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CNN Live At Daybreak

Anthrax Investigation: Interview of Surgeon General Satcher

Aired October 18, 2001 - 08:05   ET

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

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: Now, to worry on Capitol Hill: Nearly three dozen people there have been exposed to anthrax. The Capitol itself is opened, but House and Senate office buildings are closed.

As an early-morning update now from congressional correspondent Jonathan Karl -- is it pretty quiet there this morning, Jonathan?

JONATHAN KARL, CNN CORRESPONDENT: Well, I'm seeing a lot more in the way of senators milling around the actual Capitol building today. Obviously, they have been thrown out of their actual offices in those three Senate office buildings adjacent to the Capitol. So we are seeing a lot of senators looking for space to work. Some of them have very small offices in the Capitol building, one-room offices. But several of them have absolutely no place to work at all, so you're seeing a lot of activity in terms of milling around and trying to find a place to work.

But health officials up here are making three points. One, they are saying that the anthrax that they have detected is localized. Those infected or those who have been exposed were only in the immediate area around Senator Daschle's office in the Hart Office Building.

And they are also saying that nobody is actually infected. All they have so far is people that have been exposed; 31 people who have tested positive preliminarily for exposure, and they say some of those are possibly false positives. So they say this looks like it's contained and very much dealable.

The third point they are making is that even if anybody turns out to be infected, this is eminently treatable -- not only with Cipro, but with virtually any antibiotic.

That said, obviously, this has been a scare up here, and the House of Representatives made an unprecedented decision to actually shut down, for the first time, for public health reasons. And Dick Gephardt explained why.

(BEGIN VIDEO CLIP)

REP. RICHARD GEPHARDT (D-MO), MINORITY LEADER: It was the wise and prudent thing to do. We had a meeting with the president yesterday morning at 7:30, and the consensus was that we should get people out of the buildings and do the wise thing. We've got a responsibility to the young people that are here to make sure people aren't in harm's way, and we have a responsibility to make sure that these terrorists don't succeed. So it was the right thing to do.

The Senate will do one bill today that we did yesterday, and then they'll be out, and then the sweep can start.

(END VIDEO CLIP)

KARL: Now, the Senate felt very important for, at least for symbolic reasons, to keep the Senate side of the Capitol Building open.

(BEGIN VIDEO CLIP)

SEN. RICHARD SHELBY (R), ALABAMA: I believe our leadership, Sen. Daschle and Sen. Lott and all of us joining in decided to stay in session, to vote, to set an example. And that's why we're here today, and we're going to do the people's business today in the Senate

(END VIDEO CLIP)

KARL: And Paula, I have heard grumblings from members of the House of Representatives, rank-and-file members, that disagreed with their leadership's decision to go ahead and close it down.

But do keep in mind that most of the Senate is closed as they sweep every office building on Capitol Hill for possible signs of anthrax exposure -- Paula.

ZAHN: Jonathan Karl, thanks so much.

We're going to shift our focus to anthrax overseas. A letter sent to Nairobi, Kenya, from the United States has tested positive for anthrax spores. Kenya's Health Minister says a private citizen received the envelope, with a white powdery substance inside. It was mailed on September 8 from Atlanta, by way of Miami.

Authorities are also testing two other envelopes, one sent to another individual, one to a UN office in Nairobi.

The government is trying to ease the anxiety over anthrax, but as the number of exposures grow, is the United States prepared to treat victims of a widespread bioterrorism attack? Two doctors asked that very question in a letter to "The Washington Post." Drs. Beth Horowitz and Matthew Parker write: "We find it hard to counsel worried people against the stockpiling of medications and have provided prescriptions when asked." And they ask for more leadership from the government saying, "We look to the government and to scientists for guidance."

Who better to give us the answer than the surgeon general, Dr. David Satcher, who joins us from Washington -- welcome back.

DR. DAVID SATCHER, SURGEON GENERAL: Good morning, Paula. ZAHN: So how would you answer both of these doctors this morning? They get patients coming in. I know this has happened over and over again in New York. People are very concerned in particular here. And I know the doctors are told by the government don't cave into this, and yet when a patient asks for it, they're writing out these prescriptions. Are they doing the wrong thing?

HATCHER: Well, we think so. And as you know, I responded to that letter in "The Washington Post" yesterday by saying that physicians have a responsibility to respond to their patients' concerns, not by writing prescriptions that are not indicated by symptoms and diagnosis, but by explaining what the risks might be and what they are not.

So we've tried to communicate very clearly that to the extent that to the extent that physicians write prescriptions for Cipro when it's not indicated, then we are increasing the chance that organisms will become resistant to this very important drug that we have. So it's very important to respond to our patients' fears and concerns, not by writing prescriptions, but by giving them information.

But I do think that physicians have a point. They do need more help and support from us, and that's what we're trying to do. Today, between 4:30 and 6:00, the Centers for Disease Control and Prevention will have a special conference for physicians, "What Clinicians Need to Know About Anthrax." That can be found on the Web -- cdc.gov/phtn -- today between 4:30 and 6:00.

