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New Day Sunday

Dallas Health Care Worker Contracts Ebola

Aired October 12, 2014 - 08:30   ET

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

CHRISTI PAUL, CNN ANCHOR: Good morning. I'm so glad to have your company. I'm Christi Paul.

VICTOR BLACKWELL, CNN ANCHOR: I'm Victor Blackwell. Now 8:30 here on the East Coast and we're following breaking news this morning.

Texas health officials have now confirmed a second case of Ebola here in the U.S. And right now we're awaiting a live press conference scheduled to start in just minutes -- a live look here.

We're expecting to hear from Dallas County Judge Clay Jenkins. He's the county's chief executive, director of Homeland Security and Emergency Management there. We're also going to hear from Dallas Mayor Mike Rawlings as well as Texas Health Resources Chief Clinical Officer Dan Varga.

PAUL: If confirmed by the CDC, though, this would be the first time someone has contracted the deadly virus inside the United States, which is what makes it so telling here.

But we do know that this was a health care worker. This is something that came from the Texas Department of State Health Services. "A health care worker at Texas Health Presbyterian Hospital who provided care for the ebola patient hospitalized there has tested positive for ebola in a preliminary test at the State Public Health Laboratory in Austin. Confirmatory testing will be conducted by the CDC in Atlanta.

So again, as we await this press conference here any moment in Dallas, there will be a CDC conference as well, news conference for us at 11:00.

BLACKWELL: Let's get more of the details now. We've got our Ed Lavandera there inside, awaiting the start of this news conference. Ed, there's so many questions I think the most important question here is when did this doctor or this health professional contract this virus?

ED LAVANDERA, CNN CORRESPONDENT: You know those are obviously going to be many of the questions that will be asked here this morning as the officials here prepare for the news conference. We're told the mayor of Dallas will be here, the Dallas County Judge who has been very much on the forefront of this story as well as the hospital officials. But Victor, if you look back at what has gone on the last few

weeks there were a number of people who were considered to be high risk people who had been exposed to Thomas Eric Duncan. Several of those were health care workers that treated him here at Texas Health Presbyterian Hospital. We don't know for sure if this person is one of those people who was considered to be at high risk.

I'm sure that those will be the kinds of questions, perhaps they can shed some light on exactly how this particular health care worker contracted the disease, but we have been told that the person had reported a low grade fever Friday night. And then on Saturday it was confirmed that this person had been exposed to ebola and was starting to see the virus and test positive for the virus.

So many questions and the Dallas County Judge here has just shown up so we're several moments away and the Mayor has just started to walk in so we're several moments away from this news conference beginning here in Dallas.

PAUL: Ed, I think it's curious, a lot of people are wondering if a health care worker has been contracted with this virus, what do we know about the condition of Thomas Duncan's fiancee and the kids that were close to him? Do we know anything about their condition at this hour?

BLACKWELL: And we have to wait on that. We've got Judge Clay Jenkins speaking now.

JUDGE CLAY JENKINS, DALLAS COUNTY: Good morning. We're here today to communicate about a health care worker who has contracted the ebola virus. That health care worker is a heroic person who provided care to Mr. Duncan. I met with that health care worker's parents and the health care worker and their parents have asked that their privacy be respected and their name not be released at this time.

I expect with the activities that happen today, information will come to light, but let's remember as we do our work that this is a real person who is going through a great ordeal and so is that person's family. And let's be as respectful as we can possibly be.

We expected that something -- that it was possible that a second person could contract the virus. Contingency plans were put into place and the hospital will discuss the way that the health care worker followed those contingency plans which will make our jobs in monitoring and containment much easier in this case than in the last one.

I want to stress before we bring up a doctor a very important fact. You cannot contract ebola other than from the bodily fluids of the symptomatic ebola victim. You cannot contract ebola by walking by people in the street or by being around contacts who are not symptomatic. There is nothing about this case that changes that basic premise of science.

And so it's important that while this is obviously bad news, it is not news that should bring about panic. We have a strategy to monitor. I will go over that strategy and the Mayor will go over the strategy to keep the community safe and secure -- the dwelling and belongings of this patient.

But first Dr. Varga with Presbyterian will give us pertinent information pursuant to HIPAA and pursuant to the wishes of this family, as much pertinent information as he can share in an effort to give the public the information -- Dr. Varga.

DR. DAN VARGA, TEXAS HEALTH RESOURCES: Thank you, Judge.

Late last Saturday evening, a preliminary blood test on a caregiver at Texas Health Presbyterian Hospital of Dallas proved positive for Ebola. This health care worker had been under the self- monitoring regimen prescribed by the CDC. And based on involvement and caring for the patient Thomas Eric Duncan during his care that started on September 28th.

