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Gov. Perry Press Conference Regarding Texas Ebola Case; First U.S. Ebola Case Raising Concerns; Texas Officials Update Ebola Case; Governor Perry Confident Ebola Will Be Contained; Interview with WHO Assistant Director General

Aired October 01, 2014 - 13:00   ET


WOLF BLITZER, CNN ANCHOR: Hello, I'm Wolf Blitzer. It's 1:00 p.m. here in Washington, 6:00 p.m. in London, 8:00 p.m. in Jerusalem, 9:00 p.m. in Moscow. Wherever you're watching from around the world, thanks very much for joining us.

We begin with the first Ebola case diagnosed right here in the United States and the questions and the very deep concerns it's raising. What's being done to prevent the disease from spreading? What about the people who came into contact with the Ebola patient? And how worried should Americans and others be right now?

The patient is in intensive care and under isolation at this Dallas, Texas hospital. The Texas governor, Rick Perry, is scheduled to hold a news conference any moment now. We'll bring that to you live.

We'll also get the very latest developments from our correspondents and our experts here in the United States and around the world. By the way, you can send them your questions on Twitter using the hash tag EbolaQandA (ph).

Health officials are being tight-lipped about the Ebola patient. But here is what we do know right now. The man traveled from Liberia and arrived in Dallas on September 20th. According to Reuters, he traveled to the U.S. via Brussels, Belgium. He says he started feeling sick about four days later. He went to the hospital on September 26th, but an official familiar with the case tells CNN, he did not mention his travel history and hospital officials didn't ask him about that travel history.

The man later returned to the hospital two days later and was isolated. A team from the Centers for Disease Control and Prevention in Atlanta, Georgia has now arrived in Dallas to help identify people the man came into contact with. Those contacts will be monitored for 21 days. The director of the CDC says that kind of protocol helps keep the disease from spreading.


DR. THOMAS FRIEDEN, DIRECTOR, CDC: This a tried-and-true, reliable public health strategy. We go from the moment he could have been infectious, which is probably around the 24th, last Wednesday, and we retrace every step, every contact where he might have had direct physical contact with somebody. And for each one of those contacts, we will monitor them for 21 days after exposure in conjunction with the local and state health department and the hospital to see if they develop symptoms. That's how you stop an Ebola outbreak. That's what we will do in this case. There is no doubt in my mind that we can stop it in its tracks here.


BLITZER: Our Chief Medical Correspondent Dr. Sanjay Gupta is joining us now live from the C.D. Center -- CDC Center in Atlanta. Also joining us, our Senior Medical Correspondent Elizabeth Cohen. She's on the phone from Dallas. And joining us from Geneva, Switzerland is Dr. Keiji Fukuda. He's the assistant director general for health security for the World Health Organization.

Sanjay, a quick question. Should people feel reassured by what the CDC director, Dr. Thomas Frieden, just said about stopping Ebola in its tracks here in the United States?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, I think they should be reassured by that. I mean, obviously, he was -- he had strong convictions about that. He was not hedging. And I think it's based on, you know, a public health infrastructure in the United States that is far stronger, far more robust than some of the images that you've been seeing out of West Africa.

So, while -- what we're talking about today is historic, it has never happened before, no one has ever been diagnosed in this country or anywhere outside of Africa, for that matter, with Ebola. Despite that, it obviously raises some concerns. But they -- here at the CDC, Dr. Frieden feels very strongly about being able to contain this. I will point out, Wolf, and you mentioned this, but this idea that the patient -- this patient went to the hospital a couple of days after getting sick -- on the 26th of September, went to the hospital, had concerns, had symptoms and was sent away, travel history was not obtained, that's concerning. I mean, that's sort of the easy stuff, right, in all this, in trying to control an outbreak, that we can do easily but it was missed.

And as a result, there are two more days now before the guy went into the hospital. That means two more days of contacts he may have had that now have to be found. They have to be traced. They have to be monitored. And if one of them gets sick, all of their contacts subsequently have to be traced and monitored. So, it's not easy. It's laborious work. But, again, to Dr. Friedman's point, I think it can be much more easily done, effectively here in the United States, versus many of these countries in West Africa.

