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CDC to Release Updated Guidelines for Ebola Protection

Aired October 17, 2014 - 20:00   ET


ANDERSON COOPER, CNN ANCHOR: Good evening, thanks for joining us. It's has been a hectic week in the Ebola crisis and another very busy night for us but still no transparency from the hospital where it all began.

There's breaking news tonight. We've learned with CDC will shortly be releasing updated guidelines on personal protective equipment or PPE, after admitting that earlier forms of the gear did allow exposure to the virus. It's a big emission there.

Earlier today, President Obama named appointment to lead the fight and drew fire for -- from some for his choice.

Also, the Federal Government told laboratories get ready for emergency production of that experimental antiviral drug, ZMapp.

We also learned that another Dallas worker inexplicitly went travelling this time in a cruise ship. Plus, we got a look at nurse Nina Pham's journey from Dallas on a specially air-equipped ambulance. You can see the sealed containment area there as we push in on the photo.

Now the plane landed in Frederick, Maryland North of Washington, nurse Pham was taken to the National Institutes of Health in Bethesda, where she has been treated in a bio-containment ward. The hospital's clinical director saying she is doing quite well.

She and Amber Vinson, who is being treated in Atlanta, cared for now diseased, Thomas Duncan as you know. From the beginning, there had been questions about how his case was handled, then came questions about how prepared Texas Health Presbyterian Hospital in Dallas really was to treat him, to handle his needs, to deal with his medical waste and vitally to keep hospital personnel safe.

Now, allegations on the program last night from nurse and whistleblower Briana Aguirre. Listen.


COOPER: As a nurse did you receive any special training? Did you have mandatory classes? Was there discussion from higher-ups at the hospital about how to deal with an Ebola patient before Thomas Eric Duncan arrived?

BRIANA AGUIRRE, NURSE: No one ever spoke to me about Ebola. There were no classes offered. There were no training offered. COOPER: Was your neck exposed?

AGUIRRE: Absolutely. Yes. There is a --

COOPER: What part of your neck?

AGUIRRE: Well, the zipper ended about here on me. And the hood ended about here on me. And you know, this part right here made a triangle that was open. It was completely open. And the very first time that they were instructing me how to put this on is exactly the point when I said why would my neck be exposed? Why do I have on two pairs of gloves? Tape, a plastic suit covering my whole body, two hoods? A total of three pairs of booties including the one on my tieback suit. An apron, and my entire body is covered in at least three layers of plastic and my neck is hanging out.


COOPER: Well, we have been seeking answers from the hospitals for days without successes. This morning, the chief clinical officer of the hospital parent company Texas Health Resources appeared on ABC News.


JOSH ELLIOT, ABC NEWS ANCHOR: People want to know how two nurses wearing protective gear got Ebola. How did that happen?

DR. DANIEL VARGA, CHIEF CLINICAL OFFICER, TEXAS HEALTH RESOURCES: We know that Nina was the first caregiver to accept Mister Duncan as he came up from the emergency department. It was at a time prior to Mr. Duncan's diagnosis -- are confirmed diagnosed of Ebola. Nina's personal protective equipment was absolutely in compliance with the CDC recommendation at the time.

And as soon as we had the confirmation of the Ebola serologic diagnosis, all of the personal protective equipment in the MICU converted to the hazmat-type suit. We have no indication that Nina or Amber had any break in protocol.

We were working with the best information we had. In retrospect, would we have liked to, you know hermetically seal them so that distant have them absolutely.


COOPER: Well, no break in protocol. He said when we invited Dr. Varga on the program to ask him about that, we invited Texas Health Resource Chief Operating Officer, we repeatedly invited officials from the hospital itself, none has accepted.

Texas Health Resources first offered up the president of the local hospital trade association, not a doctor, not associated with the hospital or even with the parent company. Then they offered a doctor from the local medical society, who again is not affiliated with the Texas Health Resources or with the Texas Health Presbyterian Hospital in Dallas. So no one is offering to answering our questions.