And individuals who are being monitored are required to take their temperatures twice daily. And as a result of that process, the caregiver notified the hospital of imminent arrival and was immediately admitted to the hospital's isolation room. The entire process from the patient's self-monitoring to the admission into isolation took less than 90 minutes.

The patient's condition is stable. A close contact has also been proactively placed in isolation. The caregiver and the family as already stated, have requested total privacy, so we can't discuss any further details of the situation.

The judge mentioned we've known that further cases of ebola are a possibility among those who were in contact with Mr. Duncan before he passed away last week. A system of monitoring, quarantine and isolation was established to protect those who cared for Mr. Duncan as well as the community at large by identifying any potential ebola cases as early as possible and getting those individuals into treatment immediately.

Finally, we have put the emergency department at Presbyterian on diversion until further notice because of limitations in staff capacity. That means ambulances are not currently bringing patients to our emergency department. While we are on emergency department diversion, however, we continue to fully care for all of our patients and we are also using this time to further expand the margin of safety by triple checking our full compliance with the updated CDC guidelines. We are also continuing to monitor all staff who had some relation to Mr. Duncan's care even if they are not assumed to be at significant risk of infection.

All of these steps are being taken so the public and our own employees can have complete confidence in the safety and integrity of our facilities and the care we provide. Thank you.

JENKINS: As an added step, in consultation with the CDC, the CDC will be working with Presbyterian to monitor all of the people that were in the self-monitor pool as we are monitoring the 48 people in the monitor pool. And so the people that are -- that were self- monitoring, all of whom are health care professionals, will now be monitored twice daily by epidemiologists and interviewed today by CDC epidemiologist.

We are -- because that is an increase in workload for the CDC, DSHS and Dallas County Epidemiology team, it currently has 19 people -- 19 epidemiologists and disease detectives on the ground. I requested additional epi team and disease detective resources at midnight last night and they, I believe, have arrived and are meeting with Dr. Kuhar in another room.

The CDC is not here today. They are busy working and we are about to leave to get back to the EOC. The PCR test has not been confirmed by the CDC in their lab as a double test, but we are confident -- unfortunately we're confident that it will be. And that's what necessitated the state's release.

The state is also not with us this morning, but they are actively working. There is much to do right now and they are working to keep you safe. So the monitoring will continue, the 48 that we have been monitoring remain asymptomatic and without fever. We will be working with Health and Human Services, the CDC and our state partners and Presbyterian today to make sure all necessary protocols are put into place.

And here's Mayor Mike Rawlings.

MAYOR MIKE RAWLINGS, DALLAS: Good morning. We heard about this around midnight and have been working throughout the morning to make sure that citizens of Dallas are safe when they wake up. I believe I can say they are.

Let me tell you what we have done, what protective measures we have taken to ensure that safety. The Dallas fire and rescue hazmat team has cleaned up the common areas and decontaminated any of the open areas of an apartment complex in the 3700 block of Marquita. They sprayed a cleanup agent and right now police are standing by to make sure no one enters that apartment complex. Furthermore, we have knocked on every door in that block and talked to every single person that came to the door. Explained what has happened and what we have done so they will not be afraid of the hazmat unit. The police officer ensuring that no one will enter that apartment.

Later this morning we will also go back and knock on every door of that neighborhood to make sure there are any questions and we catch everybody. At 7:15 a reverse 911 call was sent out to the four blocks around the apartment complex and we left printed material at each door so if there are any questions, folks should call 311. And obviously if anyone feels sick or needs paramedics, they should call 911.

We also have a report that there may be a pet inside the apartment and we have a plan in place to take care of the pet and we do not believe that pet has any signs and we'll move accordingly later today.

At the same time we have moved our Dallas fire and rescue hazmat unit over here to Presbyterian Hospital where we decontaminated the car that the patient drove in and secured it so nobody could come in contact with the car. We decontaminated hand railings, everything in the parking lot, so everybody can feel comfortable that the exterior was taken care of.

We have a plan in place to send hazmat units into the apartment and clean up the interior later today. I want to say once again that we had this plan in place last week so when we got this phone call, which we thought we might get we put an action team in place and they have been working all this evening so as people are waking up they know that they are safe.

There is much work to be done yet, but we wanted to make sure that you knew instant information from us as soon as you woke up. And as you know, we're going to be staying in constant contact with you, but we're going to let CDC test this specimen and let them make some comments and then we'll be getting back to you.

Until then, Judge Jenkins and I have a lot of work to do and we'll leave you with the good doctor. Thank you.

UNIDENTIFIED MALE: We have time for about two or three questions for Dr. Varga.