BLITZER: So, what you're saying, Sanjay, is that the patient never volunteered the information. He had just arrived in Dallas on a flight from Liberia, and no one in the hospital emergency room asked him about his travel history? Is that right?

GUPTA: That's what it sounds like, Wolf. And that's -- you know, look, that's a mistake. I mean, I don't know that -- any other way of putting it. Someone dropped the ball on that, fell down on the job. I was here at the CDC a couple of months ago saying, look, we can almost bank on the fact that a patient is going to show up in the United States with Ebola and be diagnosed in this country.

So, what are we doing about it? And they said, well, we are contacting all the primary care sort of doctors, emergency rooms and letting them know that if patients come in, they have a travel history that's concerning, coming from West Africa, and they have these symptoms, high fever, you know, nausea, diarrhea, things like that, then they are considered higher risk. It doesn't necessarily mean that they have Ebola. Chances are they still don't. But more investigation should have been done and that wasn't done here. The person was sent out with antibiotics, is my understanding. I'm not sure how that made any sense whatsoever. Two days later, this person comes in, by ambulance now, and that prompts a further investigation, testing, and it was two days later that the test was confirmed here at the CDC.

BLITZER: Yes, it sounds like a major blunder. We'll hear more about this, presumably, coming up in the next few minutes. We're standing by for that news conference, the governor of Texas, Rick Perry, joined by Dr. David Lakey, the Commissioner of Texas, Department of State Health Services. Maybe they'll be able to clarify what precisely happened. We'll have live coverage of that.

Let me bring Dr. Fukuda from the World Health Organization into this conversation. What needs to be done, Dr. Fukuda, to screen people traveling to and from that so-called Ebola hot zone in Western Africa? Because are watching us all over the world right now. They're clearly concerned that someone's going to get on a plane from Liberia or one of the other countries, Guinea, Sierra Leone, and fly to their neighborhood and potentially infect people. What needs to be done?

DR. KEIJI FUKUDA, ASSISTANT DIRECTOR GENERAL, WORLD HEALTH ORGANIZATION: Sure, Wolf. Well, there's a couple of basic recommendations that WHO has made. The first one is that we have -- we have recommended that all countries be prepared for the possibility that they could have a case of Ebola and so to get their surveillance systems ready and so on. And then, for those countries that do have Ebola going on right now, what we have recommended is that there should be exist screening so that people or travelers who have fevers should not travel. And, in addition, we have specifically recommended that anyone who has Ebola infection or who has been a contact of someone with Ebola infection, during the 21-day incubation period, should not travel.

BLITZER: The Reuters News Agency, Dr. Fukuda, says that this patient stopped off on the way from Liberia to Dallas in Brussels. Do people in Brussels -- do you believe -- should they be concerned about this?

FUKUDA: Well, I think that all airports, everybody should be aware that there's always the possibility of patients that are sick. And so, again, I think that looking for patients who are ill but also giving information to patients who are ill to seek medical care. These are basic recommendations that we would give for any ill patients, and I think that they are very useful in the current situation.

BLITZER: Let me bring Elizabeth Cohen into this conversation. Now, Elizabeth, you're there in Dallas. You're watching what's going on. You just came back from Liberia yourself covering this huge, huge story for our viewers. And just some perspective -- hold on a second, Elizabeth. I want to hear what Dr. -- what Governor Perry is about to say. He's getting ready to make a statement. We've got live coverage coming up. He's surrounded by top officials, including Dr. Lakey, the Commissioner of the Texas Department of State Health Services.

GOV. RICK PERRY (R), TEXAS (live): Good afternoon and thank you to each of you for being here today. Congressman, thank you for your presence. And, you know, over the past 24 hours, I've been in very close contact with the director of the CDC, Dr. Tom Frieden, as well as all the appropriate Texas state health officials. We're working very closely with the local, both the city and the county, health officials as well in this very serious case as we partner.