However, late today, nurses rallied outside Presbyterian showing support, they say for the hospital and the face of Briana Aguirre's criticism.

And with that we want to bring in our panel, Chief Medical Correspondent Dr. Sanjay Gupta in Atlanta, and also back here is Seema Yasmin, staff writer for the Dallas "Morning News", former CDC disease detective and professor of Public Health in the University of Texas, Dallas. And Dr. William Fischer, the second associate director for researcher -- for research at the University of North Carolina's Division of Pulmonary Diseases in Critical Care Medicine. Earlier this year the Dr. Fischer treated Ebola patients in Guinea where he was working with a group of doctors without borders.

Sanjay, I mean, it is pretty incredible, when you feared that hospital officials, hospitals by the way that is really showed no transparency whatsoever, basically now they're says we were in compliance with the CDC standards at the time these nurses contracted Ebola. When everybody knew how Doctors without Borders have been dealing with Ebola patients, you know that all that was on line. It seems like they're still refusing to accept any level of responsibility for this.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, I know, it's amazing they still lay a lot at the feet of the CDC. And in fact, I was reading their statement again earlier. They say, you know we wanted to ensure that we were compliant with CDC guidelines. We were frustrated when the CDC guidelines changed. They talk specifically about what the nurses that you're just interviewing talked about the fact that the nurse did complained that their necks were exposed. They were two onsite CDC members observing them and they did tell them to at least cinch their gowns with tape.

That was some of those comments about the tape came from as well. So it is quite remarkable. They were a little bit contrite with regards to mistakes made regarding Mister Duncan initial care.

And with regards to this issue, they just said hey, look, we did what the CDC told us to do so, you know that this is really not our problem.

COOPER: Dr. Yasmin, does it make sense, you have been nurses could have been in complete compliance with the CDC protocol and still have contracted the virus? Because at the beginning of this week the CDC director is very firm in the fact that protocol would have to have been breached.

DR. SEEMA YASMIN, STAFF WRITER, DALLAS MORNING NEWS: Anderson, we know from previous experience it's not good enough to just tell health care workers what to do. You have to give them training and make sure that the resources are there.

Look at what happened with SARS in Toronto in 2003, one health care workers died, more than 200 became sick and inquiry have followed many health care workers said, you told us to wear marks but we were not given any. There was a shortage. We were not fitted for them properly. You told us to wash our hands but actually the examination of the clinic showed there were no sinks neither in the patient care areas. So we need to learned from these past mistakes. We need to really to train health care workers. Make sure they thought adequately prepared.

COOPER: And Dr. Fischer, you mentioning at a point in an article that I read, you said that someone could probably wear a trash bag and be safe from Ebola. It's how you remove that trash bag that would put you at risk and that's really the crucial point. It's how the protective gear is taken off and what training you have in doing that. It doesn't seem like these folks at the hospital in Dallas have the training.

DR. WILLIAM FISCHER II, UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE: That is absolutely right. I think there has been so much focus on the personal protective equipment that -- (INAUDIBLE)

COOPER: Doctor, I'm sorry, we're having a problem with your mic. We're going try to fix it right now.


COOPER: Sanjay the news at the CDC is on the verge of updating the guidelines on personal and protective equipment. What do you expect it to be?

GUPTA: I think they're going to be more comprehensive, more protective. I think this idea of inadequate protection where there was skin still showing around the neck, I mean that's -- I think that seems -- probably obvious to everybody who has been watching coverage now over the last week. Your skin has to be covered if you want to protect yourself from Ebola infection, if you're taking care of a patient, so that's the basic thing.

They got to balance it, Anderson. You don't want to make this too complicated. And I'm sure Dr. Fischer will address this but this idea that taking it off is really important --


GUPTA: So if you make it too complicated, again, when you taking it off you could introduce the possibility of error, the covering the skin is basic.

COOPER: Let me go back to Dr. Fischer, I think we have the mic sorted out.

