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Big Questions Surround Dallas Hospital; Health Worker Self- Monitors On Cruise Ship; CDC: Vinson May Have Had Symptoms Last Week

Aired October 17, 2014 - 06:00   ET

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


(BEGIN VIDEOTAPE)

CHRIS CUOMO, CNN ANCHOR: Breaking overnight, the first Dallas nurse to contract Ebola flown to Maryland after releasing a video message from her hospital bed, as the hospital back in Texas admits it never trained it's staff on treating a patient with Ebola. Are other hospitals ready now?

ALISYN CAMEROTA, CNN ANCHOR: Quarantined, eight people being monitored closely in Ohio after confirmed contact with the second nurse with the virus. Health officials scrambling to find anyone Amber Vinson may have had contact with after new revelations about her symptoms before she got on that plane.

MICHAELA PEREIRA, CNN ANCHOR: President Obama now considering a czar to oversee the government's response to Ebola, standing firm against the travel ban, and deploying the National Guard to fight Ebola in West Africa. All of this as Congress grills the nation's leading health officials. Are they doing enough?

CUOMO: Your NEW DAY starts right now.

ANNOUNCER: This is NEW DAY with Chris Cuomo, Kate Bolduan, and Michaela Pereira.

(END VIDEOTAPE)

CUOMO: Good morning, welcome to NEW DAY. It is Friday, October 17th, 6:00 in the East. I'm joined by Alisyn Camerota.

CAMEROTA: Nicely done.

CUOMO: Thank you. Good to be with you.

We do have some potentially good news. Dallas nurse Nina Pham, the first person to contract Ebola inside the U.S. has arrived at a medical facility, at the National Institutes of Health in Bethesda, Maryland. She walked onto the plane under her own power, and she released a stirring video message before leaving from inside her isolation unit in Dallas.

CAMEROTA: Wait until we show you that, it's very intimate and powerful.

Meanwhile, this troubling new development, the CDC confirms fellow infected nurse, Amber Vinson, may have been sick when she flew from Ohio on Monday. That means that health officials have to track down passengers on that flight.

All of this as the nation's leading health officials came under heavy scrutiny at a fiery hearing on Capitol Hill. There's a lot going on this morning on the Ebola front so our coverage begins in Akron, Ohio, with national correspondent, Susan Candiotti. Good morning, Susan.

SUSAN CANDIOTTI, CNN NATIONAL CORRESPONDENT: Good morning, Alisyn and Chris. Here in Northeast Ohio, 12 people have been quarantined for having contact with Nurse Vinson. And health officials are putting a shout-out for anyone who might have had contact with Vinson on Saturday afternoon, when she was in a bridal shop for just three hours.

Meantime, we are also hearing from her fellow nurse, Nina Pham, for the very first time.

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CANDIOTTI (voice-over): Overnight, the first critical care nurse to contract Ebola arriving at the National Institutes of Health Clinical Center in Maryland. The 26-year-old Nina Pham, transferred from Texas Health Presbyterian in part because of concerns about the limited number of qualified people to care for her.

UNIDENTIFIED MALE: I'm really proud of you.

CANDIOTTI: For the first time we're hearing from Pham while in isolation. The Texas hospital is releasing this video of a doctor thanking her for taking care of the now deceased Liberian, Thomas Duncan.

This on the heels of a shocking revelation -- that the second nurse to contract the virus may have been feeling ill since she left Dallas, flying to Cleveland last Friday.

DR. CHRIS BRADEN, CDC: We can't rule out the fact that she might have had the start of her illness on Friday.

CANDIOTTI: A federal official tells CNN, 29-year-old Amber Vinson said she felt fatigue, muscle aches and malaise while she was in Ohio and on the flight home. But, Amber's uncle says, it's not true.

LAWRENCE VINSON, AMBER VINSON'S UNCLE: She felt fine, she felt well until Tuesday morning.

