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The Lead with Jake Tapper

CDC Press Conference; Update on Possible New Ebola Patient

Aired October 08, 2014 - 16:30   ET

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

UNIDENTIFIED MALE: There has been a major effort from the U.S. and other partners. We hope and expect to see more resources coming in from countries around the world matching the kind of leadership that the U.S. is showing. Right now the biggest challenge is getting the resources needed to the front lines where they are most needed.

We'll go to the phone for a few questions.

UNIDENTIFIED FEMALE: Hello, next question. It's from Marilyn Martian from the Associated Press.

UNIDENTIFIED FEMALE: Hi, thanks very much. I wanted to ask about this situation in suburban Dallas. Dr. Frieden, you said the person does not have definite contact with Ebola or definite symptoms. Did he or she have possible contact and was this person among those you are tracking already and is CDC involved in this case?

FRIEDEN: You know, since it's an emergent situation I really would have to refer you to Dallas. Often in situations like this information may change from minute-to-minute, but I would just reiterate what I said earlier. We don't have a concern for symptoms consistent with Ebola or for definite contact as far as everything that I have learned up to a few minutes ago.

UNIDENTIFIED FEMALE: Thank you.

FRIEDEN: Next question on the phone.

UNIDENTIFIED FEMALE: The next question is from Lenora Ayala (ph) from Telemundo Network.

UNIDENTIFIED FEMALE: Hi. My question is more of regarding air travel and the new procedures for these five different airports. Is there a special procedure that - or any guidance given to the airlines when thinking about cleaning an aircraft that has just arrived from West Africa? Is that a necessary precaution to take and if so, can you explain what the airline should be doing in that regard?

FRIEDEN: CDC has detailed the guidelines and works very closely with the airline industry. There are guidelines if there were to be a patient potentially with Ebola for enhanced cleaning of the airplane. Deputy Secretary Mayorkas says, is there anything what you would like to add?

UNIDENTIFIED MALE: I do not. Thank you, Dr. Frieden.

FRIEDEN: In the room, then? (INAUDIBLE) people who haven't yet asked questions.

UNIDENTIFIED FEMALE: Sarah Wheaton (ph) with Politico. You noted that earlier diagnosis increases the chance of survival and so, given the delay and the diagnosis of the Dallas patient did that lead or did that contribute to his death and also it's still ambiguous what the communication failure was at that hospital and so how can Americans be confident that other hospitals are not going to make the same mistake?

FRIEDEN: I can't comment on what might have happened with an individual patient, but one of the things that we're working hard to promote now is ensuring that doctors and nurses, pharmacists, health care workers throughout the health care system think Ebola in anyone who has fever and ask whether they have been in West Africa in the past 21 days and that's really important because that will help us ensure that if there is another patient who arrives they're rapidly identified for their own sake and their care and for the community's sake to isolate them promptly.

UNIDENTIFIED MALE: (INAUDIBLE), CNN, just following up on Marilyn's question a bit. We've heard a little bit about who this person is in Frisco, Texas. Just to clarify, the 48 people that were contact, either high or low risk, are all 48 of those, have they - are they being monitored with the personal, in-person temperature checks and if this person was not one of them they would not be getting those checks. Is that fair to say?

FRIEDEN: In Texas, very intensive work has gone on to identify everyone who had -- appears to have had definite contact with the indexed patient and everyone who might have had contact with the indexed patient. That identified ten people with definite contact and 38 in whom contact could not be ruled out. For those 48 people every one of them has been identified, monitored every day with someone from the public health system measuring their temperature with an accurate device. None of them have had symptoms. None of them have had fever. There have been rumors and concerns of other contacts or other cases and none of those have panned out. I understand that there is a situation now that's being assessed. Again, the latest information we have is no definite contact, no definite symptoms. Who is next?

UNIDENTIFIED FEMALE: Tammy Libby (ph), CNN Money. Two questions. One is that Duncan didn't have a fever when he was questioned and he lied about his contact. So would our screening process now be effective in catching him today? And second of all, can you talk a little bit more about what cost the $40 billion in the SARS epidemic and what we're doing to prevent that type of needless problems today?

FRIEDEN: So, it is true that the indexed patient when he left Africa didn't have a fever and we think he didn't have a fever when he arrived here. He became sick four days after arrival. These additional questions may have identified him as a contact interviewed by CBP, customs and border protection, after arrival in the U.S. We're looking at every step that can be taken to increase the likelihood that if somebody arrives and develops Ebola they will be rapidly diagnosed and isolated.