So I mean, if that is really what is critical. The lessons and the -- just the protocol, teaching it properly, not just kind a putting it on "You Tube" were saying, well you guys, we gave you the right equipment.

Dr. Fischer? Well, sorry. Are you back there? I hear you now. Go ahead.

FISCHER: OK. Sorry about that. First, I think this is -- I think it is important to say that this is

everybody's problem. That it is not just the CDC and it's not just Dallas. This is everybody's problem. We have to get this right. We have to protect our nurses and doctors and health care workers on the front lines.

And this is so much more than just a conversation about personal protective equipment. We have to focus on the process of removing that equipment because that really the time where you're going to come in at the highest risk of coming into contact with infected body fluids.

COOPER: And Dr. Fischer, you were in Guinea treating Ebola patients this spring, and I want to underscore, you went over to West Africa voluntarily with a remarkable group, Doctors without Borders that I hugely admire. It is an incredible thing you did. And I want to read from one of the emails that you wrote home when you were there because it really just -- I mean it is so painful to read.

You said, "With Ebola you can't have a good death. You're isolated from your friends, your family, your home. You cared for by people whose primary focus is on stopping transmission from infected to susceptible and from patient to provider, rather than comfort and cure. These people often die without the comfort of a human hand, without seeing someone's full face or even just knowing that a loved one is near."

And I know your emails they've been posted by University of North Carolina online. We got a link to them on our Web site. But as a doctor, I mean, how do you deal with that? Was dealing with Ebola unlike anything else in terms of the suffering of other people that you saw?

FISCHER: It was devastating. I mean, I think it was emotionally devastating. It was physically devastating. You know, as a physician you want to -- you want to share the experience that somebody is going through when they're sick and they're suffering. And with Ebola it was very tough to share that experience just because there was such a barrier. Not only they were isolated from their family and their friends and their loved ones, but they were isolated from their health care providers. It is a necessary precaution but it just -- it makes them that much more difficult.

COOPER: I know it is remarkable what folks on the front lines are doing with this. Really continue throughout the hour.

Sanjay, next, I want to ask you about the growing political dimension of the story with the naming of the so called Ebola czar. David Gergen is going to join us. As always, make sure you set your DVRs, you can watch "360" whenever you like.

We'll be right back.


COOPER: Welcome back. Again, the breaking news tonight the federal official telling us the

CDC will shortly release new guidelines on hospital protective gear. Word on that came this evening.

Meantime, the CDC is dealing with tracing people who may have been put at risk by Dallas health workers outside Texas and even on the high seas.

We'll have more on that from Rene Marsh now.


RENE MARSH, CNN CORRESPONDENT (voice-over): Tonight, the CDC is working to track 16 people who were near or had contact with Amber Vinson when she was in Northeast Ohio.

DR. MARY DIORIO, OHIO DEPARTMENT OF HEALTH: Additional work is being done to that list. And we may have changes to that list, which is why we're talking today.

MARSH: Before being diagnosed, Vinson flew round trip from Dallas to Cleveland. Frontier airlines is notifying up to 800 passengers, including those who flew with her and those who later traveled on one of the same planes.

UNIDENTIFIED MALE: I'm more worried than I am angry. You know, it is kind of one of those things where it happened. Now I just want to be positive and deal with it and move on.

MARSH: Another person being tracked, a lab supervisor from the hospital where Ebola patient Thomas Eric Duncan died remains quarantined on a cruise ship. Eric Lupher is one of the more than 4000 passengers on board.

ERIC LUPHER, CRUISE SHIP PASSENGER: I think it is more oh holy cow. We're on boat with an Ebola scare. You know, I don't think it's oh I need to get of here. I'm going to get sick."

MARSH: The woman never had contact with Duncan but may have had contact with his fluid samples. In a statement, Carnival Cruise Line said at no point in time has the individual exhibited any symptoms or signs of infection and it has been 19 days since she was in the lab with the testing samples. The lab tech boarded the Carnival Magic on October 12th before being notified of increased monitoring requirements.

