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2nd Nurse Contracts Ebola; Nurse with Ebola on Plane; Obama Cancels Fundraisers to Deal with Ebola; Josh Earnest Gives Press Conference on Ebola

Aired October 15, 2014 - 14:30   ET

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

DR. CELINE GOUNDER, INFECTIOUS DISEASES AND PUBLIC HEALTH SPECIALIST: The real high-risk moment is when you're taking off the protective equipment. So if you're putting on multiple layers that makes it more difficult to take it off.

Now one thing I would point out initially the hospital protocol -- I'm not saying the CDC protocol -- what the hospital was instructing the staff to do was very minimal in terms of protective gear. As Duncan got sicker, you should wear a facemask, double gloves. They should have been following the CDC protocol for personal protective equipment from the get-go.

BROOKE BALDWIN, CNN ANCHOR: Sounds like there was protocol that existed but not communicated to members of this hospital. And they were saying, round this roundtable, anonymously, no training, or very little training. Let me play you one more allegation from these nurses from this hospital from this Nurses National United.

(BEGIN VIDEO CLIP)

UNIDENTIFIED NURSES NATIONAL UNITED MEMBER: Some supervisors said that even the N-95 masks were not necessary. The gowns they were given still exposed their neck, the parts closest to their face and mouth. They also left exposed the majority of their heads and their scrubs, from the knees down. Initially, they were not even given surgical booties, nor were they advised the number of pairs of gloves to wear.

(END VIDEO CLIP)

BALDWIN: Who screwed this up?

GOUNDER: If the nurse's allegations are true, they have every right to be furious at the way Duncan's case was mismanaged.

The CDC has protocols. They have been trying to do some education, but clearly that hasn't been effective enough, that's why they are ramping up attempts to train infectious-control workers and all the hospitals across the U.S. But ultimately, the hospital leadership and their infection-control experts -- and each has their own infection- control department -- they should have taken charge of this, informed themselves and trained their staff.

BALDWIN: Let me just get this in. This is a statement from the hospital, from Texas Presbyterian. They say, quote, "We take compliance very seriously. We have numerous measures in place to provide a safe working environment, including mandatory annual training and 24/7 hotline and other mechanisms that allow for anonymous reporting."

Here's the question. Maybe it wasn't the anticipation that this actually happened here, that there would be this person that came from Liberia who had been exposed, and ultimately got sick and died. But I'm curious, there's only a finite number of beds in this hospitals in this country that can handle patients like this, Emory being one of them. Do you think these patients should be treated at those hospitals or do you think heaven forbid somebody in New York winds up with Ebola that wherever that patient is, that hospital is capable of handling it?

GOUNDER: I think we need something in the middle. I think that on the one hand those four bio-containment units are the experts. We need more facilities throughout the country that can provide care. Every hospital should be prepared to diagnose and isolate an Ebola patient, call for help from the CDC and the state and local health department and the patient can be transferred to some place that has a higher level of bio-containment capacity. But everybody needs to be able to diagnose.

BALDWIN: OK. Just getting in my ear, we're getting close to the White House briefing so we'll take it as soon as we see that happening in about 60 seconds from now.

What do you make of the fact that 29-year-old Amber Vinson jumped on a plane? And that was against CDC protocol? One could easily say, listen, she's a medical personnel, she should have known better. At the same time, should she have?

GOUNDER: I think she should have known better, and I think this also happened with Nancy Snyderman breaking her quarantine.

BALDWIN: NBC News.

GOUNDER: Exactly. There's a couple of layers here. One is that, as a health care worker, people want to feel they can trust you. And part of that is following the rules, so to speak. Second of all, in the case of Nancy Snyderman, being a public spokesperson, who should inform the public and calming their fears, doing something that will cause panic and irrational responses is irresponsible behavior.

BALDWIN: Guys, let me know when we want to go to the White House because it's really important. The president -- to me -- it's not nothing that the president cancelled his campaign trips for New Jersey and Connecticut to make sure he's staying behind and meeting with these different cabinet agencies. These are the folks helping with the government response to Ebola.

And, again, getting this new information today, just to reiterate to our viewers, if you're just joining us, getting this new picture of this 29-year-old nurse, the second nurse who has now contracted Ebola at this hospital after really, to quote Elizabeth Cohen, who has been covering this for us in the thick of the treatment of this individual who passed away last week. Again, we've learned within about 48 hours time, she decided -- and we don't know the circumstances surrounding her getting on the plane and heading to Cleveland.

Let me hit pause. Here he is, Josh Earnest, White House spokesperson. Let's take a listen.