As you know, a patient was admitted to this hospital on September the 28th and subsequently tested positive for Ebola. Today, we learned that some school-aged children have been identified as having had contact with the patient and are now being monitored at home for any signs of the disease. I know that parents are being extremely concerned about that development. But let me assure, these children have been identified and they are being monitored and the disease cannot be transmitted before having any symptoms. I have full confidence in the medical professionals, in Superintendent Miles, in our local, our state and our federal partners in keeping this contained.

This is a disease that is not airborne and is substantially more difficult to contract than the common cold. We have experts here with us today who will be talking to you in a minute about the precautions that you may want to take. The medical community of north Texas along with officials from the state and federal government have been working together to take every step available and necessary to care for this patient's health and to ensure the safety and welfare of our citizens.

There are few places in the world better equipped to meet the challenge that is posed in this case. Texas is one of only 13 states certified by the CDC to conduct diagnostic Ebola testing. And we have the health care professionals and the institutions that are second to none. The public should have every confidence that the highly trained professionals involved here will succeed in this very important mission.

Public health investigators from Dallas County and from the Texas Department of State Health Services are working to identify, to locate and monitor the health of all those who have come into close contact with the patient. The highly qualified men and women of Texas Health Presbyterian are doing everything in their power to deliver the very best care for this patient. They have been and they will continue to be in close contact with federal, state and local officials to ensure the public's safety.

This case is serious. Rest assured that our system is working as it should. Professionals on every level of the chain of command know what to do to minimize this potential risk to the people of Texas and of this country, for that matter. I'd like to ask Dr. David Lakey, he is the head of our state health services, to come and share with you the efforts that are ongoing as we address this issue -- David.

DR. DAVID LAKEY, COMMISSIONER, TEXAS DEPARTMENT OF STATE HEALTH SERVICES: Good morning, everyone. My name is David Lakey. I'm the commissioner of the Texas Department of State Health Services, and I really appreciate you being here today.

I want to echo several of the comments that were made by the governor. First, you know, our thoughts and prayers are really with the family. They were notified about their loved one having Ebola yesterday. Obviously, it's a scary diagnosis and so our thoughts and prayers are with them right now. And also with the treatment, they -- the treatment team. Those individuals in the health care that are caring for the individual right now.

Since the outbreak of Ebola in West Africa, Texas has been taking steps to make sure that we are prepared for an event like this. A lot of education has taken place. A lot of protocols have been put in place. We've developed the ability to test for this virus since October -- or, excuse me, since August and to be able to do that in our laboratory. And our preparedness is not just taking place at the state level, preparedness was taking place at the local level in this hospital. They took it really seriously. They've been educating their staff. They've been putting their own protocols in place so that they were ready to care for an individual, that this individual and any individual, that showed up with Ebola. So, we've been on the lookout for this.

I had the opportunity today to spend time with the team and to talk the management team and hear how they have been preparing for a long time for this event. And then, I had the opportunity to talk to the infection control practitioners and actually go onto the ward and see firsthand the work that they're doing. And I want you to know, they're doing a great job. They're providing compassionate care. They're -- they have a committed staff that are providing top-notch care and are doing that in a safe environment. They have a whole ward that's dedicated to the care of this individual. They have a whole team of, again, professionals that are very competent caring for this individual and are doing it, as I noted, in a very safe, compassionate environment providing excellent care.

Now, obviously, this disease is scary to a large number of individuals. But I think some of the points that Dr. Frieden emphasized yesterday need to be restated. One of those statements that he said, and I want to reiterate, is that people cannot transmit this disease until they have symptoms. OK. And so individuals that do not have symptoms are not going to transmit this disease to individuals. The chance of them transmitting it is zero. This virus is not transmitted by the air. It's not transmitted by the water. It is transmitted by direct contact with an individual, with their skin, or contact with blood or secretions or other bodily fluids, or if there's a contaminated needle, then you can transmit this. But it's not going to be transmitted, again, through the air, through the casual contact with other individuals. I also want to make the case that, you know, this is not West Africa.

This is a very sophisticated city, a very sophisticated hospital. And the dynamics are so significantly different than they are in east Africa - or, excuse me, in West Africa, that the chances of it being spread are very, very, very small. And, again, unless somebody has symptoms, it's not going to be spread to another individual.