UNIDENTIFIED MALE: Doctor, did this worker -- did this health care worker come into work at specifically at the Presbyterian Hospital? Did this person come into contact with Duncan on the first E.R. visit or when Duncan was brought in the second time? And can you talk as specifically as you can about what sort of contact this worker might have had, was it with blood or vomit?

DR. DAN VARGA, TEXAS HEALTH RESOURCES: I can't speak specifically to the type of contact. This is a worker who works at Presbyterian who was involved in the care of the second visit.

UNIDENTIFIED MALE: The second?

VARGA: Yes.

UNIDENTIFIED MALE: Was it someone who was considered part of that high risk pool?

VARGA: No.

UNIDENTIFIED FEMALE: Was it in a lower risk pool?

VARGA: Yes.

UNIDENTIFIED MALE: What have you done to protect other health workers who, you know, during that second visit especially, I think there was some indication early on that there may be an ebola case here? What have you done to make sure that other workers who were involved in kind of the same way that this worker was are safe and if you can talk about specific measures you've taken from that point?

VARGA: All of our workers are following CDC-recommended precautions. To be any more specific than that would be speculating, but all of our workers are following CDC-prescribed precautions when they interact with the ebola patients.

UNIDENTIFIED MALE: Can you say that this person was wearing protective gear?

(CROSSTALK)

VARGA: Pardon me?

UNIDENTIFIED MALE: Can you say if that person was wearing protective gear when they came into contact?

VARGA: They were.

UNIDENTIFIED MALE: They were wearing --

VARGA: They were.

UNIDENTIFIED FEMALE: Was this a staff person or medical provider?

VARGA: Really in interest to the patient -- excuse me, of the health care worker's privacy, I won't go any further detail than we already have on that.

UNIDENTIFIED MALE: Going further on the question on protective gear -- gloves, mask, what other protective gear was this person wearing?

VARGA: This individual was following full CDC precautions which are barrier and droplet. So gown, glove, mask and shield.

UNIDENTIFIED MALE: How disturbing is it that even after those precautions this person is still contracting the disease?

VARGA: We're very concerned.

UNIDENTIFIED MALE: How do you assure people that somebody -- it's got to be scary for workers that have followed the CDC guidelines and still get infected -- how are you assuring people that they can't be infected?

VARGA: We're still confident that the precautions that we have in place will protect our health care workers. We don't have a full analysis of all of the care. We're going through that right now to try to understand specific elements of who came in contact with Mr. Duncan, around what circumstances, on what day, et cetera. But we're confident that the precautions we have in place right now are protecting our health care workers.

UNIDENTIFIED MALE: Did the person self-quarantine over the last week and a half or so or have they been out and about?

VARGA: The health care worker has been doing self monitoring and did not work the last two days.

(CROSSTALK) UNIDENTIFIED MALE: How many of the contacts from Eric Duncan

have been doing self monitoring and do you have a number of contacts that you're --

VARGA: I can't give you the full details of all of the contacts. Texas Health Resources and Texas Health Presbyterian Dallas are currently tracking 18 employees.

(CROSSTALK)

UNIDENTIFIED MALE: (inaudible) you learned that this was happening, what has happened since then until now?

VARGA: I can't go into specific detail on the timeline because of the protected nature of that. I would reiterate in this particular situation, however, from the time that the self monitoring indicated the need for contact to the time that the patient entered full isolation in the emergency department was less than 90 minutes.

UNIDENTIFIED MALE: We need to let Dr. Varga -- I'm sorry, Dr. Varga needs to leave.

UNIDENTIFIED MALE: He said low risk. Low risk means one of the 48.

VARGA: Yes.

UNIDENTIFIED MALE: This person was or was not one of the 48?

VARGA: I can't speak -- I can't speak to whether or not the patient falls into what the judge mentioned of the 48. Texas Health Resources has been monitoring 18 patients.

(CROSSTALK)

UNIDENTIFIED MALE: Have sections of the hospital been quarantined or closed off because of this?

VARGA: No. But to be clear, you'll recall from Mr. Duncan's care, the area that we have been using for inpatient care is a -- I believe a 24-bed ICU that we have cordoned off and are isolating specifically to use as our isolation unit for inpatient care for ebola patients.

UNIDENTIFIED FEMALE: Dr. Varga, what's your role in this?

VARGA: I'm the chief clinical officer for Texas Health Resources.

(inaudible)

VARGA: I can't comment on the care right now.

UNIDENTIFIED MALE: We will be posting updates on our Web site and sending them out through e-mail. But right now I have to take Dr. Varga to another meeting. Thank you very much. BLACKWELL: So answers to a lot of the questions we've been

asking this morning now that this second diagnosis has come -- another case of ebola. I want to bring in Dr. Amesh Adalja, senior associate for UPMC Center for Health Security; and we have our senior medical correspondent, Elizabeth Cohen, with us as well.