JOSH EARNEST, WHITE HOUSE PRESS SECRETARY: -- meeting this afternoon 3:30 in the cabinet room with members of his team who are responsible for responding to this, to the Ebola diagnosis in Texas. So, I need to leave here about 3:25. Feel embarrassing to walk in late. Yes. And so I don't want to be late.

So do you want to get us started?

UNIDENTIFIED REPORTER: Thank you. Can you give us any more details on the meeting that you said you're going, to what the president will get out of it, who are some of the people participating, and does this in any way affect the travel that's on the schedule for tomorrow?

EARNEST: The president is convening members of his team who have been responsible for responding to the Ebola situation in this country. The president wants to do that because he wants to make sure that all of the needed resources of the federal government are being deployed to deal with this specific situation. We'll have a full manifest of those who are participating in the meeting for you. At the conclusion of the meeting, you'll have an opportunity to hear directly from the president himself about what decisions were made in the course of that meeting.

At this point, I don't have any changes to tomorrow's schedule to announce. We're obviously operating in a dynamic environment right now so we'll do our best to keep you updated. If there's something that requires a change in the president's schedule then we'll definitely let you know.

UNIDENTIFIED REPORTER: Can you explain why he thought it was necessary to cancel both trips, both stops in New Jersey and Connecticut, and to stay here and have this meeting?

EARNEST: Obviously, we have a second diagnosis of Ebola. Again, this is a health care worker who was working to treat the patient at Texas Presbyterian Hospital, the first individual who had been diagnosed with Ebola in this country. So that indication -- that indicates the seriousness of the situation. And the president believed that it was important to convene the senior members of his team who were responsible for coordinating this response. And the president was not able to host that meeting and travel at the same time.

What we have always indicated is that the president of the United States is president wherever he goes and that's true 24/7. But what's also true is if the president determines it's necessary for him to return to the White House to fulfill his responsibilities as the leader of the country and as the commander-in-chief, then he'll alter his schedule accordingly. And the decision we made about today's schedule is consistent with that guiding principle. UNIDENTIFIED REPORTER: I know this question was asked yesterday, and

I want to ask it again today. Does the president and the White House, is there continued confidence in Dr. Frieden to lead the CDC at this time. And also, is the administration going rethink the idea of appointing somebody to be an Ebola czar given this new urgency.

EARNEST: The answer to your first question is yes. Throughout this process and this crisis, dating back to March, this administration has been guided by the science, by our medical experts who have experience in dealing with Ebola outbreaks. For almost four decades now, the global health community, led by the United States, has been dealing with Ebola outbreaks in Africa. And as we are dealing with a public health situation in this country, we continue to be guided by the advice of medical experts and scientists who have knowledge in this field and can use that knowledge to protect the American people.

As it relates to a so-called Ebola czar, what I will reiterate is what we said in the past on this, which is we have designated very clear lines of responsibility in terms of which agencies are responsible for which aspects of this response. We've got CDC and USAID personnel operating in West Africa to work with those local governments to meet the urgent humanitarian public health needs in those countries. You have a Department of Defense that is responding to the orders of the president of the United States to set up enhanced logistical ability as they seek to move equipment and into the region to confront this outbreak.

You have Department of Homeland Security staffers who are responsible for securing our transportation infrastructure and monitoring individuals who are entering this country at ports of entry across the map. And then in addition to that you have HHS and CDC official who responsible for coordinating with state and local public health authorities to ensure that the American public is safe. And there are clear lines of authority for each of those sets of responsibilities. At the same time, you have the president's chief Homeland Security adviser, Lisa Monaco, working here at the White House who is responsible for integrating the efforts of all the agencies and making sure they have the access to the information and resources that they need to do their job.

All of that said, we have said on a number of occasions that if additional resources or if additional staffing is necessary to augment the response, then we won't hesitate to consider it. But at this point, the lines of authority are clear. And the person responsible for coordinating those efforts here at the White House continues to do that work well.

Steve?

UNIDENTIFIED REPORTER: Sounds like you're not inclined to appoint a czar.

EARNEST: Well, again, there are clear lines of responsibility that are in place. There is an individual here at the White House, highly competent individual, Lisa Monaco, the president's Homeland Security advisor, who is responsible for integrating that response. But again, if we determine additional resources or additional staffing or additional expertise is needed to augment this response, then we won't hesitate to take advantage of it.

UNIDENTIFIED REPORTER: Is the president wanting to know how this health care worker was able to get on a commercial plane?

EARNEST: Well, there are a number of things that we're eager to know. The first is -- and this is the subject of an investigation by CDC officials -- is to determine exactly how this virus was transmitted from the so-called index patient in Dallas to at least two of the health care workers who were treating him. That is the focal point of an investigation that the CDC is expediting at the direct order of the president of the United States.

