Return to Transcripts main page

LEGAL VIEW WITH ASHLEIGH BANFIELD

Nina Pham Press Conference; Doctor with Ebola Isolated at NYC Hospital; Ebola Patients Manhattan Apartment Isolated

Aired October 24, 2014 - 12:00   ET

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


NINA PHAM, NURSE THAT HAD EBOLA: Although I no longer have Ebola, I know that it may be a while before I have my strength back. So with gratitude and respect for everyone's concern, I ask for my privacy and for my family's privacy to be respected as I return to Texas and try to get back to a normal life and reunite with my dog Bentley (ph). Thank you, everyone.

DR. ANTHONY FAUCI, NIH: Thank you very much, Nina.

Before I open it up for questions, I want to recognize two people who really helped us in linking with Nina and getting to know her as essentially a member of our family here at NIH, and that is Nina's mother Diana and her sister Kathy.

OK. So, questions?

QUESTION: Dr. Fauci, how do you know that she is virus-free? What did you do for her while she was here at NIH?

FAUCI: Well, we know she's virus-free because we now have five negative -- consecutive negative PCRs on her. Now, I don't want anyone to take from that that that is the norm and the standard that you can only guarantee someone's virus-free if you do five. We did five because this is a research institution, but that's not the norm. We provided her with supportive care, and that's something that I've been saying all along, that one of the most important things in bringing back an Ebola patient to health is to give them the kind of medical general support to allow their own body to then be able to fight off the virus and essentially get rid of the virus.

QUESTION: (INAUDIBLE).

FAUCI: I would leave that up to her, but that's not for me to answer right now.

QUESTION: Dr. Fauci, a more broad question, given all the concerns of this right now with what's happening with the doctor in New York City right now, should Americans or others returning from the Ebola zone be forced into a more strict or mandatory quarantine?

FAUCI: That is something that is right now on the very active discussion and you'll be hearing shortly about what the guidelines will be. But I want to point out, to remember that it isn't just the CDC and the federal government, but the states have an awful lot to say about what happens when people come in. But you'll be hearing more about that.

QUESTION: Give us a sense -- you're an expert right now, but your take though right now because there is real concern that if you went to a bowling alley or sat on a subway car that you might be in trouble.

FAUCI: Yes.

QUESTION: So is that a unreasonable concern?

FAUCI: Well, I think I can repeat what we've been saying all the time, that the way you get Ebola is by direct contact with the body fluids of an ill individual. And if you don't have that, you do not have to worry about Ebola. And I think that's important to point out that you must separate the issue of the risk to a general public with the risk with brave people like Nina and her colleagues. They're two different things. Nina put herself in a situation where she knew it was a risk, but because of her character and her bravery and that of her colleagues in the field, she happened to unfortunately get infected. That's a different story from the general public. She was with a very sick person.

QUESTION: Dr. Fauci, what have you learned by treating Nina Pham? What have you learned and what experimental drugs, if any, did you use? And what can you teach other doctors such as Dr. Spencer in helping him recover?

FAUCI: Well, first of all, we did not administer to Nina any experimental drugs while she was here under our care. We followed her. We have a considerable amount of laboratory data. Remember, this is only one patient. We are in contact and in discussion with our colleagues at Emory and at Nebraska. We continually compare notes back and forth.

And I think it's important for people to understand that there's the public health issue and there's the scientific issue of understanding what's going on. And that's essentially what we do here. Primarily it's the care of the patient first. But together with that is to learn information that might help others.

Now, that's easy to do when you have a whole bunch of people that you could collect data on. But when you have one or two or three, you've got to focus very much and try to get enough information where gradually we'll be able to say things that will help others who are taking care of patients. That's the reason why we may have done different kinds of lab tests or more of them. That doesn't mean that everybody has to do that, but we're trying to learn from that.

QUESTION: Dr. Fauci, how -- why has it taken so long to get an Ebola vaccine? There were reports today that there was one ready for human testing a decade ago.

FAUCI: Yes. Well, there's a lot of reasons why when you say, to get a vaccine, you've got to make sure you separate that from a vaccine candidate because if you're saying a vaccine's something you could distribute, first of all, since Ebola is a disease that has outbreaks and then disappears, it's very difficult to be able to prove something except in the setting of disease, which we're actually trying very hard to do right now when we go from the phase one study where we show it's safe and that it induces a response that you could predict would be protective. We're planning a larger efficacy trial that's a randomized controlled trial to be able to do that, as well as some other designs.