I want to start with you, Elizabeth. The questions that we were asking and waiting for, this health professional had contact with Mr. Duncan during the second visit and was in this full CDC-recommended gear -- the impermeable gown, the gloves, the shoe covers, the face mask, the eye protection, low risk group -- and still contracted the virus.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: I know. I'll tell you Victor, I was devastated to hear that. I was sort of hoping in some way that maybe this was the first visit when they didn't know that Duncan had ebola. That would sort of easily explain it. But why would a health care worker at a good hospital, they knew they were dealing with an ebola patient, how could this health care worker get ebola?

There's so many questions that need answering. So many, hundreds of health care workers have gotten ebola and mostly in West Africa and I think a lot of people thought, well, they just maybe didn't do it quite right. Well, this is a U.S. Hospital that should know how to do it right. They said they were following all the CDC guidelines. How in the world did this happen? That question has to be answered.

PAUL: And then we bring back to today, Dr. Adalja, one of the other things that really stood out in this is the fact that they are -- he came out and said ambulances are not bringing people to the E.R. here at Texas Presbyterian, they're being diverted to another hospital. What does that say to you?

COHEN: You know, they weren't clear on why they were doing that. It may be because they sort of feel like they have their hands full dealing with now a second ebola case. It may be that they're concerned that passengers, the patients would say wait a minute, don't take me there, that place now has had two ebola patients and just sort of even though they don't need to be worried, just sort of this anxiety, this public anxiety and they just want to get rid of that altogether.

It does tell me that there is sort of a heightened sense of concern. And I'll tell you having watched Judge Jenkins at press conferences over the past couple of weeks, there was sort of a level of concern in his face that I hadn't seen before.

BLACKWELL: Yes, and I noticed that too. Kind of speaking slowly there in the beginning and actually stepping away during the middle of the doctor's comments. Elizabeth Cohen, stay with us. Dr. Amesh Adalja stay with us as well. We'll get to you right after the break.

More on the breaking news out of Dallas. Stay with us.

(COMMERCIAL BREAK) PAUL: I want to go to Dr. Amesh Adalja when we're talking about

this second case of ebola that has been contracted here in the U.S. in Dallas. Elizabeth Cohen, you heard her Dr. Hidalgia say that she was devastated to learn one of the biggest things we learned in this news conference that this was a person considered low risk to Thomas Duncan who died of the disease on Wednesday. This was also a person who was in full protective gear and they still contracted the virus. What was your first reaction to hearing that?

DR. AMESH ADALJA, UPMC CENTER FOR HEALTH SECURITY: Like Elizabeth Cohen, I was also shocked that this was during the second visit, but I would say that personal protective equipment is one thing. Wearing it is one thing but taking it off is another important aspect of that. And that's what we saw with the Spanish nurse that was infected, there may have been contamination when taking it off.

And really -- the virus hasn't changed so there must have been some breach in infection control protocol that allowed this worker to get exposed.

BLACKWELL: We know the CDC is now taking a larger role, Elizabeth. The question I asked -- would the state, would the feds get involved to some greater degree now and we know that they will be doing this twice daily monitoring. One person, we know the patient is in isolation but then a close contact of the patient also in isolation.

Elizabeth, I'll put it to you. You said a lot of questions have to be asked. What's at the top of your list right now?

COHEN: Well, at the top of my list is just as we were discussing is how did this health care worker get ebola when he or she was in full protective gear? Where they using it properly? Did they put it on properly and did they take it off properly, which is actually even -- can be even more important. This is a hard thing to do to put on this gear, to use it right. Was there some kind of a misstep? That's a really, really important question to be answered.

Now, as far as the CDC involvement, you know, the CDC traditionally really kind of lets the state take the lead on things, whatever the situation is. And they really defer to the states. We may see that they do more command and control now that there is this first case of where someone has gotten ebola in the U.S. In other words, didn't contract it in West Africa.

And I think the CDC really at this point will also be called in to send more manpower. I don't know how much more they have but to send in more manpower. Now you need to trace contacts for two people. I think this contact list will be shorter. I think it's important to note that they said in the press conference that only 90 minutes passed between the time that they realized they were ill and the time the person was isolated. That's a short period of time.

PAUL: All right. Elizabeth Cohen and Dr. Amesh Adalja, thank you both so much. We should point out that the judge also said this person is a heroic person and going through a real ordeal right now. BLACKWELL: Absolutely. And we'll continue to follow the

breaking news.

We hand things off now to Candy Crowley and the start of "STATE OF THE UNION". Let's send it to Washington.