CANDIOTTI: The CDC now expanding their outreach to all passengers on board both Frontier Airlines flights, to and from Cleveland, and anyone with potential risk will be actively monitored. Vinson's family said she felt she put no one in danger and she called a Texas health official, who told her the CDC said it was OK to fly.

VINSON: If in hindsight someone decides that there should have been flight restrictions, that's fine, but to misrepresent and to say restrictions were in place when they actually weren't, is inappropriate.

CANDIOTTI: It was while in Ohio for a bridesmaids fitting, according to Vinson's uncle where she first learned fellow nurse, Nina Pham, tested positive for the deadly disease. The bridal shop owner says Vinson did not look sick at all.

ANNA YOUNKER, BRIDAL SHOP OWNER: She was probably here, about three hours, maybe. I had no idea that anything was wrong with her.

(END VIDEOTAPE)

CANDIOTTI: And this is interesting -- that bridal shop owner told me that she had a personal visit again from health officials, to her home last night and they went through a role-playing scenario with her where she demonstrated exactly how much interaction she had with Nurse Amber Vinson. Now as a precaution, that store owner is closing her shop for the time being. Back to you, Alisyn.

CAMEROTA: Nerve-wracking for her, we're sure. Susan Candiotti, thanks so much for that update.

Meanwhile, Texas Health Presbyterian Hospital says transferring the two nurses for specialized Ebola treatment is the right move. This as another nurse who works there should administrators should be, quote, "ashamed."

She said she and her colleagues were asked to treat Thomas Eric Duncan without the proper equipment or training. CNN's Elizabeth Cohen is following the developments from Dallas. Elizabeth, what's the latest there?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: There are no more Ebola patients here, Alisyn. One transferred out last night and the other transferred out the night before. Now at a congressional hearing yesterday, a hospital executive was grilled about how prepared this hospital was to treat Ebola patients.

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REPRESENTATIVE DIANA DEGETTE (D), RANKING MEMBER: Your hospital received the first CDC health advisory about Ebola on July 28th. Was this information given to your emergency room personnel and was there any actual person-to-person training at Texas Presbyterian for the staff at that time? Yes or no?

DR. DANIEL VARGA, CHIEF CLINICAL OFFICER AND SR. VP, TEXAS HEALTH RESOURCES: Was given to the emergency department.

DEGETTE: Was there actual training?

VARGA: No.

(END VIDEO CLIP)

COHEN: Now, in a press release yesterday, the hospital said it was best for everyone if the nurses were transferred out. Now, a CDC doctor who spent time in this hospital told me, this hospital is two- thirds empty because people are scared to come here because of Ebola.

Certainly that is an untenable situation for the hospital to do for very long. Obviously, they are losing money. The hospital says they wanted to transfer the nurses out to prepare for what might come next.

Certainly, CDC Director Tom Frieden has said don't be surprised if there are more Ebola patients who took care of Thomas Eric Duncan at this hospital -- Chris.

CUOMO: That's a very important point that you made there, Elizabeth. Two-thirds empty. Just goes to show that confidence often follows competence and that hospital has to show it can take care of the situation and that will really flow through to a lot. Thank you for the reporting this morning, appreciate it.

Now a big part of this situation is becoming political, right? And the politics of this may be shifting. President Obama is now says he will consider appointing a czar to oversee the government's response to the scary virus, the real place to fight Ebola, is in Africa, of course.

And the president is authorizing the deployment of the National Guard to West Africa, but is standing firm against a travel ban. He said he's not philosophically opposed to one. Let's figure out what that means.

Let's bring in senior Washington correspondent, Joe Johns, live from the White House with the latest. What do we know, Joe?

JOE JOHNS, CNN SENIOR WASHINGTON CORRESPONDENT: Good morning, Chris. Yes. Two or three headlines from the White House overnight on the issue of Ebola. The president meeting with his team, talking in an extended session with reporters in front of a camera saying that it is a good idea, at least to consider someone to spearhead the efforts against Ebola.