In terms of the costs of SARS, many of those costs were related to people canceling travel to trade restrictions or to trade that didn't occur and I have to say I've spoken with business leaders who have emphasized to me that there are so many misconceptions about Ebola that they're already seeing things like a reduction in investment in parts of Africa that are not in any way, shape or form involved in an Ebola outbreak. So we're concerned that if we don't ensure that we focus on what works and do that well, we may have that same kind of unnecessary and counterproductive cost here. On the phone, please.

UNIDENTIFIED FEMALE: Our next question is from Ana Alimendrola (ph) from "Huffington Post."

UNIDENTIFIED FEMALE: Hi. I wanted to ask a question about the difference in care between Thomas Eric Duncan and Kent Brantley's, but I think you've already addressed that you're referring all of those questions to the hospital, is that correct?

FRIEDEN: Yes, I would just comment that each patient situation is different. Unfortunately, Zmapp which is a promising, but unproven experimental treatment for Ebola is not available. There is, as far as we understand no more of it in the world and while people are working hard to manufacture more it takes a long time to develop. Other medications, it's really up to the treating physicians and the family whether or not to use. So that's all I would have to say at this point. Next question on the phone?

UNIDENTIFIED FEMALE: Our next question is from Jack Nigus (ph) from "Wall Street Journal."

UNIDENTIFIED MALE: Hello. Are these announced measures the extent of the new screening protocols or is there more to come - screenings for outbound travelers in West Africa or further screenings for those travelers or for other ports of entry here in the U.S.?

FRIEDEN: First off, screening of outbound travelers is already under way. It has been for some time. Every person leaving has their temperature taken with an FDA-approved device. Every person leaving is monitored for fever and over the last two months we've identified 74 with fever and three others with symptoms that resulted in them not boarding the plane. So outbound travel is being monitored now. We're always looking at all of the programs that we're implementing to see how they can be better or more effective. One of the things that we'll be looking at in the coming days is how the pilot goes or how this program goes, starting in JFK and rolling out to the other four airports and thinking about what else can be done as we continuously work to increase safety of the American people.

UNIDENTIFIED MALE: OK. Thank you. Just one follow up. You mentioned yesterday and I know you've done screenings for outbound travelers, but you would mention maybe strengthening those outbound screenings. And one other quick followup, how will passengers to be screened be identified particularly if a traveler's original flight out of West Africa is a separate booking from the U.S. - bound flight, that original flight will not shop up on the itinerant data provided to CBP.

FRIEDEN: Deputy Secretary Mayorkas, would you like to respond?

ALEJANDRO MAYORKAS HOMELAND SECURITY DEPUTY SECRETARY: Yes, thank you very much, Dr. Frieden. And if I can just add something in response to the immediately preceding question that we are working very closely together across the administration, and we will continue to assess the risk, you know, of the spread of Ebola into the United States and take additional measures as necessary to protect the American people. I think it is very important to emphasize the point that Dr. Frieden made which is we are continuously assessing the situation and taking the measures that we deem necessary. We have in our screening capabilities the ability to identify individuals' travel not only with respect to the last point of departure, but at the point of origin and so that we can, in fact, identify the full journey of the individual arriving in the United States. Thank you, doctor.

FRIEDEN: In the room?

UNIDENTIFIED FEMALE: Yes, hello, I'm Wendy Corona with WSBTV. My question to you is the goal has always been to stop the outbreak at the source. We are seeing that that's not the case anymore. Ebola was identified originally decades ago. What can you tell us then? Is this a new day for the U.S.? Is Ebola here, in essence, as one of our viruses and diseases that we need to keep an eye on?

FRIEDEN: We have stopped every Ebola outbreak until this one. This is an unprecedented outbreak in West Africa. We are surging the response with the whole of government approach from the U.S. and the global community. It's going to be a long, hard fight, but we remain convinced that we can contain the outbreak in West Africa. If we fail to do that then it would be a very different situation because it could spread to other parts of Africa and could be a longer term risk to us here now, but as of today the only patients with Ebola in the U.S. are in hospitals. The only risk is among people who have returned in the last 21 days and it is important to put into perspective what the risks are. Ebola is scary. It's a deadly disease, but we know how to stop it and we're stopping it in West Africa, community by community. Dallas is doing an excellent job of tracing contacts to stop it there and health care workers throughout the U.S. need to think, Ebola in people who have fever and have returned from each -- or any of these three countries in the past 21 days.