So we do believe that we have to strengthen the front line, and physicians represented the front line of this public health infrastructure.

ZAHN: Before we come back to the front line, though, what is the danger of people just getting this Cipro and having it on hand? I mean, these folks aren't necessarily taking the medication. They just want to know if they are exposed to it, in the weeks and months to come, that they have it on hand if there's a run at the drug store, because, as you know, in New York, a lot of the drug stores have a waiting list 100 or 150 people strong.

SATCHER: Our experience, Paula, is that when people store antibiotics, whether it's penicillin or any other antibiotic, they tend to take them at the wrong time, and it leads to real problems in terms of resistance. That's why penicillin is not the powerful drug that it used to be.

But by the same token, Paula, we have the ability to deliver the antibiotics in a very short period of time. That's why we've invested in the stockpile at CDC, with eight sites distributed throughout the country. That's why we have the vendor management inventory, which will allow us to call upon pharmaceutical companies or manufacturers to deliver drugs on a short order.

So far, we have been able to deliver antibiotics, and we can deliver many more than have been required to this time. ZAHN: Well, what difference will it make now that -- I'm not sure which federal agency decided this yesterday -- penicillin and another drug are almost equally effective to Cipro. Should that say to the American public don't worry, if you can't get Cipro, there are two other drugs that will work equally well?

SATCHER: Well, it should certainly say that we have a stockpile of drugs far beyond Cipro. We generally start every new patient whom we think has been exposed to anthrax with Cipro until we get the sensitivities back. And when we find out that it's definitely sensitive to penicillin and the tetracyclines, we can change the drug.

So we have, at our disposal, many drugs beyond Cipro to fight this problem, and that's the point we're trying to make.

The FDA, by the way, is the agency that's authorized to regulate drugs and to say doctors can prescribe these drugs for this purpose and at this dosage.

ZAHN: And, Surgeon General Satcher, you know there's been some debate whether Bayer should be asked to drop its patent on Cipro, allowing other companies to manufacture the pill generically, and I understand Bayer kind of gave an indication yesterday they might allow that to happen.

Can you confirm that this morning?

SATCHER: I cannot confirm that. I know that there are ongoing discussions between the secretary and the pharmaceutical companies.

Again, we believe that we have the ability to increase the amount of Cipro to at least the amount that would allow us to treat 12 million people for 60 days. And we don't necessarily believe that we will have to do that, because we can use other drugs.

But we do need to get the companies to cooperate, and my understanding is that they are cooperating. But there are legal issues involved here, which I won't get into. But my impression is that the pharmaceutical companies are stepping up to the plate, meeting with authorities, and saying that we want to support this effort.

ZAHN: And you talked a little bit earlier about how you will be holding this conference to better educate physicians and nurses about symptoms to be looking for if there have been exposures to anthrax among their patient population.

In the end, though, who is it that the American public should expect to turn to? Is it you for this information, or will it ultimately be Gov. Tom Ridge, when the Homeland Security Department is up and running? How is that going to work?

SATCHER: Well, the CDC is the most important federal agency in terms of this information. The question as to who would deliver the information to the American public is a different question. But I think we rely upon the Centers for Disease Control and Prevention, with all of the resources of that institution, to produce reliable information.

Every day almost, CDC releases alerts for the American people. And if you go to their Web site, cdc.gov, you can get the latest information about anthrax, any new discoveries, etcetera.

They are not going to release information before it's reliable. Now, a lot of people would like for CDC to answer questions that we don't have the laboratory results for officially to answer, so sometimes people are going to become impatient. But when the CDC releases information, it's going to be reliable. So the information we are providing for clinicians today, the alerts that CDC will issue from time to time, can be relied upon.

Who speaks in terms of the government, obviously, it's going to take probably more than one person, but seemingly, ultimately, Gov. Ridge will head this overall effort.

ZAHN: Dr. Satcher, I need a brief answer to this one. There was some confusion I saw in pieces and newspapers yesterday about whether people should be getting flu shots this year. Your recommendation?

SATCHER: Most definitely, and we should begin now. However, it's important that people who are at the highest risk -- people over 65 years of age, people with chronic diseases like diabetes and heart disease -- be immunized first, beginning now. And people who are at lower risk can wait until November 15 or later. That way, we believe that the vaccines will certainly go around.

We don't know how serious the flu season will be this year, but it's still critical for people to become immunized. One hundred thousand people a year are hospitalized for influenza.

ZAHN: Yes, I know. I read that number last night. It's just staggering to me...

SATCHER: And 20,000 die.

ZAHN: ... how sick people can get. Wow!

SATCHER: And that's not necessary.

ZAHN: Well, flu season, I guess, is almost here.

Dr. Satcher, thank you for covering so much territory for us this morning -- we appreciate it.

SATCHER: Thank you, Paula. Great to be with you.

ZAHN: Thank you.

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