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CNN Live At Daybreak

Interview with Dr. Ivan Walks on the Switch from Cipro to Doxycycline

Aired October 29, 2001 - 07:07   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: From almost the first day of the anthrax attacks, we've been hearing about the drug known as Cipro. Cipro has been the drug of choice in treating the disease. But now that has changed.

The Centers for Disease Control and Prevention now recommends Doxycycline. It will be given to those in Washington exposed to anthrax.

(BEGIN VIDEO CLIP)

COMMANDER GREG MARTIN, BETHESDA NAVAL HOSPITAL: We are just taking safety's sake and looking at all of the people who were actually in that office, who had business in that office, and we'll be treating them with 60 days of Doxycycline, which is what the CDC is now recommending because we are fortunate to have a very sensitive organism.

(END VIDEO CLIP)

ZAHN: Let's talk now about that with Washington's chief health officer, Dr. Ivan Walks. Welcome back. Good to see you again this morning, sir.

DR IVAN WALKS, D.C. CHIEF HEALTH OFFICER: Good morning. Thank you.

ZAHN: Can you help us understand why the switch in the drug treatment?

WALKS: Well, I understand it. Let me see if I can explain it.

ZAHN: Good luck.

WALKS: Doxycycline is a better tolerated antibiotic for a lot of people. It's also an antibiotic that we have a lot of experience with long-term. A lot of us in the medical community have been concerned about 60 days of Cipro without a lot of experience in terms of what that does. We've seen some upset stomach type reactions to that. We've seen some really bad reactions in a few people.

Doxycycline is just as effective with respect to killing the anthrax but in addition to that, people can tolerate it. What that means is we'll get better compliance. Folks will take the medication as opposed to stopping on their own because it doesn't agree with them.

ZAHN: So right now you have some, what, 10,000 people taking some kind of antibiotic. Are you going to ask them to make the switch midstream?

WALKS: Well, one of the things that we did, again, planning ahead, anticipating what our needs would be, we did not give people initially a 60 day supply. You use the big gun, Cipro, early, and then you look at the bug itself, what can kill it best? Doxycycline kills it. When people are up with their 10 days, they'll come back. We'll switch them to Doxycycline. And that should be beginning today. And the new cases were starting on Doxycycline.

ZAHN: So a lot of those people are expected to come back today. I mean do you have a sense of how compliant they'll actually be?

WALKS: We planned to have them come back and we know where they are. We have their names. We have their phone numbers and we want them protected. So the ones that come back on their own we will switch. The ones that don't come back we'll work closely with the postal service. And with the non-postal workers, we'll go after them -- I don't want to say it that way -- but we want people to stay safe.

ZAHN: You probably heard a little bit of Jonathan Karl's report and the assumption that some government leaders are operating under that perhaps there is another letter out there that is laced with anthrax. Is that the assumption that you're operating under this morning?

WALKS: I'm operating under the assumption that we, last week, looked beyond Brentwood, looked early at who else would be at risk and we started appealing to those folks to come in, get their medication. We horribly saw the gentleman at the State Department become ill. He's doing well. Now we see they're finding anthrax at different spots, first order places from Brentwood.

I think what we need to do is to focus on that appeal. We don't want people to take medication when they don't need it. But when we in the public health system tell you, "it's time to come and get medication, you're in a risk group," please come and get your medication.

ZAHN: So you're entirely comfortable with the numbers of people that are now on antibiotics? Because there was a sort of a different tactic here in New York, particularly with those folks who potentially might have been exposed to the anthrax in the governor's office and those folks at NBC. Not all of those folks were put on antibiotics.

WALKS: I think what we knew two weeks ago about anthrax is absolutely nothing compared to what we know now. Everyone talked about cutaneous anthrax, the skin version, being the one that folks have to worry about unless they opened a letter and it poofed up in their face. Now we know that not to be true. It's important for us in the health community not to focus on whether there's one letter or 10 letters. What we know is that we have seen demonstrated at a very high price, the price of two lives here in the D.C. area, that we didn't know as much about anthrax two weeks ago as we know now. We're focusing now on protecting the public health.

ZAHN: I know the last time I spoke with you, you were very candid about what it's like to take the incoming fire from all the folks who are scrutinizing you. Just a thought once again to those postal workers who actually went to several local hospitals last week in the D.C. area to get tested and they were told you don't need a test, we're going to start you on drugs right away. That was very confusing to those folks. Can you explain to us once again why you didn't feel like you needed to test every single one of them?

WALKS: Yes, I can. One of the problems with the test is that a negative test, the nasal swab, has no relation to an individual's risk of illness. A negative nasal test can still happen in someone who was exposed. What we are doing is we are looking at every single person and that's why the perimeter was expanded early last week to get all these folks in, each and every person -- and we've treated over 2,000 people that are not postal workers, but especially those first order front line postal workers. We want them to get treated first.

Let us do our scientific stuff, but let's get you safe first.

ZAHN: A final question for you this morning, there has been so much talk about this learning curve all of you face right now, and even you just admitted to me that you know a lot more this week perhaps than you knew two weeks ago. What is that like to be in the middle of?

WALKS: It's especially difficult because from a scientific perspective, we know somebody tried to kill a lot of people by putting this kind of anthrax in the mail. They failed. They killed two people here in the District. But those two people live with me. Those are people that are close to me. I'm the health officer here and it's hard to lose even one person. And that's why I look right into the camera and I say, "Please come and get your medication."

We won't let people win. Myself, Georgus Benjamin, people like Dr. Henfling out at the Fairfax Hospital, all of us are focused on keeping people safe. We don't want to lose even one person. Those stats about well, they didn't kill very many, they mean nothing to me. Each person that dies is one that we lost and we are going to focus and we're going to continue to focus -- the CDC is learning as fast as anybody else is learning. They're doing a great job working with us and we're going to keep people safe.

ZAHN: We wish you all tremendous luck.

Dr. Ivan walks, as always, good to see you.

WALKS: Thank you. Thank you.

ZAHN: Thank you very much for sharing some of your time with us this morning. We know how busy you are.

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