The other headline I think that's important is the issue of a travel ban. The president, as you said, did not think it is something that he is philosophically opposed to. Nonetheless, he said, he does think that at this stage, the United States government should stay with the issue of screening.

Screening people who are coming in and out of the country because there are concerns here at the White House, and elsewhere, that people who want to come from the hot zone into the United States, might actually go underground, underground so that they won't be detected when they want to come to the United States.

The third issue is the issue of reservists. The president has signed an executive order now, allowing up to 4,000 individuals from the National Guard, from the reservists to be made available to the Pentagon, to be sent to Africa, to deal with the situation.

They have not set any type of a timetable for those people to go. Nonetheless, they want to make that available so that the Pentagon can do some planning -- Chris. CUOMO: All right, Joe, thank you very much for keeping us on the latest. Let's do some more discussion about what this all means -- Alisyn.

CAMEROTA: Chris, wait until you hear this. We have learned this morning that a health worker "who may have," that's a quote, handled lab specimens from Thomas Eric Duncan has been, quote, "self- monitoring" on board a cruise ship in the Caribbean.

The State Department says the person has no signs of Ebola, but the government contacted authorities and believed to make them aware of the situation. So what's going on here? How can the virus be contained if the people who may have been exposed are traveling the world?

Joining us to discuss all of this is Dr. Amesh Adalja, a representative for the Infectious Disease Society of America and Dr. Joseph McCormick, professor and the regional dean at the University of Texas School of Public Health.

He worked for the CDC for 25 years and helped investigate the first Ebola epidemic in Central Africa. Dr. McCormick, let me start with you. Someone is on a cruise ship right now. That is as we know a petry dish it can be of bacteria self-monitoring. How do you feel about that?

DR. JOSEPH MCCORMICK, PROFESSOR AND REGIONAL DEAN, UNIVERSITY OF TEXAS SCHOOL OF PUBLIC HEALTH: Well, I think the whole issue of monitoring has been very disappointing, the way it's been done. Those people who were in contact with material specimens or with the patient should have been under active monitoring and certainly should have been under travel ban.

CAMEROTA: Dr. Adalja, is it time for anyone from Texas Presbyterian to stop traveling?

DR. AMESH ADALJA, BOAD CERTIFIED PHYSICIAN FOR INFECTIOUS DISEASE: I really think that we don't really know what happened with this infection control lapse and this exposure may be much wider, because Dr. Frieden is thinking we may expect more health care workers to test positive.

So I think everybody at Texas Health Presbyterian has to assess their exposure risks to Mr. Duncan's body fluids and think about whether or not, as you said, they should be all self-monitoring and not moving around.

CAMEROTA: Yes, but if it's up to the person, Dr. Adalja, as you're saying to think about their exposure and to decide on their own, that's why we're having all of these inconsistencies, isn't it? Does there need to be a rule?

ADALJA: Right, right. I think what we do need to think about doing that from, with an official through an official decree, maybe by the hospital itself or by the local health authorities. Until we understand exactly what the breach was and know how many people really are at risk because right now we don't know. It still hasn't been announced how these two nurses were infected.

CAMEROTA: Yes. OK, so I want to talk about Amber Vinson. She's the second nurse from Dallas to be diagnosed because there are conflicting reports about what her condition was on the plane when she came back from Cleveland to Dallas.

So this morning, there are some officials who say that she was experiencing symptoms while she was in Cleveland. Let me tell you what those were. They say she felt fatigue. She felt muscle ache and she felt malaise.

Help us understand this, Dr. McCormick, because those symptoms are not any that omit bodily fluids. If she was feeling malaise and muscle aches, is she contagious or not?

MCCORMICK: No. And I think that's what we have to remember. This -- and I think the fundamental issue is, you are at risk when you are in contact with bodily fluids from someone who is overtly ill. So does that mean you don't have initial symptoms when you start to develop Ebola? Of course, you do.

