Different airports throughout the United States. I want to talk a little bit more about the travel restrictions. Dr. Frieden, how many nonu. S. Military commercial flights are are going into the affected countries . I dont have the exact numbers. Does anyone on the panel know how much commercial flights are going into these areas . From the United States or from anywhere . From the United States. There are no direct commercial flights from those three affected areas into the United States. Into the area . Into west africa . There are flights into west africa. How many . That i dont have offhand. Anybody on the panel know how many . How many coming back into the United States . There are no commercial flights coming directly into the United States from those three areas. What about europe . Theres hundreds of flights coming from there. People traveling from west africa to europe to here . Thats generally how they would get here. 94 screening . How many flights are required daily every other day or weekly to get the supplies and personnel to the affected areas . The quantity of supplies is quite large. We would have to get back to you in terms of numbers. Theres huge quantities needed but its not just supplies but also personnel who need to move back and forth. If you could get back to me with that number, i would appreciate it. Dr. Frieden, nigeria, are you aware if nigeria has a travel band with countries affected by the outbreak right now . I believe thats not the case. They do not. Dr. Frieden, one of the issues that was brought up regularly to me back in the district when i go home, what should i tell my local hospital and local doctors that they need to do to address ebola . The single most important thing they need to do is make sure if anyone comes in with fever or other symptoms of infection, they need to ask where theyve been for the past 21 days and whether theyve been in west africa. And the training that small local District Hospital would receive, is that the same kind that a major Metropolitan Hospital would receive . There are a variety of forms of training. We support hospitals. Hospitals are regulated by states and not by cdc. Dr. Frieden, were entering the flu season now. What do we need to do to make sure people understand that there could be similar conditions, similar circumstances so that we dont have a situation where people are indeed panicked . The key issue, it is getting into flu season. By all means, get a flu shot. And for Healthcare Workers, any time someone comes in with fever or other signs of infection, take a travel history. Thats really important. Dr. Frieden, i want to be back to what i said at the beginning. You mentioned that we cant have a travel ban because youre afraid of the impact it would have but you dont know how much personnel, equipment and flights are currently in use. My point earlier on was that if passengers are not allowed to come directly, theres a high likelihood they will find another way to get here and we wont be able to track them as we currently can. Were talking about supplies, equipment and personnel. How many . How many flights . How many personnel . How much equipment . The point i made earlier was that if we are not able to track people coming directly, well lose that ability to monitor them for fever, to collect locating information, to share that with local Public Health authorities and to isolate them if theyre ill. Gentlemans time has expired. Thank you. I want to follow up with some of mr. Gardners questions. I want to understand this. Theres been one person that came to the u. S. And then he infected two Healthcare Workers in dallas, correct . At this point, none of the 48 contacts he had before getting isolated have developed symptoms and they are mostly well past the maximum incubation period although not completely out of the woods. For everybody on the panel its been code red. Weve had two instances of infection here in the United States but this is such a highly contagious disease that were on full alert, correct . Its a disease that is very severe. Its not nearly as contagious as some other diseases but any infection in a Healthcare Worker is unacceptable. We appreciate the efforts you are making. There have been Lessons Learned about whats happening in dallas. The hospital is forthcoming about mistakes that have been made. You are telling us there is information provided to all of our hospitals in the country about what protocols to follow, correct . Correct. On a practical level, does it really make is it feasible that all of our hospitals are going to be in a position to provide state of the art treatment or does it really as a practical matter make sense for hospitals to contact you when they have a potential infection for you to come and then for us to have centers to which that individual who is infected can be treated . Every hospital needs to be able to think it may be ebola. Diagnose it. Call it as they do. Weve had hundreds of calls. Then well send a team to determine what is best for that hospital and that patient. And then what we have also heard this is absolutely a Public Health infrastructure issue where it gets out of hand, correct . Public Health Measures can control ebola. They have had effective measures in nigeria where they have controlled it but not in the affected countries where its gaining headway . Correct. In the u. S. We do have a good infrastructure but we need an