Our laboratory has been developing the ability to do this test. Since August, we've done the proficiency tests and have that ability to do that diagnostic test in our laboratory. And that ability is available to support the state of Texas. We do a rapid diagnostic test, a (INAUDIBLE) chain reaction. And, again, the test yesterday, the controls worked as they were appropriately supposed to work and the test was obviously positive.

We take great care in our lab to inactivate the virus and to make sure that, again, our laboratory folks are safe and it was done in a very safe manner. And we have a bio threat team that is specifically trained to handle these high-risk specimens.

And so a lot of work is taking place right now. A lot of investigation is taking place identifying individuals. The family's been identified. Contact has been made. Messages have been conveyed to them about how we need to approach the situation. And we will continue to work very closely with the -- our federal partners at the CDC, our local partners with the Dallas County Health Department, with this hospital, with the Dallas city government, mayor and judge, thank you for being here today. And with the full support of the state of Texas to make sure that we protect Texans and that we provide the care that needs to be provided.

Thank you.

GOV. RICK PERRY (R), TEXAS: David, thank you.

And let me add to that, Mayor Rawlings and to Judge Jenkins (ph), thank you both.

This is all hands on deck. We understand that. And we've got great local partners and everyone has their marching orders and understand the importance of that good collaboration, that good partnering from the state right through our federal partners with the CDC. So, with that, we'll open it up to those of you in the media for any questions and individuals on the podium here can respond.


PERRY: I beg your pardon?


PERRY: Mark, why don't you.

DR. MARK LESTER, ZONE CLINICAL LEADER, TEXAS HEALTH RESOURCES (ph): We're categorizing his condition as serious but stable.


LESTER: A checklist was in place for Ebola in this hospital for several weeks. And Dr. Ed Goodman (ph), to my right, had led the implementation of that. That checklist was utilized by the nurse who did ask that question. That nurse was part of a care team. And it was a complex care team taking care of him in the emergency department.

Regretfully, that information was not fully communicated throughout the full team. And as a result, the full import of that information wasn't factored into the clinical decision-making. The overall clinical presentation was not typical at that time yet for Ebola. So as the team assessed him, they felt clinically it was a low-grade common viral disease. That was the presentation.


LESTER: He volunteered that he had traveled from Africa in response to the nurse operating the checklist and asking that question.


LESTER: I can't answer that question because that's one piece of information that would be factored into the entire clinical picture. The clinicians did not factor it in. So it was not part of their decision-making.


LESTER: I -- that's a question that's really not in my domain.


LESTER: We are carefully assessing that now. And that is being investigated. So we are investigating it. I can't give you specific information. We will look very carefully at that.

QUESTION: Sir, would I - would I call that a misstep, would you not?

LESTER: I would call that not factoring all the information among the team that was present so that all the information wasn't present as they made their clinical decision.

QUESTION: Was there any (ph) expressed any information that this person (INAUDIBLE).

LESTER: That information was not obtained when the patient was in the emergency room.

QUESTION: But do you know that now?


LESTER: Oh, I'm Dr. Mark Lester. And I'm an executive vice president with Texas Health Resources. I'm the zone clinical leader for the southeast zone in Texas Health Resources.


LESTER: Well, remember, it's unprotected exposure to the bodily fluids that constitutes an exposure. And so very carefully and together with the CDC, we're investigating how many people that might be and how they might be monitored if that's so.


LESTER: As I said, we are investigating that right now.

WOLF BLITZER, CNN ANCHOR: All right, we're going to continue to monitor this news conference in Dallas, Texas. But we did get some pretty startling information from Dr. Mark Lester who just told us that the -- a nurse did ask this Ebola patient if he had traveled recently. And the Ebola patient did volunteer he just flew into Texas from West Africa, specifically from Liberia. But, unfortunately, unfortunately that information was not passed on to the others -- the other medical professionals who were dealing with this patient who determined he just had a low-grade fever and they released him and let him go out there for two days.