But that doesn't mean you're infectious, and let's just keep in context here, that I think Sunday is the final 21 days for all of those people, who were in contact with Mr. Duncan before he was admitted to the hospital.

CAMEROTA: His family and friends.

MCCORMICK: And the people who were at the hospital. That he was seen, who saw him in the emergency room.

CAMEROTA: The first time.

MCCORMICK: That's right, the first time. None of those people have become infected. I think we have to all remember that.

CAMEROTA: OK, Dr. Adalja, this is what her uncle, Amber Vinson's uncle, disputes the reports that she was symptomatic and feeling sick on her flight back from Cleveland to Dallas. Here's what he told Don Lemon last night.

(BEGIN VIDEO CLIP)

Amber has directly told me is that she felt fine, that she felt well until Tuesday morning. Tuesday morning she woke up, felt that she should take herself in. She checked her temperature, it was actually below the threshold. She was 100.3.

CAMEROTA: See, Dr. Adalja, this is what's so confusing to the average American is that then why, if as Dr. McCormick says, nobody needs to be worried if she wasn't -- if there were no bodily fluids on the plane, nobody needs to be worried. Why then are officials contacting everyone on the plane to make sure that they now start self- monitoring?

ADALJA: There's a generalized panic. These are two health care worker infections that shouldn't have occurred. As Dr. McCormick said, she wasn't infectious, because the symptoms that she was having weren't ones that caused her to emit body fluids, that's the only way you can get infected with Ebola.

However what you're seeing is people going above and beyond, because they're trying to quell this general panic that's going on in the population. Understandably because there are, conflicting messages, legitimate that there is panic because there is a sense that this story keeps shifting.

CAMEROTA: Right. And of course, this is the problem. Herein lies the rub, which are we quelling public panic by contacting everyone on the plane and by the ripple effects that stems from one of these cases or are we helping? Are we helping or hurting?

MCCORMICK: I think the answer is yes because for some people, we're going to be calming them down. For other people, they're going to continue to have panic, because they look at pictures from West Africa, and they're terrified. And so that's what is driving, other people are going to be reassured.

CAMEROTA: All right, well, we thank you for all the information. Dr. Adalja, Dr. McCormick, thank you so much for being here. Let's go over to Michaela for more.

PEREIRA: All right, Alison, good morning, everyone. Here's a look at your headlines. Vice President Joe Biden's son was discharged from the Navy back in February after sources say he tested positive for cocaine.

Hunter Biden has released a statement admitting that he is embarrassed by his actions and that he respects the Navy's decision, but he is not specifically addressing why he was discharged. The 44-year-old is now a managing partner at an investment firm.

ISIS is on the president's agenda this afternoon. He will hold a closed-door meeting with the vice president and the National Security Council. In recent days the U.S. has ramped up air strikes against the terrorist group as part of operation inherent resolve. Sources tell CNN the increased action has helped Kurdish fighters gain ground in the key Syrian town of Kobani.

The New York City medical examiner revealing the official cause of death for Joan Rivers, a therapeutic complication during surgical procedures. The 81-year-old comedienne died from brain damage caused by a lack of oxygen. Since Rivers' death was not classified a homicide this could complicate efforts to bring criminal charges against the doctors who performed those procedures.

Cheering coming from the west -- the San Francisco Giants are going to the World Series, winning the national league pennant in dramatic fashion. A three-run walk-off home run by Travis Ishikawa. The Giants beat the Cardinals, 6-3.

And take the NLCS in five games and they will face the American League champion, Kansas City Royals in game one of the World Series Tuesday night in Kansas City. Go Gigantes.

CUOMO: Uh-oh, we have a little bit of a situation here. Luckily I'm out of it.

PEREIRA: You're in the middle.

CUOMO: But you got Pereira from the West Coast, sympathies are obvious, but you got Camerota whose husband from Kansas City is wearing royal blue.

PEREIRA: She is.