answer to the question thats being asked about travel. Thats a concern that people have because its seen as a easy answer. I want to understand what the debate is within the medical community. For a lot of us sitting up here, were hearing from our constituents and it sounds like there is something we can do to eliminate an infection come here but that may be a psychological answer but not necessarily an effective medical answer. All of us have been asking you to give your explanation and anyone else can come in, as to why from a medical standpoint you have concluded that a total travel ban is inappropriate and not effective. First off, many of the people coming to the u. S. From west africa are american citizens. American passport holders. Thats one issue to be aware of. I dont have much time but Healthcare Workers if theres a risk of infection if well encourage people to do the important work including our military personnel, we have to take them back and make sure we can treat them if they do get the illness, correct . People travel. People will be coming in. And as i understand, you say theres basically a tradeoff. If you have a fullout ban, there will be ways around it and you will lose the benefit of tracking folks who may be infected and that could lead to greater incidence of outbreak. Is it a tradeoff, if thats whats going on . Were open to any possibility that will increase the safety of americans. Are there mid points in terms of travel restrictions as opposed to a travel ban that may make sense, you in coordination with your colleagues particularly mr. Wagner . We would look at any proposal that would improve the safety of americans. All right. This isnt about funding so im not going to ask you. I just want to share my concern that it was expressed. Mr. Chairman, we may want a hearing at some point about what is funding requirements. To make certain that the infrastructure this country needs to be in place before something happens is robust, its strong, weve got people who are trained. They are ready to do the job and they have everything that they need. Thats not todays hearing but i think its a question that we should address because with 20 across the board funding in nih, i find that to be a reckless decision with 12 at cdc i think thats definitely the wrong direction. I think this congress has to revisit our priorities on making certain that we have the Public Health infrastructure to be prepared to protect the American People. We are planning a second hearing in preparation of that and well also ask if nih does have flexibility to transfer funds and hhs moving forward. I now recognize mr. Griffith for five minutes. Thank you, mr. Chairman. I believe we should have reasonable travel restrictions. In answering a question from my colleague, i have in my possession and ask it be submitted to the committee for the record, a letter from manassas, virginia, to the governor of the commonwealth and in that he cites international sos, a prominent travel company with more than 700 locations in 76 countries reports that african countries imposed travel bans by persons from countries where ebola is present. 14 countries allows highly restricted entry from ebola infected regions with monitoring for 21 days and travel to public gatherings discouraging. I find that interesting. Some countries have had previous outbreaks of ebola themselves. Wouldnt you agree that some countries have had to face ebola before . I would have to check the list carefully to know but ill take your word for it. I will tell you this is a concern to a lot of our constituents and to mine as well. I was checking my Facebook Page recently when i saw that a facebook friend of mine, a father from virginia, asked for prayers for his daughter because she lives in the apartment complex with the first nurse, nurse number one as i think someone referred to her earlier and was very concerned. I think i know the answer but i would like your answer to reassure this father. The question is if i count to 21 days and my daughter is not infected, at that point can i exhale and breathe a sigh of relief . Not only can he do that, he can do that now. Because the first nurse only exposed one person, one contact, and that was only in the very early stages of her illness. One person from the community was exposed. He asked a second question. He said theres suggestion coming out of dallas that the patients dog may be infected and may have infected other dogs through contact or feces. Can the virus be transmitted by dogs . I did homework on this because i thought it was an interesting question and found a cdc publication from march of 2005 that did a study on dogs in africa in the infected areas and a study in france as a control group and they found that while dogs show antibodies for ebola, they are asymptomatic but there are questions about how ebola is transmitted and in some insta e instances, there is a question mark as to whether or not or how that Ebola Outbreak occurred. It wasnt in the normal or standard ways. It wasnt human to human. And this report indicates that dogs might be, might be, i dont want to scare folks, might be suspect. My question to you is, isnt it true that we really dont know a whole lot about the various outbreaks of ebola and so when were trying to assure the American People like previously we didnt think it would come to this country and if it did, we wouldnt have any problems controlling