The other thing that the CDC is reviewing is the protocols that were in place to protect the health of the health care workers who were treating this patient. It's not clear exactly what protocols were in place and how those protocols were implemented. And the CDC wants to try to get to the bottom of that so that they can offer advice to medical professionals and hospital administrators and others across the country about the protocols that are needed to ensure their health care workers remain safe.

What the CDC is also doing -- and they are expending significant resources to do this -- is to do contact tracing of the two health care workers that have contracted the virus. And that involves, as it sounds, tracing the contacts these individuals had after they got sick. And so you saw the news released from CDC and one of the domestic airlines today indicating that they were contacting passengers who were on the same flight as this individual to make sure that they were educated about the risk to which they were exposed.

Now what our medical experts tell us is that risk is quite low but it's important for people to have access to that information so that they can get the facts about what sort of risk they are facing -- again, that risk is low -- and what steps should be taken if necessary in the unlikely event that they do start to display some symptoms.

UNIDENTIFIED REPORTER: Yesterday, the president said an Ebola epidemic in the United States is highly unlikely. Is that statement still true today?

EARNEST: It's true. It's guided by the science. That's what our experts say. Our experts say that because the way Ebola is transmitted is very clear and it's something that's not likely to happen in the United States.

Let's walk through what that is. Ebola is not like the flu. Ebola is not transmitted through the air. Ebola is not transmitted through the food that we eat in this country. And it's not transmitted through the water that we drink in this country. The only way an individual can get Ebola is by coming into close contact with the bodily fluids of an individual that's already exhibiting symptoms of Ebola. That's why in this case, tragically, we've seen two health care workers that were obviously in very close contact with the index Ebola patient contract this virus. How exactly that transmission occurred is something that remains under investigation, but the risk to which they were exposed was elevated by the fact that they were in close contact with this patient trying to meet that person's medical needs. OK.

UNIDENTIFIED REPORTER: To follow up, the president used the word "epidemic." Yesterday, you used the word "outbreak." Chances are exceedingly low. Isn't what we have in Dallas now an "outbreak," with multiple transmissions?

EARNEST: Well, I think there's a medical professional who could give you a specific definition of what actually constitutes an "outbreak." My layman's understanding that I think the vast majority of the American public would agree with is that we're talking about a situation in which two health care workers, who were treating an individual with Ebola, contracted the virus. We are -- the CDC, our medical experts are conducting an investigation to determine how that transmission occurred. But that is different than images that are conjured up with an "outbreak" where you have individuals who are, who are basically in public transmitting the virus. That's something that we think on a large scale is exceedingly unlikely.

UNIDENTIFIED REPORTER: Your definition of an "outbreak" says it's something that's an occurrence in excess of what normally would be expected in a defined community. It can be a case where a disease long has been absent from a population. That may also constitute an "outbreak." It sounds like even if it's not large scale it's an "outbreak." So I guess I wonder if that calls into question some of the reassurances that we've heard in this room.

EARNEST: It doesn't, Mark. Simply what we're talking about here is a situation where there were health care workers who came into direct contact with an Ebola patient who did tragically contract the disease. We are very focused on making sure that those individuals get the treatment that's necessary. And our thoughts and prayers are with them and their families as they fight this terrible virus.

But that is wholly different than, for example, the situation we see in West Africa where, tragically, you're seeing people who live in the same household be -- passing the virus from one to another. What we're seeing as a result of unsafe burial practices that individuals are contracting the virus from corpses. Again, that's a tragic occurrence. It is an indication of the poor medical infrastructure that exists in those countries. And that is something that poses a much broader risk to the population of West Africa. That's why the president has devoted significant resources from the federal government to combat that outbreak. But that is, obviously, a far cry from the situation that exists in Dallas right now.

John?

UNIDENTIFIED REPORTER: Josh, you said that the president still has confidence in the director of the CDC. Let me ask you a broader question. You were pretty strong in defending the federal government's response to this yesterday. Now given what we've learned about another case in Dallas and the fact that that individual was able to -- did fly on a plane while supposed to be monitored, how would you -- would you still say the federal government's response to this situation has been successful, up to the president's own standards?

EARNEST: Well, I'll say a couple of things about that. The first is Dr. Frieden, the director of the CDC, himself, has said that it's unacceptable that even one health care worker was exposed to this virus while they were providing medical treatment to this patient. So that is an indication that there were -- that there were shortcomings. And that is something that's being thoroughly investigated by the Centers for Disease Control and other medical experts. That investigation, obviously, will also now expand to cover the second health care worker that's now been diagnosed with Ebola.