Two more questions and then we're going to stop. I think, sir, you haven't had a chance.

UNIDENTIFIED MALE: Doug Stauter (ph) with NBC News. Earlier today the CDC sent out some strict guidelines for the handling of human remains of Ebola patients. Can you expand on some of those guidelines, the seriousness of them, and if the CDC will be playing a role with the Dallas victim.

FRIEDEN: Yes, as in Africa, we are concerned that handling of individuals who have passed away from Ebola is a very high-risk procedure. The way Ebola works, is if you're exposed, but not sick you have no ability to pass it on to others. As you begin to get sick and you have a fever, you may be able to pass it on to others and the sicker you get, the higher the amount of virus in your body and when someone dies from it there are large quantities of virus. So we have worked very closely with the authorities in Texas to ensure that respectfully and with the ability of the family to view the body, the patient who died earlier today, his human remains will be safely removed and safely handled so that they will not present a risk to anyone in the family, to anyone in the health care system or to anyone who is participating in the process of burial. We have one last question and that will be back to the beginning.

UNIDENTIFIED MALE: Christopher King with CBS 46 here in Atlanta. Again, we already know about Nancy Writebol and Kent Brantley, but there was another patient who is brought here to Atlanta about a month ago. What happened to that patient and can you tell us who the patient is?

FRIEDEN: We don't reveal information about individual patients. We certainly provide detailed consultation from CDC on every single patient who we find, every single patient who might have Ebola so that we can provide that expert consultation and ensure that they get the care that's available here. So just in wrapping up, I would like to thank all of you for your interest. I'd like to remind us of the tragedy of Ebola for the patient's family in Dallas and for the thousands of families throughout West Africa that have been dealing with this terrible disease for the past six months. I would like also to thank the Department of Homeland Security and Deputy Secretary Mayorkas for their partnership in this, and for customs and border protection and the commissioner there Gil Kerlikowske, with whom we work very closely and have a very productive relationship and remind us that the bottom line here is that we're stepping up our efforts to protect Americans, that we will always look at what works. We'll continuously evaluate it and consider what more we can do to keep Americans safe understanding that as long as Ebola is spreading in Africa, it will remain a risk here. We will do everything we can both to stop it at the source and to protect Americans here. Thank you very much.

END VIDEO CLIP)

TAPPER: That was Dr. Thomas Frieden, the director of the Centers for Disease Control talking about steps that the United States government and the Obama administration are taking to try to stem the possible importation of the Ebola virus from individuals coming to this country. Additional screening at several airports that constitute the ones that take in the bulk of those traveling from Western Africa.

Let's go back to Dallas right now where we are awaiting news about a possible second Ebola case. Possible. There has been no confirmation yet. Elizabeth Cohen is outside the hospital of Texas Health Presbyterian Dallas. And Elizabeth, what more do we know about the hospital? We understand that Dallas county sheriff's deputy may be the patient in question.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Right. That is what we understand. And we know the three deputies from Dallas County escorted a health official from the county when he went on Wednesday last week to hand over orders to the family to stay in their apartment. So, again, the health official went to hand over those orders and was escorted by three deputies.

Now we don't know if this patient who walked in is one of those three deputies. What we do know is that a -- that this patient showed up at an urgent care center in Dallas and was showing signs and symptoms of Ebola and claimed to have contact with Dallas, quote, "patient zero."

Now it would seem that patient zero would be Duncan himself. As far as we know these deputies did not have contact with patient zero. They escorted an official to hand orders to the family who are perfectly healthy. So it is unclear what deputy would have had contact with Duncan himself. He's been in the hospital, of course, for quite some time.

TAPPER: Of course, Elizabeth, last week some of the Dallas County sheriff's deputies publicly expressed concern about going into Thomas Eric Duncan's apartment without protective gear, talking about how they did have contact with light fixtures, other items in the apartment. Now the medical community has said that Ebola can be contracted from bodily fluids. There were reports of vomit outside Duncan's apartment.

I'm wondering just how serious the concerns are that if Duncan was in that apartment, was sick, he obviously died of Ebola today, how -- I'm sorry, Elizabeth. I'm going to interrupt myself right now. We're going to go to Frisco to learn -- Frisco, Texas, outside Dallas, to find out more about this patient.

MARK PILAND, FRISCO FIRE CHIEF: That dispatch was based upon some preliminary criteria. The CDC puts out that all heath care facilities, urgent care facilities the hospitals are using currently to screen patients that present certain types of symptoms. At the time we've been training for this type of event in Frisco Fire Rescue, since the outbreak of Ebola in West Africa some weeks ago.