it, now weve got all kinds of people being monitored, isnt it true there is a lot of questions about how ebola is spread . Although were still learning a lot about ebola and over other organism that we study and control, we have a lot of information about ebola. We have a good sense of how its controlled. Weve looked at the issue of exposure to animals. We know that in parts of africa consumption of forest living animals can be a cause. We dont know of any documented transmission from dogs to humans. Thats why the authorities with our agreement have quarantined a dog and well be helping them to assess that situation. Its also true that while we have no evidence of transmission from human to dogs, we dont know if there can be . We have a lack of evidence as opposed to negative evidence. We dont have clear evidence that you cant transmit it either. Whats interesting is that raises the question for me about no restrictions on travel of human beings, how about the dogs . I called customs. They said our experts are there and then after pushing them a little bit they said thats usda. We call usda and they said that would be cdc. So i understand all of your reasons, while i dont agree with them completely, i understand the concern about humanitarian and et cetera but dont you think we should restrict travel dogs. Well follow up with whats possible and indicated. Thank you, mr. Chairman. Before i begin my questioning, i would like to submit an article by the director of the institute of bioethics at the university of louisville medical school. I would like to submit that for the record. Thank you. I would like to thank the panel for their testimony and answering questions. Its been a very enlightening hearing. I also want to acknowledge at the beginning that the Kentucky Air National guard based in my district is providing the infrastructure for the 101st and in their efforts i want to acknowledge their participation in this effort. At the risk of displaying my ignorance, we apparently know that you cannot detect ebola until it becomes symptomatic. Any other test that would indicate something is going on in the body. My doctor says you have an elevated blood cell count. Something is going on. Is that true of ebola or would that not indicate something is going on . We dont have a test that would identify it before someone has symptoms. The test turns positive when theyre sick and its for the virus itself and thats another reason besides the patterns of disease that were confident that it doesnt spread we cant even find tiny amounts of it in peoples bodies until they get sick. Is there any research being done as to a possible earlier test for this . Theres a lot of research being done to understand and diagnose and treat and prevent better. Im a media person by background. Thats where i spent most of my career so im sensitive to how the media treats situations like this. Certainly the media can be a very important part of providing Public Information about a potential threat to Public Safety as this is. But they can also go overboard as we know and im curious because i see every day comments in the media about the spread of ebola and outbreaks of ebola and while, yes, technically it has spread from one person to Healthcare Workers, i know that the public may hear that very differently. And perceive there to be a much broader and widespread incident of ebola in the country. I see things in the Washington Post the woman at Dulles Airport that looks like shes mummified because of her concern of contracting ebola. So i know that now one survey showed 98 of the American People are aware of the ebola situation and not even 50 know theres an election coming up in three weeks. So the media has certainly let the public know theres something going on. My question to you is, has the Media Coverage so far been helpful or harmful in your efforts to have the public have an appropriate concern and awareness of what the situation is . Any time Healthcare Workers become infected and ill in this country, its unacceptable and our thoughts are with the two affected Healthcare Workers and hope for their recovery. Its a scary disease thats new to the United States. A movie was made about it. Its important to have that attention so that we as a society Pay Attention and doctors and hospitals and Community Health clinics and primary care clinics think of ebola and we protect americans and stop it at the source because it has to be stopped at the source to make us completely safe. Some of the coverage i think many would agree may exaggerate the potential risks or may confuse people about the risks. There really is a lot we know about ebola. Cdc has an entire branch and group of professionals who spend their careers working on ebola and other similar infections. They go out and stop outbreaks all the time. We have stopped every outbreak of ebola until the current one in west africa. Theres zero doubt in my mind that barring a mutation, which changes, which we dont think is likely. There will not be a large outbreak in the u. S. We welcome the attention. It would be important at times to put it in perspective. I appreciate that. I agree totally. One final question in the last 30 seconds. Is there any Additional Authority that cdc would find more helpful in conducting or in meeting your responsibilities . I know most of yours is guidance and information. Is there any specific authority that congress could