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@THISHOUR WITH BERMAN AND MICHAELA

Ebola Patient Duncan Thomas Dies; Answering Questions about Ebola.

Aired October 8, 2014 - 11:30   ET

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


JOHN BERMAN, CNN ANCHOR: Elizabeth, we have learned a great deal just over the last few days about the power of Ebola. I think some people thought, well, if it happens in the United States our hospitals are certainly deal with it. I think people may have thought "you can't catch it out of Africa." Nevertheless in Spain there was a case contracted on European soil. So we're learning a great deal more about the power of this virus.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: We certainly are learning a great deal about it and I think one of the lessons from Mr. Duncan's death is that this virus can move very quickly. We knew, but to actually see this happening in our own country -- he's at a hospital which is generally recorded to be a good hospital. But this can be a tough disease to fight especially you don't nab it early. I can't emphasize enough how important that is. Also that even when you have a modern country like Spain taking care of an Ebola patient, something went wrong and that nurse's assistant got infected and there's a need to look back and see what happened. Was there a problem with the gear, how she put it on or took it off? That needs to be investigated and answered. It shouldn't be allowed to happen and end there.

MICHAELA PEREIRA, CNN ANCHOR: Any point of weakness, we've already seen they are looking at how the travel history is taken. We are looking now even at the question of if animals like dogs can carry the Ebola virus. It's interesting how the education of all of us is increasing vastly.

We want to bring in Dr. Jorge Rodriguez, he's a certified internist. He's been here with us several times here @THISHOUR, and he joins us on the phone.

I know that, given the news that we have received, the terribly sad news that Thomas Duncan, the patient from Dallas, has died, once of the concerns is the people he came in contact with. There are loved ones inside the apartment. We saw that all too well and you talked about that with us. Obviously, that will be more of a concern now that the patient has died because they want to make sure these people are getting the kind of help they need.

DR. JORGE RODRIGUEZ, CERTIFIED INTERNIST (voice-over): Of course, Michaela. That's correct. Let me just put things in perspective. This disease still has a 50 percent to 90 percent death rate depending on the strain of it. So unfortunately, as sad that is -- and my heart goes out to the family -- this is not unusual in the scheme of things. I don't know if you know, I did my training at Baylor, in Dallas, with the big triumvirate of Presbyterian, Parkland and Baylor, so I know from the faculty I know that he got the best care. But we have to be vigilant about everyone that's been in contact with Mr. Duncan. You're right. This is a learning curve. We are learning a lot about the transmission of this disease.

BERMAN: We just got a statement from the Texas Department of State Health Services. It says, "The past week has been an enormous test of our health system but for one family it has been far more personal. Today, they lost a dear member of their family. They have our sincere condolences and we are keeping them in our thoughts. The doctors, nurses, and staff at Presbyterian provided by excellent compassionate care but Ebola is a disease that attacks the body in many ways. We will continue every effort to on tan the spread of the virus and protect people from this threat."

Elizabeth Cohen is outside Presbyterian Hospital.

You heard Dr. Jorge mention he believed the hospital is giving terrific care. The statement says compassionate excellent care. Remind us of what was done and what was not done for Thomas Eric Duncan and perhaps how the timing may have played into this.

COHEN: First, I want to say that the hospital has never come out and said, "Here's what we did, here's what we didn't do." So this is pieced together by talking with his family and making inquiries to the hospital.

So in the very beginning, he came on September 25 with a fever, abdominal pain, and he said he had just traveled with Liberia and he was not admitted. He was then admitted on September 28. As far as we know, he is getting hydrated, which is crucially, crucially important with Ebola patients. I mean, good fluid management, as they call it, is really enough to save a life. Sadly, it wasn't here. But it is often enough to save a life.

Now, the other ways that Ebola's been treated is with experimental treatment. So the two that have been used in this country are experimental medications. So medications that are not yet approved but are used with the permission of the Food and Drug administration. So Kent Brantly and Nancy Writebol gotten an experimental medication called ZMapp. Other patients in Nebraska got experimental medications. Mr. Duncan did not get an experimental medication until he had been in the hospital for nearly a week, which is considerably longer than the other patients.

