we can take. The temperature testing, the questionnaires, the testing for fever and making sure that people who are symptomatic.

And as Dr. Fauci has said and Dr. Tom Frieden has talked about this repeatedly, you cannot get Ebola other than from direct contact with bodily fluids of somebody who is at that time symptomatic. So the most effective way to go about controlling this is to prevent those individuals from getting on a plane in the first place.

I think it's important to remember that since these measures have been in place, dozens and dozens of people have been stopped from getting on flights in the region.

UNIDENTIFIED MALE: But we now know people have gotten on planes anyway. So why not have the U.S. Customs and Immigration people asked them -- clearly, it's not been effective to do it just on the African side.

MONACO: We've had an individual in Texas who did come to this country and later became symptomatic and that person is now being isolated and dealt with and significant contact tracing is being done.

Now, your question about passive versus more active screening is an understandable one. But as Secretary Burwell indicated, we've taken a number of steps to ensure that customs and border patrol individuals -- teams are trained to identify symptomatic individuals.

And where they do present people who may be symptomatic, they have instructions about what to do and how to handle that. Now, all of that which is to say that we are constantly going to evaluate what may be the most effective measures we can take.

Secretary Johnson is constantly evaluating that with his team and in consultation with the medical professionals. Right now, the most effective measures are focusing at the source countries and taking the steps, the very concerted training and precautionary measures and notification measures that we've taken with the folks here on the receiving end.

UNIDENTIFIED FEMALE: Talk in broad terms about hospital procedures -- obviously in Dallas there have been breakdown. I'm wondering specifically lessened learned from the Dallas situation. Tell us what the U.S. knows about the latest video we heard about the hostage --

MONACO: Let me address that and then ask Secretary Burwell and Dr. Fauci to address the medical measures in Texas within the constraints that I'm sure you understand they'd be operating in.

We are aware and have seen and are evaluating the newest video. If it in fact proves to be authentic, it is yet another demonstration of the brutality of ISIL. And our hearts go out to the British aid worker who we believe is in that video and to the remaining hostages and to their families.

This is, again, yet another just very clear example of the brutality of this group and why the president has articulated and is moving out in a comprehensive way to degrade and destroy ISIL. Let me now turn to my colleagues on the latter part of your question.

BURWELL: With regard to the efforts that the CDC is pursuing and that we've been pursuing, we've had the efforts in Charlotte. We saw the system work in Mount Sinai. We have a case here, Howard, the question there. The systems are in place. We continue to communicate and to give good instruction.

It's important to reflect on whatever lessons we learn, we build and incorporate. We are making sure if there are any lessons learned going forward, we will continue to incorporate those.

UNIDENTIFIED FEMALE: What's the lesson learned from some of these failures in Dallas and how you may be changing or modifying any lessons --

BURWELL: What we know are the critical steps that we have said throughout the process. That is about identification and identification at the point at which there actually is a temperature and as Dr. Fauci said, when something can be done.

What we are doing is making sure that hospitals, health workers across the country know that when they see that, what steps to take, how to isolate and what to do immediately when they see those steps. We'll continue to do that and make sure that we are responding to the questions we're getting from the community.

ACOSTA: What about the case -- potential case, Howard University, is there any new information about that? And to Dr. Fauci, if it doesn't spread like the flu or a cold, why is it spreading so quickly and are you confident we won't see an outbreak in the U.S.?

BURWELL: With regard to the Nigeria case, haven't seen the results of the test yet. That's the most definitive thing and the most important thing. What you see is people taking precautions because the symptoms are malarial. We believe it's the right thing to do.

CDC gets contacted, we make a determination and work with the community and the health center in this case to do the test. When we get that definitive, in each of the cases, we make public as quickly as possible what we know about that.

UNIDENTIFIED MALE: Also a patient is being tested at Shady Grove Adventist, I'm led to believe. I'm being informed of all these suspected cases.