Sanjay Gupta, Dr. Sanjay Gupta, is with us. This sounds like there was a basic, major problem in communication between the nurse and others who were treating this specific patient.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, Wolf, I don't know any other better way to put that. I mean somebody messed up here. I will tell you that typically, you know, emergency rooms are very busy. You've heard that a lot over the last day or so in terms of what was going on there. And -- but there was somebody usually in charge, somebody who usually signs off on the final decision regarding the patient, the discharge papers, let me review everything again, put it all together, make sure we're doing the right thing.

Look, I don't want to pile on here at this point. I mean, they messed up. I mean I think there's almost no question that maybe the question was asked I guess now we're hearing. First we heard that they didn't even ask about travel history. Now we're hearing that they did ask about this patient's travel history, but then did not convey that to the team. What's one to make of that, Wolf? That shouldn't happen.

And when we talk about stopping outbreaks, there are so many complicated parts of this. The contact tracing, possibly the vaccine at some point in the future. Asking about travel history? That's easy. And acting on it, that's easy. That wasn't done here.

BLITZER: Let me bring in Dr. Keiji Fukuda from the World Health Organization in Geneva, Switzerland.

Dr. Fukuda, people are watching us right now all over the world, health care professionals are watching all over the world, tell them what they need to know to make sure that a blunder that occurred in Dallas when this patient was checked out and allowed to go home and be in contact that we just heard Governor Rick Perry of Texas say that school-aged children are now being monitored because he was in contact with school-aged children -- tell health care professionals and others around the world, Dr. Fukuda, what they need to learn from what happened in Dallas, Texas.


Well, I think there's some really basic lessons here. One of them is that everybody, all health care professionals especially need to be aware that in this world where people get on airplanes and can travel anywhere around the world that it's possible to see a case of Ebola infection. You know, it's not so surprising to see a case appear somewhere in a traveler. And so knowing that, then, you know, there are some basic things that you want to do, and as has been emphasized in the story, ask questions, ask about the travel history of the person. And then you want to make sure that you understand the symptoms and the illnesses of things like Ebola.

And then once you have some kinds of suspicions that that's what you may be dealing with, then you want to make sure that that kind of person, that traveler, is handled in the right way, to make sure that they're handled in a way which is safe for the person, but also which is going to minimize the chances of spreading infection to others. And then you want to communicate that information, as was done in this case. And so now we have a public health investigation going on. We do have the patient in good treatment and in isolation. And so I think that all things considered, you know, this situation appears to be handled quite well.

BLITZER: Except for the fact that the nurse, who learned that this patient just arrived in Dallas, Texas, a couple of days earlier from Liberia, that information was not passed on to some of the other health care professionals who eventually released that individual and allowed him to go on.

A quick follow-up to you, Sanjay. When we heard the governor of Texas say that school-aged children are now being monitored for 21 days, what does that say to you?

GUPTA: Well, look, that's obviously - it's frightening. I think any - you know, being a father myself, you know, you hear these types of things and, you know, it doesn't - it doesn't sit well you. I will tell you, the odds are very much on these children's side. The odds are that they are not infected. The odds are that they are going to do just fine. If they were exposed during this other two-day period after the patient had gone to the hospital and was released and not tested for Ebola and then subsequently had contact with these children, all I can say, again, I, you know, I -- I don't want to pile on here, but all I can say is that that didn't need to happen. The number of contacts that this person should have had after the 26th of September was zero. That's the number of contacts the person needed to have. And here he may have had more contacts. We don't know at what point he had contact with these school-aged children, but that's the concern.

BLITZER: It's a deep concern indeed. And we're, obviously, going to stay on top of this story has worldwide ramifications.

Dr. Fukuda, we'll stay in close touch with you in Geneva, Switzerland. Thanks very much for joining us. Sanjay, of course, we'll be staying in touch with you throughout the day here on CNN and CNN International.

We'll get back to this story, but there's other major news we're following here in Washington, D.C. The man arrested after actually getting into the White House armed with a knife is about to face a judge. This as new questions surface about the competence of the U.S. Secret Service.

And President Obama goes on the offensive to address major security and health threats around the world. But does his strategy go far enough? We'll discuss that and more with the Democratic Party chair, Congresswoman Debbie Wasserman Schultz. She'll join us this hour.