CAMEROTA: Wow, I didn't realize that this was going to be a source of tension.

PEREIRA: But the thing is we love each other despite.

CUOMO: I don't know.

CAMEROTA: And you know what? No, Chris, I'm going to go with Michaela.

PEREIRA: Chris wants to stir it up.

CAMEROTA: My husband's on his own.

PEREIRA: See how women do this? Take my hand. See how we do this.

He's just -- we violated man law, I appreciate that.

CUOMO: I win either way, because I tell you what, the Giants win the pennant, and it's one of the most famous lines in sports announcing, from back in the day. Remember that? The Giants win the pennant. It was big on "MASH", the TV show and everything. But I look forward to the tension.

(LAUGHTER)

CAMEROTA: All right. Meanwhile, nurses in Texas are outraged by what they call a lack of protocol in the hospital where two colleagues contracted Ebola. Are health care workers getting what they need to stay safe? We'll ask the head of the nurse's union.

CUOMO: And hospital officials made their case and got angry responses from members of Congress. But this isn't just about outrage, it's about facts. And we have an interview with the woman you just saw, the whistle-blowing nurse who says Texas Health Presbyterian, quote, "violated the basic principles of medical care." Is she now at risk of losing her job?

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CUOMO: Welcome back.

Nina Pham, the first nurse who contracted Ebola from Thomas Eric Duncan arrived overnight at the National Institutes of Health in Maryland to continue her treatment. And right now, it looks good. She walked onto the plane herself. That's a good sign.

Now, this comes on the heels of explosive comments from another nurse, claiming Texas Health Presbyterian Hospital did not follow protocols, if they even had protocols in the first place. The hospital of course flatly denies that take.

Pam Cipriani is the president of the American Nurses Association. She joins us this morning from Washington, D.C.

Ms. Cipriani, it's very good to have you with us this morning.

We don't want to get caught up too much in just one hospital. So, let me start this by asking the question that may matter more.

Do you think that Texas Presbyterian is that different from the situation that hospitals all over this country would have found themselves in, if they had been hit with a case of Ebola out of the blue?

PAM CIPRIANI, PRESIDENT, AMERICAN NURSES ASSOCIATION: I don't think they're significantly different. I think without any of us having firsthand experience with treating an Ebola patient, there was bound to be some type of learning curve.

CUOMO: Because I'm sure you're hearing it much more. But we are hearing from nurses and health care workers all over the country who are saying -- hey, we're just starting to get ready now. We weren't getting ready before. We didn't have any hazmat suits, I don't know what to do they're just starting to talk to us about it.

Did we get caught by surprise?

CIPRIANI: Over the last few months, again, hospitals have begun preparing. I think you're absolutely right. The training is ramping up. We all know a lot more than we did know a couple of weeks ago.

But I think it's important to recognize, too, that the initial screening tools and the ability to assess a patient coming into our emergency departments and clinics was really the first wave of training that was necessary. And then waves of training for those individuals that would then care for patient that we've truly believed would need to be tested and then ruled out as positive for Ebola.

So, it's unrealistic to think that every single individual in every hospital would have been trained by now.

CUOMO: Right, the proof is in the pudding, also, right, Pam? Because you now hear about hospitals all over the country, doing more in doing more in what they're doing, obviously, it's in response to what happened in Texas. Obviously, they weren't ready themselves, right?

CIPRIANI: Well, we definitely have been learning again, day by day. And we -- and the American Nurses Association has been in close contact with the CDC. We're calling for very clear guidelines, making sure that we know exactly what changes need to occur, additional recommendations on the extent of personal protective equipment, because we've learned that the two really important ingredients are again, screening patients, putting them in isolation as quickly as we believe there might be any risk and then really adequate education and practice, so that individuals know how to use the protective equipment. And make sure that we do have full body coverage.

CUOMO: Now, let's talk about Brianna Aguirre specifically and what she says about Texas Presbyterian. Does it concern you that the hospital management is fighting back against what she says?