grant you that would make your job that would make it easier for you to do your job . Were looking at a variety of things. Emergency procurement to see in conjunction with the Administration Whether there are some changes that might allow us to respond more quickly and effectively. Thank you. I yield back. I recognize mr. Johnson for five minutes. Thank you, mr. Chairman and dr. Frieden, thank you for being here. I thank all of you on the panel for being here today. This is not about politics. Its not about international diplomacy. Its about Public Health and protecting the Public Safety of the American People particularly our Healthcare Workers who if i understood correctly you acknowledged are some of the highrisk folks to be exposed. You know, i want to one of my main concerns, dr. Frieden, is that we dont know what we dont know. Throughout testimony and questioning today, i heard you say multiple times i dont know the details of this. I dont know the details of that. I think what the American People are wanting is some assurance that somebody does know the details. So let me ask you a question. Do we know yet how the two Healthcare Workers in dallas contracted the virus . Was it a breakdown in the protocol . Was it breakdown in the training of the protocol . Do we know whether or not the protocol works . The investigation is ongoing. Weve identified some possible causes. Were not waiting for the investigation to be completed. We dont know. Were implementing safety measures. We dont know. I get it. The people in ohio are concerned especially now that we know that one of those Healthcare Workers traveled through ohio and even spent some time in akron with family members. I applaud the governors immediate actions to try and address the situation. You know, in my experience as a military war planner, 26 1 2 years in the military, i know we have military engaged in this process overseas, we dont wait until the bullets start flying to figure out whether our war plan is going to work. When did the cdc find out there was an outbreak of ebola in west africa . Late march. Has there been one of the things we do in the military is conduct operational readiness inspections. We gave real world scenarios in a controlled environment no notice so those responsible for executing a war plan knows what to do when the first shot is fired. For panic. No secondguessing. They know what to do. Has the plan to address an Ebola Outbreak ever been tested by the cdc in a real world environment . Not only has the plan been tested but outbreak control has been done multiple times in parts of africa. What had not been done is in this part of africa which im talking about here in america. In america we do a series of preparedness plans. Do you know of any hospitals in eastern and Southeastern Ohio that have participated in any real world scenario of an Ebola Outbreak . I cant speak to that specific example, no. Let me go further. You mentioned earlier that 150 per day roughly are coming in from west africa. Mr. Wagner indicated 94 screening. Let me give you a scenario. Lets say a person comes into the country from west africa and lets assume that everything in the screening process works right. They are maybe in day 14 of having been exposed to ebola in west africa. They show up here in america with no symptoms. They go through the screening process and so they go on about wherever they go. Akron, cleveland, cincinnati, los angeles, wherever. Day 17 or 18, they start getting ill and they start seeing a spike in their temperature. If they walk into any emergency room in ohio and start throwing up, having symptoms, does your plan identify that and does your plan tell that hospital emergency room what to do in that scenario . They dont know that person came from liberia or any other place. We have detailed checklists that we have distributed widely and provided repeated trainings and information so that Healthcare Providers throughout the country have a detailed checklist of what to do step by step by step to determine whether the person has ebola if they do to call for help and well be there. Mr. Chairman, i yield back. Thank you. Mr. Green is next in line but mr. Mathison is next for five minutes. Thank you. I have a number of questions. Ill try move through them quickly. Dr. Frieden, as mentioned by a couple people in opening statements, it strikes me that controlling the outbreak in west africa is really one of the real key issues to keeping americans safe. There are reports indicating we may lose ground in liberia. What would enhance the international communitys ability to regain control of the situation in terms of actions and resources in west africa . The fight against ebola in west africa is challenging. The Health Systems are weak. What were finding is that its moving quickly. Theres a risk it will spread to other parts of africa. The key ingredient to progress there is speed. Because the outbreak is increasing so quickly, the quicker we surge in a response, the quicker we blunt the number of cases and the risk to other parts of the word including the u. S. Decreases. Are you resource constrained in that context . Congress provided money or approval or agreement to use money for the department of defense, usid has resources going in. At cdc we received 30 million for the first week of this fiscal year which we appreciate. You have a number, cdc has an unprecedented number of people in the