So that is a clear indication that -- let me say there's a second thing that Dr. Frieden also said, was that -- I believe it was earlier this week he noted that knowing what he knows now about the situation in the hospital, he indicated that he regretted not sending a team of experts to that hospital sooner to assist the hospital as they responded to this specific diagnosis. So what you are seeing from the federal government, however, is the kind of tenacious response that reflects evolving circumstances. So Dr. Frieden indicated that he would send a whole team of experts earlier this week after observing -- he believed they should have been there sooner.

What you're seeing is, after this diagnosis, you're seeing stepped-up monitoring by health officials in Texas of other health care workers that were responsible for treating the index Ebola patient. So this is a response that indicates a commitment to protect the health and safety of the American public.

There are other ways in which this has happened as well. You know, we have adapted to circumstances by beefing up airport screenings, for example. At the end of last week, we announced new screening measures that would go into place at five airports across the country. They cover 95 percent of the arrivals of travelers from -- that started out in West Africa. Those improved or strengthened screening measures are indicative of our commitment to constantly evaluating our policies and, where possible, put in place measures that would strengthen them.

UNIDENTIFIED REPORTER: Why do so many Americans feel, first of all, that there's a real risk of an epidemic in this country? And that the federal government is not doing enough to stop it? The latest poll, ABC/"The Washington Post" poll, two-thirds of Americans think the federal government is not doing enough on this. Are they wrong?

EARNEST: Well, let me say this about that. It sounds to me that a significant portion of the American population agrees with Dr. Frieden that even one transmission of the Ebola virus to one health care worker in this country is something that's unacceptable and something that won't be tolerated and something that's prompted a review of protocols and careful investigation of how that transmission exactly occurred. What people can continue to be confident in is the priority and attention that this issue is receiving across the federal government and here in the White House. I think that's evidenced by the fact that the president is convening some of the top-ranking officials in his administration to discuss that response.

But, again, what I would urge people to do -- I think the other thing that's motivating the answer to that question, is something related to fear. This is a deadly, terrible disease. And it is wreaking havoc in West Africa. It's having a debilitating effect on the population there and genuinely tragic. At the same time, because of the way that that virus is transmitted, because of the modern medical infrastructure that exists in this country, the risk of a similar outbreak like that in this country is exceedingly low. That's what our medical experts tell us. That's advice that we continue to follow.

However, the administration continues to pursue the kind of tenacious response that will protect the American public here at home but do what is necessary to eliminate the risk to the American public from the Ebola virus and that's to stop this outbreak at the source.

UNIDENTIFIED REPORTER: Still no consideration of a travel ban from the affected countries?

EARNEST: That's not something that's on the table. The reason for that, in case people haven't heard the previous answer given to that question, it's important for people to understand why that's the case. Shutting down travel to that area of the world would prevent the expeditious flow of personnel and equipment into the region. And the only way for us to stop this outbreak and eliminate any risk from Ebola to the American public is to stop this outbreak at the source. We're mobilizing significant resources to make sure that supplies and personnel can get to the affected region and start meeting the needs of the affected regions so we can stop the outbreak there.

UNIDENTIFIED REPORTER: The president cancelled political travel today, obviously, to do this meeting. Does he plan to cancel further political travels? Is the president going to continue his campaign schedule going forward, despite the situation, or is this just kind of a one-day thing?

EARNEST: John, we'll evaluate it on a daily basis. Is this a dynamic situation? If necessary, I have no doubt that the president will postpone his political travel to attend to important priorities here. But whether a change in tomorrow's schedule is required, we just don't know that yet. And when we do, we'll let you know.

OK. Major?

UNIDENTIFIED REPORTER: Josh, couple of a months ago, when the Malaysia Airlines jet was shot down over Ukraine, the president carried on with his campaign schedule. A member of the senior staff said abrupt changes to the president's schedule could have unintended consequence ever creating a false sense of crisis. Did you do that today?

EARNEST: No, Major. What drives these kinds of decisions are the president's responsibilities. And you'll recall -- I don't know if you traveled on that trip with us to Delaware and New York but, over the course of that trip, the president called five different world leaders while on the road, including President Poroshenko, including the leader of Malaysia, including the prime minister of the Netherlands, who's -- that's the nation that bore the brunt of that tragedy. The president was able to continue his schedule that did include some political events while also attending to his responsibilities as commander-in-chief.