The other treatment that's been used has been blood products, receiving blood products from someone who's recovered from Ebola and that's believed that that might help. If you have the blood of someone who survived, that might help you survive. Other patients in the U.S. received that. For example, the two patients treated in Nebraska received that. Mr. Duncan, according to his family, did not receive that. I've asked the hospital several times if he did and they have not gotten back to me.

Now, I want to emphasize that none of these treatments are proven to be effective. As a matter of fact, it is not sure if it worked at all. But in this situation, doctors are saying we have to do something, we have to do something that makes sense, and that's what they've been doing.

PEREIRA: Well, he was the first patient to be diagnosed in America with Ebola. Thomas Eric Duncan is the first to die from it on American soil.

We're going to have more on this right here on CNN. Stay with us. We'll be back in a moment.

(COMMERCIAL BREAK)

PEREIRA: Our breaking news is the passing of Dallas Ebola patient, Thomas Eric Duncan. Texas Presbyterian Hospital in Dallas releasing this information that he lost his battle with Ebola this morning. Obviously, the entire staff at the hospital is concerned and grieving his passing and offering their support to the family as we do as well. Condolences are, we are told, pouring out to the family and to the people that they knew.

BERMAN: There's been a great deal of focus going on about what's going on in Dallas over the last few days. And a new focus from the administration about what's happening in these three West African nations fighting Ebola right now. The Secretary of State John Kerry just a short time ago made a statement about Ebola. He was meeting with the British foreign secretary, Phillip Hammond. Now I don't believe that Secretary Kerry knew about the passing of Thomas Eric Duncan when he made this statement. Still, let's listen to what he says.

(BEGIN VIDEO CLIP)

JOHN KERRY, SECRETARY OF STATE: I'm here this morning to make an urgent plea to countries in the world to step up even further. While we are making progress, we are not where we can say that we need to be. And there are additional needs that have to be met in order for the global community to be able to properly respond to this challenge and to make sure that we protect people in all of our countries.

(END VIDEO CLIP)

BERMAN: We're not where we need to be. That's the message from so many in terms of the treatment in West African countries, the money being spent or perhaps the procedures in place in the U.S. as well.

PEREIRA: Now that a patient in America has died, I'm sure the call for more to be done -- interesting, because today just at the start of the show we were talking to Elizabeth Cohen about increased screening and what was going to be done at our airports of flights coming into the United States.

We want to bring back the people that have been joining us. Elizabeth Cohen is live in Dallas. We also have Dr. Frank Glover with us, as well as Dr. Jorge Rodriguez who joins us on the phone. Dr. Glover, I want to ask you, because I think one of the things

people will wonder is that we know that this man, Thomas Duncan, did not receive this highly experimental antiviral drug. We also know he didn't get a transfusion from a survivor. But we know he was getting excellent care from the American health system. Help us understand why some people can survive. We know the fatality rate is incredibly high. In West Africa, there are people that can survive Ebola. Is there any way for us to understand why some can win the fight and others can't?

DR. FRANK GLOVER, DIRECTOR, THE UROLOGY INSTITUTE & CONTINENCE CENTER: Well, that's a very good question and, unfortunately, we don't know the answer to that. More research needs to be done. When a patient is stricken with Ebola, we, as professionals, try to stabilize the patient, keep the blood chemistries in order, hydrate the patient, and give the patient's body a chance to mount an effective immune response so the body will then fight off the virus, if we can keep the patient alive and healthy long enough. If the patient is not able to fight off the virus, then the organs within the body become damaged irreparably by the virus and this leads to the demise of the patient.

BERMAN: Elizabeth -- I want to bring in Elizabeth Cohen at Presbyterian Hospital. We know some people survive and some don't. We know here in the United States now almost a half dozen people have been brought back here, these missionaries and doctors, all of them have survived. But Thomas Eric Duncan did not. What was the difference or was there a difference in their care?