Now, in direct answer to your question, you might recall that we started on this 10 years ago and we've done different iterations of improvements. One must appreciate that the incentive for a pharmaceutical company to get involved in putting a major investment to develop a vaccine for a disease that, up until this outbreak, had less than 2,500 people infected. We did not have the kind of incentivisation on the part of industry. We certainly have that now. So it was not essentially a scientific obstacle and it was not an obstacle of wanting to have one, it was the ability to actually bring all the cards together to get that.

QUESTION: (INAUDIBLE) the ability to get funding for it?

FAUCI: No, I don't -- well, first of all, the funding one is a very complicated issue. I think we should put that off the table because we're really talking about what we're doing right now. And we're on the way in the sense of, we have the capability and the resources to do the trial that hopefully will start in the beginning of 2015.

QUESTION: Dr. Fauci.

FAUCI: Yes.

QUESTION: Can you pinpoint a turning point in Nurse Pham's care where you just saw things turning around? You saw the tide turning (INAUDIBLE)?

FAUCI: Well, you know, I don't want to make an absolute statement on that because, remember, she was taken care of by very good people in two separate hospitals. So when she was in Texas Presbyterian, she was in the process of actually doing better. She came to us and she continued to do better and better. We both supported her so I can't pinpoint in one patient what was the turning point. The only thing that we're really happy about, that the turning point occurred.

QUESTION: Was the plasma donation from Dr. Brantly the (INAUDIBLE)?

FAUCI: That is conceivable but you can't prove that. The question you may not have heard is, was it the plasma transfusion from Dr. Kent Brantly? Certainly that could be the case. But, remember, when you have so many separate factors at the same time going into the care of a patient, and the n (ph) is one (ph) for this patient, it's virtually impossible to say that this is the thing that did it and this is the thing that didn't do it. It's just impossible to do. I'm not trying to evade it. That's the reason why you want to do clinical studies where you can actually get that information so that the next time we have an outbreak, or maybe even during this outbreak, we can say, this is the recommendation because we know it works. At this point, everything is experimental and that's what we're trying to do is take the experimental and make it evidence. ASHLEIGH BANFIELD, CNN ANCHOR: Dr. Anthony Fauci standing in front of

Nina Pham in the green shirt, black jacket, who is flanked by her sister and her mother. Nina Pham, after suffering through a deadly disease, Ebola, standing on her own on the day she's being released from that Bethesda, Maryland, institution. She was thanking those who took care of her and particularly reaching out to Dr. Kent Brantly who also went through this problem, but donated blood plasma for her care. She thanked him directly.

And then as we learned from Dr. Anthony Fauci, that was, essentially -- her care was that transfusion. She received no experimental drugs. But great news to see her looking as good as she does. It's a great day just in terms of the bad news we've had about Ebola and the good news that she has pulled through. The nurse from Texas, Nina Pham, going home today.

Joining me to talk about this fantastic development, Dr. Alexander van Tulleken, along with CNN's chief medical correspondent Sanjay Gupta, who joins us on the phone.

First to you, Sanjay Gupta, great news. Perhaps not unexpected considering her condition had improved over the last few days. But still, I'm a little surprised to hear all of these success stories in America and so few of them elsewhere.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT (via telephone): Yes, I think you're absolutely right, Ashleigh. And, you know, you've heard that mortality rates can be as high as 90 percent in some of these previous outbreaks. You know, I think it speaks to a very important point. Dr. Fauci mentioned this. But the bottom line ultimately for these patients is that their own immune systems, if they are healthy, can ultimately fight this virus if they are just supported while they're doing that. And that means giving them fluids, making sure they don't become too dehydrated. If they have any bleeding problems, give them blood back.

She did receive the blood transfusion, as you mentioned, from Dr. Kent Brantly. And the thought there is that he fought Ebola and succeed, so his body would have - his blood would have antibodies to help fight the Ebola. And if they're given to somebody else, it could help.

But, you know, Ashleigh, we don't know for sure. What we're talking about, some of this stuff has never been done before. Some of these medications have never been given to humans before. So we don't know still if that works, but we do know if someone has started off healthy and their immune system is supported, just with fluids and basic things, they can make a recovery. You know, Dr. Brantly, Ms. Writebol, Ashoka Mukpo, now nurse Nina Pham. It's a pretty good track record so far here in the United States.

BANFIELD: And I'll add, you know, Dr. Rick Sacra, as well an unknown patient who pulled through this as well.

I want to bring in Dr. van Tulleken on this.

The more I hear these stories, the more I think Ebola is survivable. And the key is getting at it early. But if you're in the health care system in the United States, you can beat this.