As it relates to today's schedule, the schedule did need to be changed so the president could fulfill his responsibilities as leader of the country. We'll evaluate the schedule tomorrow based on his requirements, and if we need to make a change to his schedule so that he can do what's necessary here at the White House, then we'll change his schedule. I don't know yet whether that will be required.

UNIDENTIFIED REPORTER: His meeting you indicated at the top some decision will be announced by the president. Is that what makes it of signature importance that he had to cancel --

(CROSSTALK)

EARNEST: No. Again, the reason this meet cigarette important because we're talking about the senior members of his team who are responsible for dealing what's a pretty urgent situation here in this country.

UNIDENTIFIED REPORTER: New methods announced after this meeting --

(CROSSTALK)

EARNEST: Quite frankly, Major, I don't know the answer to that. If there are, the president will have an opportunity to discuss them with all of you at the conclusion of the meeting.

UNIDENTIFIED REPORTER: Have there been additional meetings that the president or his staff conducted on Ebola that has not appeared on the schedule

EARNEST: The president has been briefed and updated on this issue. I don't know if there have been any other formal meetings that have been convened but there's been a number of occasions in which the president has been updated.

UNIDENTIFIED REPORTER: Let me ask you this question. Can you understand that the public watching this story play out can have a genuine sense of either skepticism or possibly alarm, because they hear, we know how to deal with this, we're taking all the proper steps, all the precautions are being implemented. And then, yet, someone who has it, doesn't show symptoms, gets on a commercial aircraft. Even though the exposure risk is minimal, everybody on that planed contacted. That creates a low-level sense of alarm. But everyone on that plane and everyone who remembers hearing just a couple of days ago, that's not going to happen, we got this under control. Do you understand how the public is becoming less confident and possibly even more alarmed as this story plays out?

EARNEST: People should continue to be confident in the response that's organized by the government in reaction to this specific situation. The reason for that is simply that we have a modern medical infrastructure in place that, again, has not been flawless. We pointed out the case, that even one transmission to a hearth worker is unacceptable. People should take solace in the fact that, quite frankly, we know how Ebola is transmitted. It's not transmitted through the air. It's not transmitted through food or water but only through close contact with bodily fluids of an individual who has symptoms of Ebola. This is a deadly graphic disease.

UNIDENTIFIED REPORTER: That travel was a big mistake. That looks to me, and I think it looks to most people evaluating this fairly, as sort of a gap in the system, that something that should have been communicated very tightly within the Texas Presbyterian community, hey, don't get on a commercial aircraft, happened anyway. Do you understand how that can create some degree of uncertainty among the public when trying to evaluate where the story is going and how tightly you have your arms wrapped around this situation?

EARNEST: Major, I can certainly understand the concern by the American public about this terrible disease. It's a deadly disease. But it is a disease that we know -- whose outbreak we know how to contain here in this country. Ad that's what we're very focused on, from trying to meet needs of the health care workers who have contracted the virus, to investigating how exactly that virus transmission occurred, to doing the necessary contact tracing to ensure that other individuals who may have come in contact with somebody who had the Ebola virus are aware of the risks they face and monitoring their own health. That's active monitoring -- has now been expanded to include all of the health care workers that came in contact with the index Ebola patient in this hospital in Dallas. So there are a number of steps that we have taken. And I think that people can be encouraged that the federal government is demonstrating the kind of tenacious adaptive response that's required to dealing with what is understandably a pretty concerning situation.

UNIDENTIFIED REPORTER: My last question, does the president want his response team to be more tenacious and more urgent so stories and situations like this stop happening?

EARNEST: I can tell you that the president himself certainly feels a very strong scene of urgency about ensuring that his administration and the medical experts are mobilizing the kind of response that will ensure the safety and health of the broader American public. That's what the president expects. That's what the American people expect. I'm confident that will be discussed at today's meeting.

Olivier (ph)?

UNIDENTIFIED REPORTER: The president spoke with leaders of Japan, U.K., Italy, Germany. Ebola was part of the conversation. These conversations --

(CROSSTALK)

EARNEST: I don't mean to interrupt you. The conversation with the prime minister of Japan was separate from the conversation with other leaders.

UNIDENTIFIED REPORTER: He spoke to those leaders either together or separately, however, you want to put it. EARNEST: There's intense interest with the modality the way that the

president communicates with world leaders since the very first day I've been this briefing, so I'm cognizant of the importance of those kinds of details.

UNIDENTIFIED REPORTER: I respect that. I appreciate it. The president has said repeatedly now he's not satisfied with the global response in terms of stemming Ebola at the source. So my question for you regarding these various conversations is whether he made any specific asks of these world leaders or whether he's satisfied that they have fully stepped up to their responsibilities.