CIPRIANI: Our goal is really to make sure that staff feel very comfortable talking with their management. You know, again I think everyone's stress level is probably extremely high. Everyone is concerned that if there was not adequate training, it put nurses and other front-line procedures in harm's way.

This is a good hospital. I hope that they have been able to open the dialogue and will continue to resolve any kind of conflict swiftly because this is a really important way for to us make sure that nurses' needs are heard and at the same time we're keeping them safe and they can safely take care of other patients.

CUOMO: With what you've heard up to now, if you were working in Texas Presbyterian, would you feel confident to treat someone with Ebola?

CIPRIANI: I believe they have also learned and have begun or already put in place the requirements that are necessary to safely care for a patient. But again, we would want to have that group on a daily basis talking about what are the precautions? You know, how well -- how comfortable are the staff? Do they feel they've had the training? And if not, I believe they would have a responsibility to stop, regroup, make sure that everyone is prepared. And if not, defer taking any additional patients.

CUOMO: Practically speaking, do you believe this -- everybody has to be ready is a really workable way to do this or should we have specialized centers like some of the bigger states are doing now, like New York is going to pick a certain number of hospitals and have those set up and ready to go. But everybody has to be able to diagnose, but not necessarily treat.

Is that the smarter way to go?

CIPRIANI: You know, this is a public health issue. And so there has to be a level of readiness, again, being able to screen individuals who come in. Have you traveled from West Africa? Do you have a fever? What other symptoms do you have?

So, that initial front-door readiness, I think has to be in place in all institutions. Just because we know we get better with practice and experience. You know, I believe there will be continuing discussion about whether we need to have a limited number of facilities, whether it's one in each state or in specific regions. I think still under discussion.

Our hope really as you can imagine, is that there is a small number of patients who end up having Ebola in this country, so that we won't really have to worry about every institution dealing with a patient coming across their threshold.

CUOMO: Well, it's the secondary infections we're really worried about here, if you break it down, right? I mean, it's not that we're going to see a lot of people coming into the country with Ebola. It's that will our health care providers, workers, get hurt, you know, get infected by treating them. And what matters most is the confidence of the men and women who will be doing that work.

Where is your membership on this? What are you hearing? How shaken are they?

CIPRIANI: You know, I think everyone is concerned. However, what we do know, and this has been reinforced, is if we have really thorough education, and we're using a buddy system and we're training where people actually are practicing, putting on and taking off the personal protective equipment appropriately and that we have full body coverage, then we've proven in places like Emory and Nebraska, and NIH and Montana, that patients can be safely taken care of.

We've been using universal precautions for years to prevent the spread of other deadly diseases. We've done that well.

Ebola, I think, has created some different challenges because of the lack of clarity initially about the extent of body protection that was needed. And as you've said, you know, what we found is there was probably a delay in training and perhaps not really recognizing the seriousness with which we need to ramp up from basic, what we call droplet precautions, to really a higher level of protection.

CUOMO: We're certainly dealing with it now and we see the facts, Nigeria figured out how to do it. They figured how to do it safely in tents in West Africa. Certainly, the United States should be able to do it and not have to learn it on the job.

Pam Cipriani, thank you very much. Stay in touch with us about your membership.

CIPRIANI: Thank you.

CUOMO: And, of course, Alisyn, all this comes down to the big interview with the nurse from Texas Presbyterian who gave a very different sense of reality of what was going on in that hospital.

CAMEROTA: Yes, you're so right, Chris, because there are shocking charges from a nurse in Texas who cared for the Ebola-stricken colleague. She says she sounded the alarm bells, but hospital supervisors ignored her warnings. Wait until you hear what she told CNN about Ebola-contaminated waste in the hospital hallways.

And a powerful category 4 hurricane packing 144-mile-per-hour winds barreling toward Bermuda. The island could take a direct hit this afternoon. We are tracking it.

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