ALEXANDER VAN TULLEKEN, CNN MEDICAL ANALYST: I think that's absolutely right. And we know that early diagnosis and treatment make as massive difference. So we can't give up on West Africa. I mean this is the real concern is that there's a fatality about this. We're just saying, you know, nothing can be done at this point. It's out of control.

Well, it's out of control in West Africa because there's basically one or two organizations doing most of the work and really Doctors Without Borders is shouldering a vast front (ph) of cases. I mean the U.S., which has made the biggest commitment of any country, is still really only operating a tiny handful of the beds (ph) they've committed to. So -

BANFIELD: Yes, and these doctors are taking a real hit as well.

VAN TULLEKEN: Exactly.

BANFIELD: Many of them getting sick.

Let me ask Sanjay about that as well.

Sanjay, a lot of people have been talking about the need for quarantine of people who are either arriving here, having treated patients in West Africa, or American who have gone on missionary work and returned. Is that something now that we're seeing so much in terms of those who treat the sick getting sick? Is that something that really needs to start being codified in a way?

GUPTA: Well, you know, the science would suggest -- and I think very strongly - that, you know, somebody who is not sick is not going to be infectious, is not going to transmit this virus.

So you take the case of Dr. Spencer. He wasn't sick. He was, in fact, out bowling. He developed a low-grade fever, 100.3, and called and got in. And my guess is that there's absolutely no chance that he infected anybody else. So it worked the way that it's supposed to work.

It was interesting, Ashleigh, this morning I was reached out to by some administration officials and they said, look, we want to just tell you that we're considering the idea of a quarantine for these returning health care workers from West Africa. But they were very careful to say, we are acknowledging that there is some public fear here and you don't want to be dismissive of that, but that doesn't change the science. The science is the science. He wasn't a risk (ph), Dr. Spencer. Other people who are not sick are not a risk. I mean New Yorkers should not be worried this morning. As Dr. van Tulleken is saying, he lives in that area, he'd go on the subway, he'd bowl in that bowling alley. You know, all of that. I would too.

And I just think that that's such an important message. We could potentially spread so much misinformation that fosters fear. We've just got to be so careful not to do anything that is confusing or contradictory and, unfortunately, there has been some of that - those confusing messages.

BANFIELD: And, Dr. van Tulleken was nodding as you said that, Sanjay.

VAN TULLEKEN: Absolutely. I mean I think you've been so clear and so effective about that, Sanjay. I mean these protocols, the - I've been on the phone to MSF this morning. They sent me their detailed protocols. And this is not something that's poorly thought out. It's not saying that go home and call us if you're sick. This is many pages of detailed guidance, all of which he followed, all of which meant that he didn't expose anyone to risk.

BANFIELD: And -

VAN TULLEKEN: And they're the most expert organization in the world. They're dealing with this. They're not doing it casually.

BANFIELD: And Sanjay just alluded to it as he spoke about Dr. Craig Spencer, who's returned from treatment, is now in a hospital here in New York City. It is making a lot of headlines in this town. But just how dangerous now is it to be on the subway, at that bowling alley, et cetera? When we come back after the break, we're going to take you live to the hospital where not only he's being treated but now his fiance is being quarantined as well. More on that in just a moment.

(COMMERCIAL BREAK)

BANFIELD: The city that never sleeps, New York working around the clock dealing with its first case of Ebola now. 33-year-old Craig Spencer, a doctor who served in Guinea with Doctors Without Borders has now himself tested positive for Ebola. And before he felt sick, he was out and about the city taking the subway, going bowling. He clearly did not self-quarantine, and now an Obama administration official says the United States is considering a mandatory quarantine for all returning health care workers coming from West Africa.

Officials don't believe there is a risk of transmission from someone not showing the symptoms but they want to reassure the public.

And speaking of reassuring the public, that's what New York officials are doing right now, telling people that the subways are safe. And Governor Andrew Cuomo said on CNN "NEW DAY" New York is ready.

(BEGIN VIDEO CLIP)

GOV. CHRIS CUOMO (D), NEW YORK: Between New York City and New York State we have been preparing for this for weeks. We've been running drills. We have the equipment. We had the training. The health care workers feel like they're really to handle it.

(END VIDEO CLIP)

BANFIELD: So also the Centers for Disease, Control and Prevention -- well, they sent a three-person team to New York City and specimen from Spencer, from Dr. Spencer, is being tested at the CDC headquarters in Atlanta as well to double-confirm his initial positive test results. And those results from the CDC are expected very soon.

Before Dr. Spencer felt the symptoms, he went for a three-mile jog, he visited a bowling alley in Brooklyn named The Gutter and he also traveled on three of New York City's subway lines. That gave people a lot of jitters.