We sent the appropriate response which includes our medic unit, two or three field supervisors and members from our hazmat materials team that are equipped to wear protective clothing in dealing with patients not just Ebola but also patients that also have other infectious diseases.

At that time our units got on the scene. We made contact with CareNow officials and their physicians and their staff members. Our medical director who actually happened to be here during a meeting was also on the scene, Dr. Mark Gamber, who is the medical director for Frisco Fire Department, based upon consultation with the staff we transported the patient to Texas Health Resources in Dallas.

This patient had reported that they initially had been in the apartment in the initial Ebola patient in Dallas and had some contact with family members. I'd like to emphasize that at this time our information is they had not had contact with the patient, but family members and they had also been inside the apartment. After transport, our paramedics are currently being decontaminated at

Texas Health Resources in Dallas. We also have members from the Denton County Public Health Department epidemiologist and in consultation with the Centers for Disease Control, they're advising on the proper decontamination procedures of our fire fighter medics as well as our medic unit that are still currently at the hospital.

At this time I would like to introduce our mayor of Frisco, Mayor Maso, for some comments.

MAYOR MAHER MASO, FRISCO, TEXAS: Thank you, Chief. I'll keep my comments very short. As you all are aware, you have most of the information that we have currently and while we are being told the risk is minimal, over an abundance of caution we are taking several actions to make sure that the public health safety and welfare is protected.

We will communicate any information we receive as soon as we receive it, but again, we are being told by the agencies we are in contact with, which is both the local, the counties, the state and the federal health agencies that the risk is minimal, but again we are taking all precautions. So we will take some questions. Our chief will attempt to answer any questions you have for him.

PILAND: As the mayor said earlier, a lot of this information is coming in quickly. Obviously, we'll just post about three hours, post the call. Again, I think it was just based upon the screening criteria from the CDC.

(INAUDIBLE QUESTION)

PILAND: No. We don't have that information.

(INAUDIBLE QUESTION)

PILAND: I do not.

(INAUDIBLE QUESTION)

PILAND: That's also information that we don't have right now.

(INAUDIBLE QUESTION)

PILAND: Well, no. It's a sign the CDC puts out of Ebola, which you have nausea, vomiting, headache, some fever, diarrhea. I would indicate that this patient was not experiencing all of those symptoms, just a few, but again based upon screening criteria from the CDC, the treatment tends to be based more conservative at first.

(INAUDIBLE QUESTION)

PILAND: Well, that's certainly a call the patient has to make.

(INAUDIBLE QUESTION)

PILAND: Again, we really don't have that information and it's our understanding the person was in the apartment and had contact with family members from the Dallas patient. That's all we know.

(INAUDIBLE QUESTION)

PILAND: At care now? We have -- on the scene we have public health officials and epidemiologists from the -- Denton County Health Department as well as Collin County Health Department, and they have been in contact with the Centers for Disease Control. Based upon the low-risk nature and their opinion of the patient, all the hospital staff which was a doctor and several nurses along with people that were actually in the waiting room have been released.

They've reversed treatment. They have been released by the Department of Public Health and it's our understanding that care now is now open.

(INAUDIBLE QUESTION)

PILAND: Well, I think it's thoughts we all have. The fire department always has to be prepared for any type of emergency. We're an all- hazard response unit like I said. We trained for it and the firefighters are prepared for whether it's this type of call or whatever the call may come in next. They are used to dealing with the unexpected and the expected.

(INAUDIBLE QUESTION)

PILAND: Well, I think there's always a heightened awareness. But they come here to do their job and they're dedicated, fire, paramedic professionals, and they responded and they take their job seriously. And I believe there is a heightened awareness obviously, but we do a lot of calls that are high risk.

(INAUDIBLE QUESTION)

PILAND: Well, I would leave that to the medical professionals. We're on the response end of it. We'll let public health officials and physicians make that determination.

(INAUDIBLE QUESTION)

PILAND: It's our understanding it's a 48-hour timeframe at this time.

(INAUDIBLE QUESTION)

PILAND: The patient -- the patient is currently at Texas Health Resources in Dallas. I do not know the residency of the patient nor their occupation.

UNIDENTIFIED MALE: How do you handle the apparatus that you use? Is there anything special on your end to sanitize them?