field right now in west africa and texas. How many people do you have deployed doing airport scre screenings . I would have to get back to you on the exact numbers. Were overseeing screenings in west africa and to screen individuals here and it would be interesting to get that number and also find out if those resources are best used there or elsewhere with your limited number of people. That would be interesting to hear. Is there a development of a more rapid test to determine if someone has ebola than what we use today . A more rapid test would be very helpful. The u. S. Navy has a pilot test in development. Were currently testing that in parts of west africa. Its simpler and quicker and would be helpful even if it isnt as sensitive in west africa. Were working with a number of commercial manufacturers also on a more rapid test than there is currently. It seems to me that standards vary widely from hospital to hospital in this country. What legislative or regulatory actions could strengthen these systems . To the end, how can we reduce this variability among hospitals in our country . Infection control in our hospitals generally is a challenge. Something that cdc works hard with hospitals and state Health Departments and state governments to improve. Hospitals are regulated by the states within which they operate. And the issue of what could be done to improve Infection Control is complex. Cdc has a Large Program hospital Infection Prevention and we share lessons and figure out new ways to prevent infections and that model is an important one. You suggest that while you can provide the information and the expertise and guidance, the actual implementation and responsibility still is a state function more than a federal function. Should we be looking at that issue . In the u. S. We have a federalist system. The cdc provides information and input. There are roughly 5,000 hospitals in the country. Were not a regulatory agency. One other line of question. Theres no good news about ebola. At least its not an airborne entity. Its clear we dont want to underestimate its ability to be transmitted and while the focus is ebola and the purpose of this hearing, there are other pathogens that ought to be of great concern including this congress that exist around the globe today. Is this experience weve had with ebola, how do we learn from it to make sure that were prepared for other human to human transmittable, higher rate than ebola. There are two major lessons. First, prevent it at the source. If we had basic Public Health system in place in these three countries a year ago to find it, stop it and prevent it, it would be over already. Second, within our country, to continue to support hospital preparedness, Community Preparedness and the Public Health measures to find, stop and prevent health threats. Thanks, mr. Chair. Mr. Long is recognized for five minutes. Thank you, mr. Chairman. Today we referred to people on the panel, people up here have referred to nurse 1 and nurse 2. These are two young women that have dedicated their lives to helping other people. Sick people. And to refer to them as nurse 1 and nurse 2 doesnt set well with me. Reminis the first nurse to contract ebola was nina pham and number two was amber vincent. It would serve us well to remember that these are human beings, young women, that dedicated their lives to helping other people and for them and nurses everywhere and their family i would just like to open with that. Dr. Frieden, you said in your testimony earlier that only by direct contact can you contract ebola. Do you stand by that statement . Direct contact with someone who is ill or died from ebola or their body fluids. Its not airborne and you agree it cannot be contracted airborne . Ebola spreads person to person and not the airborne route. You need personal contact . Yes. If you need personal contact with body fluids, why is there an airliner in the Denver Airport right now that Frontier Airlines scrubbed four times. Why cant they get that back into service if you have to have body close contact, why scrub that airliner . I understand that people are very concerned about ebola. Its a scary disease. I cant comment on just for public perception. They really dont need to be doing that, right . We have detailed guidelines along with epa for how to clean airlines. You need to be sick. The first symptom of illness is fever. Do you need a fever to be contagious . Late in the disease when people are deathly ill, they may not have fever but they would be unable to walk at that point. A 21day period where you need to show symptoms within 21 days from exposure. Could you be contagious on the third day of that point . Only if you were sick. Only if you had symptoms. Okay. And the incubation period is anywhere from 0 to 21 days . 