So earlier this morning, Mayor Bill de Blasio of New York City went ahead and just tweeted this out. It is a picture of himself riding the rails. He is a strap hanger this morning, wanted to reassure people. And he said this, quote, "We are working very closely with our state and federal partners to protect the health of all New Yorkers."

I want to get an update now on Dr. Spencer's condition. And for that, I go straight to CNN's senior medical correspondent Elizabeth Cohen who's live outside of Bellevue Hospital Center in New York, and that is where Dr. Spencer is right now being treated. And he's not the only person in this story who's in that hospital as well because of this.

Update me on the entire story if you would, Elizabeth.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Well, right now all we know about Dr. Spencer's condition is what we learned last night from Mayor de Blasio which is that he is in good shape.

And, you know, I think we are seeing a pattern here, Ashleigh, that you were just discussing, which is that when this disease is caught early, when you get good medical care, the prospects are very bright. We have seen every U.S. Ebola patient survive, except, unfortunately, very sadly, Thomas Eric Duncan passed away. But he did not care very quickly. So, you know, of course, we are hoping for this same outcome for Dr. Spencer.

BANFIELD: All right. Elizabeth Cohen live for us outside of Bellevue Hospital, thank you for that.

You're probably noticing as well on the right hand side of your screen, we have this small box and that is because there's a series of live mikes that are set up. We are awaiting a live news conference actually from the mayor himself, from Bill de Blasio. He's expected to speak on this situation here in New York City.

If you don't already know this, this is an unusual series of circumstances in which Dr. Spencer actually had completed his work as a doctor in Guinea back on October 12th and then left on October 14th. So two days passed there. Then, five days later, after he completed his work on the 17th of October, he arrived here in New York City at JFK International Airport, still feeling fine, no symptoms, no suggestion he was afflicted.

On October 21st, three days after arriving at the airport in New York City, he began to feel sort of sluggish. So he started self- monitoring and taking his temperature twice a day, and then on the 22nd, Wednesday, he went for a three-mile run, he went to a restaurant, he visited New York City's Highline Park, a very popular place for New Yorkers and tourists alike. He also traveled from the island of Manhattan to the outer borough of Brooklyn. He did that via subway. All of this on the 22nd, on Wednesday of this week. And then at

night, instead of coming back home to Manhattan after his outings, he didn't take the subway. He instead ordered an Uber taxi and went from the bowling alley in Brooklyn called The Gutter back home to Manhattan. Then the next day, on the 23rd, those symptoms started to appear in earnest. A temperature of 100.3 degrees Fahrenheit, nausea, pain, fatigue. All of those appearing and he immediately makes the phone call right away to the New York Fire Department.

And guess what's happening now? As you would expect, those who live in his neighborhood, those who were in the apartment building, all very concerned. Many New Yorkers who ride those subway lines also concerned.

So these are live pictures outside of Dr. Spencer's New York apartment. And earlier we saw barricades going up, what they call bicycle rack barricades. There is a plan to do a -- a disinfecting of his apartment as well.

Our Jean Casarez is live on location there and she's just sort of collecting all the details of what's happening right now.

Jean, can you tell me what the story is this morning?

JEAN CASAREZ, CNN LEGAL CORRESPONDENT (via phone): Sure, Ashleigh, we're right here, right across the street from the apartment complex. You're looking at the apartment. This is where Dr. Spencer was when he saw that he had that 100.3-degree temperature and was then taken to Bellevue.

We are waiting for all of the trucks to come that will sanitize the apartment and one has already arrived. It is a white truck. These are outside contractors that they are getting and the outside of the truck says Regulated Medical Waste. And a little bit ago, they opened up the back of that truck and there were blue barrels, sealed blue barrels that were inside that truck.

The men that -- were in that truck do not have the hazmat suits on but they have taken a few items inside the apartment complex but we're waiting for more to come.

Now what are they going to do when they get in there? Well, we understand they are going to take sheets, towels, toothbrushes, anything that could have the bodily fluids of Dr. Spencer on there. They will, we have heard, meticulously sanitize and clean that apartment. It will take hours. But when they are done, they say it will be ready for Dr. Spencer to come back after he no longer has the Ebola virus.

One more thing, Ashleigh, I want to tell you, there is some trash that is outside on the street right now and earlier today the New York Police Department Environmental Police actually took photographs of all of that trash and then left.

Why? We don't know. But they wanted to document the trash that was outside his apartment building -- Ashleigh. BANFIELD: So it's still sitting out there right now? I mean, you

could see it from your vantage point?

CASAREZ: Yes. Yes. We are seeing it.

BANFIELD: These are live.