PILAND: Right now, again, our medical physician, Dr. Gamer, is on the scene at the hospital. We have calls in to the Centers for Disease Control. We also are working with our public health officials here in Denton County. We're going to get their recommendations on the proper decontamination procedures of the ambulance. I would like to mention that -- and I understand the nature of Ebola,

but we deal with a lot of patients with infectious diseases on a pretty continuum basis. We decontaminate these units all the time. It's nothing new. We have different cleansers, (INAUDIBLE), and things of that nature that kill a lot of germs. So we're used to decontaminating these units, but we're going to wait for their recommendations.

(INAUDIBLE QUESTION)

PILAND: I can't speak to what he was concerned about. I know that the hospital staff felt that he met the preliminary guidelines from the CDC and that's why they called.

(INAUDIBLE QUESTION)

PILAND: Right now our estimate that we're dealing with about 14 people. That includes the physicians and the nursing staff as well as the people that were in the lobby and some of the other patients that were in some of the other rooms for treatment.

(INAUDIBLE QUESTION)

PILAND: It's our preliminary understanding that they are not part of the 48 that are being under surveillance. That's according to our health department.

(INAUDIBLE QUESTION)

PILAND: Our health department has -- in conversation has told us that this patient is not one of the 48 persons that's under public health surveillance for the Dallas patient.

(INAUDIBLE QUESTION)

PILAND: I do not know, but that's something else. The patient obviously aside from the treatment at the hospital, public health officials are interviewing the patient as to other contacts in the event that this may turn out to be something else, but again, right now they're treating this as a low-risk event.

(INAUDIBLE QUESTION)

PILAND: Well, I can understand it. There's a lot of attention that is surrounding the Ebola cases in Dallas and any time that we have a call, if it comes out as a possible exposure, I can understand the concern, but rest assured that the Frisco Fire Department and the city are doing everything that we can.

We have talked about this. I think that's the key here is this wasn't something that was sprung on us this afternoon at 12:32. We've been preparing for this for weeks, if not months. So what may be a sentinel event for us is something that we trained for.

(INAUDIBLE QUESTION) PILAND: Again, I don't know, and I think Dana mentioned earlier. I mean, you can imagine the speed of information that's moving out there and our main concern initially was the treatment of this patient. The patrons that were at care now and mostly, and simply, our firefighters that transported this patient to Texas Health Resources in Dallas and we haven't had an opportunity to drill down into that so we've -- this is information we do not know.

(INAUDIBLE QUESTION)

PILAND: I cannot. I do not know.

(INAUDIBLE QUESTION)

PILAND: It's my understanding it was -- again, and the information is preliminary, but it is my understanding it was family members that he had contact with.

(INAUDIBLE QUESTION)

PILAND: I'm sorry?

(INAUDIBLE QUESTION)

PILAND: It's my understanding he was inside the apartment.

(INAUDIBLE QUESTION)

PILAND: Yes. We're working with all public agencies, we've been in contact with Denton County and Colin County Health Department. Also our regional representatives from the Department of Emergency Management with the state of Texas and all of the associated agencies that we need to contact, so both local and state resources have been contacted about our event.

(INAUDIBLE QUESTION)

PILAND: That's right. We've been in consult with the CDC on the scene. While we were on the scene at CareNow. We were in contact with Centers for Disease Control.

(INAUDIBLE QUESTION)

PILAND: Well, I'm not going to go too deep in the personal aspects, but I will say that out of five or six symptoms, he was minus a few that I think gave us reason to believe or maybe the health department reason to believe that this was a lower level risk.

I said he had several, but not all five or six. He was exhibiting some. He exhibited enough to trigger the preliminary screening. I think the important thing to note is once you get more in depth and you talk to the patient and they get more information I think then they're able to rule out some of the risk.

(INAUDIBLE QUESTION) PILAND: Well, I would encourage anyone to call us any time they feel they need us, and I think that's good counsel. And if you think that you're an at-risk patient, call us and we can respond. But again, you know, that becomes an individual choice based upon the risk factors that you may or may not have.

(INAUDIBLE QUESTION)

PILAND: I do not.

(INAUDIBLE QUESTION)

PILAND: I'm sorry?

(INAUDIBLE QUESTION)

PILAND: Yes, I don't know if it was actually the position, but it was the staff at CareNow that called us. They actually called our (INAUDIBLE) 911 and we were dispatched to them.

(INAUDIBLE QUESTION)

UNIDENTIFIED MALE: What does that say?

ANNOUNCER: This is CNN Breaking News.