COHEN: You know, sometimes you just don't know why some people die and some people survive. It may have something to do with each person's own internal chemistry and immune system. But we can also look at the treatment that he got. And so Mr. Duncan sought treatment on September 25 but was turned away because they didn't think he had Ebola and he ended up getting treatment on September 28. That doesn't sound like a long time, but for Ebola, that's quite a bit of time. So how quickly you get treatment is crucially important. It doesn't have to be fancy treatment but keeping someone hydrated, doing the things the doctor just mentioned, that's really important. So I think sometimes people look to what's the person's chemistry or the strain of the virus. Often, it's much more about how quick they got care.

PEREIRA: Dr. Glover, you spent time with the missionary group SIM in Liberia. You have seen the front line of this battle. On a day like today when we hear of a patient succumbing to Ebola in the United States, and yet we're being cautioned not to be concerned of an outbreak, you can see the fear some might have of an outbreak happening in the United States. Why do you think that's not likely to happen? Is it the robustness of the American medical system?

GLOVER: That's a large part the reason. As doctor of public health, I have observed the response of Dallas and community health officials that's been superb, textbook. They have isolated the index case, gotten in touch with all of the contacts, quarantined those that they needed to quarantine, and are following the contacts with twice-daily vital sign checks, including temperatures, to ensure if they there should be another case that that person would immediately be isolated and treated. So we saw the same thing in Nigeria and we saw the same thing in Senegal where they had cases come in. They used good public health measures, namely isolate the patient, bring people who need to be observed in for observation, and they were able to stop the transmission of the disease in its tracks. And I am confident that we will do the same here in the United States.

BERMAN: Again, the breaking news we're covering right now, we just learned a few minutes ago that Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, has passed away.

We have Dr. Jorge Rodriguez on the phone, a board certified internist who's dealt with all kinds of epidemics and contagious diseases all over the world.

Dr. Rodriguez, we have this death here in Dallas. We also learned just today that the U.S. will start implementing new screening measures for patients coming into the United States from the so-called hot zone, those three countries in West Africa dealing with Ebola. So we have these two pieces of news today. What's next? Where does the CDC, where does the U.S. Health system need to go from here.

JORGE (voice-over): Well, I think where we need to go is the direction that we're going, which is we're establishing systems to respond a lot more quickly to situations. We need to be able to have protocols in place for quarantine. I think the vigilance we'll be doing when people arrive is absolutely essential. So I applaud the fact that we were going to be testing people for fever. So we're learning and we're aware and that's where we need to be right now.

PEREIRA: I have a question for both you and Dr. Glover. I'll put it to you first, Dr. Jorge, since you're on the line with us now.

There have been some citizens that have said, "Why are we allowing flights from West Africa, from the so-called hot zone to come into the United States?" Should we ban? Are you supportive of banning flights from West Africa coming to the United States?

RODRIQUEZ: Absolutely not. I've never been in favorite of that for the simple reason that we, first of all, are picking one area, one type of people. And if that's the case, we're being negligent. This disease could come from anywhere, from anyone who has had contact.

Listen, my experience has been primarily with Hepatitis-C and HIV. Initially, we stereotyped that it was a disease in this country just of gays. What we did was we missed the boat and the disease became rampant to the point where it killed 30 million people in Africa. So we can't just isolate one part of the world. This is a disease of anyone that has blood and that's the way we need to look at it. So we need to be aware, we need to be open to every possibility.

PEREIRA: Dr. Glover, do you agree with Dr. Jorge Rodriguez that it makes no sense, counterproductive to ban flights to America from West Africa?

GLOVER: I agree 100 percent with Dr. Jorge Rodriguez. We cannot isolate in that way. What we need to do is continue to fight the fight but understand that we need to help build infrastructure in these countries. We need to build schools of medicine and public health and research facilities and nursing schools and schools of pharmacy that they can deal with the next outbreak. We know that diseases occur. We know that Ebola, for example, is a recurrent disease. We have not seen the last of Ebola. There is one right now taking place in Uganda in Central Africa. And so we -- I'm sorry, in Zaire in Central Africa and it's also been in Uganda. So we have to prepare for the next battle, and to do that efficiently, we need to begin thinking about building infrastructure in these affected countries.