CASAREZ: My photojournalist is right here. You're looking at some live pictures out there.

BANFIELD: So those are the live pictures, they're still sitting out there.

CASAREZ: They sure are.

BANFIELD: They photographed it and left. I also saw some NYPD officers actually taking their gloves off and throwing it in some outdoor trash barrels presumably right within that neighborhood as well which seemed odd. They were not wearing hazmat suits but they were wearing latex gloves and masks and they were taking the gloves off and throwing them.

Quick question for you about the neighborhood itself. I can't see many people out on those sidewalks there but I do know that there were pamphlets and flyers being handed out. I'm not sure if it was earlier this morning or yesterday but do you know much about what the neighbors are being told, how are they being communicated to? Obviously, the reason I don't see anyone on the sidewalk as we've just panned over. Everyone is being held at bay by those bicycle rack barricades that are on the other side of the street.

CASAREZ: Well, people are very concerned here. I've spoken with a number of locals here and it's a solemn feel right here because this is the apartment, this is where Dr. Spencer lived and really self- diagnosed himself when he got that fever.

But what is happening, we understand that they are taking volunteers and training them today for outreach so they can disperse amongst this community to educate the people. And there also will be those flyers that you're talking about, Ashleigh. It will be distributed probably this afternoon around the community and I spoke with one lady and she said, I'm scared. She said I have a child right here.

So I think the point is that people do need to be educated. We know that it's passed only by bodily fluids but just to have the first case of Ebola here in New York City I think is very alarming to some.

BANFIELD: So I think they're not only still to hand out some flyers but they have already been able to send some flyers under the doors of those who live at least in Dr. Spencer's building because one of the neighbors named Eugene Upshaw (ph) actually said the hand bill read "Ebola, Am I at Risk?: It explains the virus, its symptoms, how you get it.

Was also told that what we're doing know by the person handing it out was telling folks who live here in the neighborhood that they are all safe, quote, "That it's safe for them to be in their building, it's safe for them to go to their apartment. It's safe for them to walk down the street." That's interesting given the fact that they can't walk down that side of the street right now.

This was according to Sam Miller, association commissioner of the New York City Department of Health and Mental Hygiene.

Jean, stand by if you will for a moment. Keep on eye on what's happening. We'll keep our live pictures up as well.

There's obviously very heavy media presence. But this is a living and working community. It's real hard just to shut down one of the neighborhoods in New York City. But an interesting scene playing out with hazmat crews arriving to disinfect that apartment.

At the same time, I want to let you know what's happened regarding the subways. Because the Metropolitan Transportation Authority, the ones with the jurisdiction over all of the trains underground here, they've just issued a statement to explain what the protocols are for cleaning not only their buses but their subway cars as well.

And this comes to us courtesy of Kevin Ortiz, who is the MTA spokesperson. And this is what he says.

"The MTA has existing protocols for cleaning potentially infectious waste such as bodily fluids from anywhere in the mass transit network. And they include isolating a bus, train car or subway car so that no other customers can enter providing personal protective equipment and training for employee who have to remove the waste and then ensuring that it is disposed of safely."

And then it's kind of foreboding but the message says "more to come". Because clearly there are a lot of people -- there are people in this newsroom with whom I work, emailing this morning, suggesting I'd take those trains. I took those trains yesterday. So obviously a lot of concern in the city, the headlines and all the papers screaming that Ebola has hit New York City.

So the mayor is not only riding the rails today, going underground right at the subway to try to reassure New Yorkers, all eight, nine, 10 million and it swells upwards of 1213, with all the commuters. But he's also going to hold this news conference you're seeing live.

It's 12:28 right now. Eastern Time. He is expected at any moment so we got our live mikes ready to go. We're going to squeeze in a quick break, come back right afterwards. Expecting to hear from the New York City mayor on the first case of Ebola.

And in fact, we are not going to go to break because we now hearing that he's entering the room. We do not want to miss a word of what he says. We're not exactly sure of who is going to flank him at this news conference and which of the public health officials will be able to address the concerns of New York City and the concerns of the patient who is being treated at Bellevue Center right now.

But obviously with this many people, something has to be said about the circumstances the city is under and the close quarters everybody maintains from grocery stores to gyms to parking areas to mass transit hospitals. Everything. Everything is within walking distance and it's the city that doesn't sleep because there's always something you can hear and people you can see.

So one case of Ebola in the city, obviously a grave case of concern.

I also want to just mention to you, there was a special ambulance that was used, a whole unit actually that was used to transport Dr. Craig Spencer when he went to the hospital. So as New York City's mayor, Bill de Deblasio, takes to the podium, let's listen in and hear what has to say.