DR. WILLIAM SCHAFFNER M.D., VANDERBILT UNIVERSITY: If I were on this cruise ship I wouldn't be concerned at all. In a vast excess of caution she is isolated herself, which from on objective science-based risk assessment is quite unnecessary.

MARSH: The ship is currently returning to Texas. Mexico refused to allow it to dock. And a request by the U.S. government to evacuate the passenger through Belize was rejected.

(END VIDEOTAPE) COOPER: Wow, Rene Marsh joins us from Washington, what more did we learn why this lab technician thought it was a good idea to get on a cruise ship.

MARSH: You know Anderson, we're really not sure what she was thinking and why she thought it was a good idea. But what we do know is she was self-monitoring for symptoms, she did not have symptoms at the time, she still doesn't have symptoms. And as you know, health officials have stress you're not contagious without the symptoms. But when you really look at the time line here, this lab worker got on the cruise ship on October 12th. That was before the monitoring requirements got more strict. So perhaps that's an explanation, Anderson.

COOPER: In terms of contacting all the passengers who may have flown in the same flight as nurse Vinson, we're talking about 800 people are on those specific aircraft shortly thereafter, has the CDC already talked to everyone? It seems like it is a lot of people for them to follow up with.

MARSH: Right, it is a lot of people. And I mean, you have to make sure you have the right contact information and essentially get these people on the phone. The CDC says that it has contacted all the passengers on board, Vinson's flight from Cleveland to Dallas, the flight that she was on the day before she was diagnosed. But they are still in the process of notifying the passengers on the first flight that she took. However, I have been in touch with Frontier Airlines and today they tell me they have completed their passenger notification -- Anderson.

COOPER: All right, Rene Marsh, Thanks very much.

At the White House today, President Obama answered the calls for him to put a single person in charge of the fight against Ebola. He did exactly that for more whom he choose and why he had setup a storm among some. Let's go to Senior White House Correspondent Jim Acosta.

So the new Ebola point person, Ron Klain, what more do you know about him? Tell us about him.

JIM ACOSTA, CNN SENIOR WHITE HOUSE CORRESPONDENT: Anderson, Ron Klain is more of a spin doctor than medical doctor. He doesn't have any experience in dealing with Ebola but he has plenty of beltway experience. He was chief of staff to both Vice President Joe Biden and Al Gore. And you may recall he was prominent figure during the 2000 Election recount that was turned into a movie, Klain by the way was played by Kevin Spacey.

And now Klain did lose that recount battle but White House officials say he was brought in for his government experience, he knows how the bureaucracy works. And aides say that will come in handy.

COOPER: And for weeks, members of Congress have been pushing for an Ebola point person, do we know why the President felt the need to bring in one now? ACOSTA: You're right, Anderson, earlier this week, the White House

was brushing off these calls for an Ebola czar. Where Ebola response coordinator is the White House is calling, Ron Klain, and then less than 48 hours ago they were saying that counterterrorism adviser, Lisa Monaco, could do that job and be the Ebola point person. Then the President changed his mind, Aides say he decided that was too much on her plate. But make that mistake, the political pressure was building and that combined with the mistakes that were being made over at the CDC, I think all of that appears to have forced the President's hand somewhere.

COOPER: And in terms of this guy's exact responsibilities, what are the White House officials saying about him?

ACOSTA: Well, they're saying that because there are so many different agencies and departments involved in this Ebola effort, Ron Klain's job is going to be to make sure all of those different government entities are working together, that all trains are running on time and that the right hand knows and what is the left hand is doing. That has not always been the case over here lately.

But keep in mind he is not going to be the all-powerful czar, he still ask to report to Liza Monaco and the National Security Adviser Susan Rice, to answer to the President and as the White House reiterated today, Anderson. The buck stops with him.

COOPER: All right, Jim Acosta, appreciate the updates.