BERMAN: Dr. Glover, Dr. Rodriguez, Elizabeth, stay with us.

I do want to remember here that there is a man who has passed away, Thomas Eric Duncan. Our heart goes out to his family and those close to him, four of whom are in quarantine in Dallas. I want to talk about them and what they're going through right after this break.

(COMMERCIAL BREAK)

BERMAN: We are following the breaking news out of Dallas that Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, has passed away.

We're joined by Elizabeth Cohen who is outside the Presbyterian Hospital down there. Has been following his treatment over the last several days.

Elizabeth, here at CNN, we've been speaking with the family, those close to Thomas Eric Duncan, for several days now. Anderson Cooper had that interview with Louise, his fiancee, girlfriend, partner. I spoke to a woman who calls herself his stepdaughter. Over the last few days, you sensed a growing frustration among that family over the way that this situation has been dealt with in Dallas. I wonder if you can speak to that a little bit and also speak to what is next for this family, four of whom are still in quarantine.

COHEN: I sense that same frustration as I speak to family members as well. I think it came in -- there were different reasons for that frustration. One is, as we've said before, he showed up on September 25th and he had a fever, he had abdominal pain and he said, I was just in Liberia. And the fact that he wasn't admitted, that he was sent home with antibiotics, that is obviously frustrating to the family because just missing a couple of days of good care could possibly -- it's possible that that could have saved his life.

I think the second point of frustration is that the family told me that they were pressuring the hospital to give him an experimental medication. We know that Dr. Brantly and Nancy Writebol got ZMapp. And they told me they were pressuring the hospital. But it took a while. He was admitted on Sunday, September 28th. And he didn't get that experimental medication until the following Saturday. So almost a week later. I know that was frustrating to them.

I also heard from his nephew who said that they kept asking about blood transfusions or blood donations from someone with Ebola that was used on Dr. Brantly. It was used on the two Nebraska patients. And they were told that that wasn't proven to be effective so that he wasn't going to get it. I think that they felt that he only got the Brincidofovir, because they pressured him into it. Jesse Jackson talked about it on his radio show and had viewers calling into the hospital complaining. So I think they felt what experimental medication he did get, when he did get it, was because of their pressure.

Now, I've asked the hospital all of these questions. I want to hear the hospital's side of the story. They haven't responded to numerous phone calls and e-mails.

PEREIRA: Elizabeth, a big thank you to you.

If you have those questions, you know folks at home have them, we have certainly had them.

I want to say a big thank you to Dr. Jorge Rodriguez, who joined us on the phone, and also Dr. Frank Glover, who's done a great job in joining us here on CNN talking about the work that he's done in Africa and in Liberia.

One of the other concerns, John, we've talked to several people from Liberia who are concerned about the stigma being attached to them. I'm curious what kind of awareness campaign, what kind of support those communities are going to be getting, too.

BERMAN: Elizabeth, if you're still there, just in the last few seconds here, give us a status report on the people they're still monitoring in the Dallas area.

COHEN: Right. 48 people are currently being monitored. They get their temperature taken twice a day. They're supposed to keep track of their health, see if they're feeling any symptoms of Ebola. Five of those people are actually legally quarantined, so four family members have to stay in their residence that they're in right now. And then, a homeless man has also been quarantined because they were afraid they couldn't keep track of him.

PEREIRA: Yeah, they were keeping an eye out for him. They were able to locate him finally.

Elizabeth, thanks so much for joining us with that information.

There have been a lot of updates in the last hour. We've just learned that Thomas Eric Duncan has passed away from Ebola in the Dallas hospital where he was receiving treatment.

CNN will stay with this story. You can get the latest online and on our air.

Thank you for joining us. I'm Michaela Pereira.

BERMAN: I'm John Berman.

"LEGAL VIEW" with Ashleigh Banfield starts right after this quick break.

(COMMERCIAL BREAK)

ANNOUNCER: This is CNN breaking news.

ASHLEIGH BANFIELD, CNN ANCHOR: Hello, everyone. I'm Ashleigh Banfield. Welcome to "LEGAL VIEW"