2 to 21 days. Generally within the first ten days or so. You said there are 100, 150 a day people coming from west africa to the United States. You are opposed to travel restrictions. I predict youre going to put on or the president will put on travel restrictions. I dont know if will be today or tomorrow or two weeks or a month from now, i think theyre going to come. If you say we dont need to worry about that because they could get cross borders and go by land and get here. Dont you think that number might be reduced to five or ten a day if we put on travel restrictions . I cant comment on what numbers if someone had to make an effort other than going to their local airport, dont you think that number would drop . I know that people do come back. Right now were able to screen them and collect their information. What if they dont come back . A lot of people come into this country and we lose track of them. They dont come back. What happens then . If you have 150 a day coming in or five, i would rather have five coming in and this thing of checking for temperatures like its going to help is kind of like scrubbing a plane that doesnt need to be scrubbed. I would like to commend folks reading this copy of Bloomberg Business week. Ebola is coming. Coming to america. The u. S. Had a chance to stop the virus in its tracks but it missed. That issue came out before mr. Duncan came to this country and before he was diagnosed with ebola. Theres some good reading in there that i would recommend. I would also recommend for you if you want to google a hospital from hell is swamped by ebola. The New York Times came out a few days ago. I think that everyone would be in favor of the travel restrictions we talked about here today and today osha, occupation safety and Health Administration just today said that customs and Border Patrol immigration and enforcement agents are at risk of coming into contact with ebola. Are we prepared for that . Are your agents protected to the fullest extent what they need . This just came out today. We issued them personal protective gear and train them on how to wear it and what circumstances to wear it. They encounter different travelers with a whole host of communicable diseases. Were aware and we train to recognize signs of illness and we have protocols with the Health Officials to get those travelers into that care and protect our employees. They found in the same category as nurses. They are there to save us and protect people in this country. God bless them. I yield back. Gentle lady from north carolina. Thank you so much, mr. Chairman. I have a number of questions. I would like to start with dr. Varga in regard to the two nurses that were exposed. My understanding is the first nurse, nurse pham was exposed in the emergency room, is that correct . Repeat the question. The first nurse was exposed in the emergency room. Is that correct . No, that would not be correct. Nina was one of our icu nurses and first came in contact with mr. Duncan when mr. Duncan was transferred from the Emergency Department to the e. D. That was sometime from september 28th to the 30th, is that correct . Thats correct. The second nurse, ms. Vincent, was she also an icu nurse . Correct. So they were exposed after a point when we recognized that ebola was being looked at, is that correct . No nurses from the first time they had contact with mr. Duncan were in personal protective equipment according to the cdc guidelines. Nina, cared for mr. Duncan they were already using universal precautions but also were using some of the more isolation and just answer yes or no . Yes. Okay. To that, i would like to move to dr. Frieden. This, of course ill back up. On october 6th, i sent a letter to the cdc and hhs calling for travel restrictions. Theres no question i believe travel restrictions need to be put in place. Now after having this subcommittee hearing, i believe even more strongly that we need them. I just want to back up to a couple questions for dr. Frieden and dr. Fauci. Are there multiple strains of ebola . There are five different subspecies. This outbreak is one particular subspecies and all of the strains that weve seen have been closely related. So we know that its isolated to one particular strain . Yes. You mentioned and i believe the quote was unless it mutates, there will not be an outbreak here in the United States, is that correct . There will not be a large outbreak here barring a mutation. The question i have is when the nurses were using the protective gear, how is it that this has happened . It tells me that something is changing here and are we currently looking into the situation right now . Were absolutely looking for other mutations or changes. What weve seen is very little change in the virus. We dont think its spreading by any different way. And you already have said a couple of times that you dont believe that this is airborne and yet there again i know how nurses are. I was one for 21 years before coming to congress. Youre protecting yourself and your patient and your family. They followed precautions, im sure, and now were having this conversation and im very concerned about that. We are confident this is not airbor airborne transmission. There was a lot of infectious material and investigation is ongoing but we immediately implemented a series of measures to increase the level of safety. Im going to move on. In the discussion of fast tracking a test for ebola, where is the fda on that or is there a fast track process right now that you know of . For diagnostic tests . Yes. There are three authorized for use and we have also taken some steps by contacting commercial manufacturers who we know have potential technologies to be brought to bear here and we reached out to a handful who might be interested in working with us. So youre in the process of looking toward a fast track process . We would expedite every such test. Dr. Frieden, lastly, im speaking on behalf of my constituents and every american in this country. I just dont believe that its acceptable that the quote that you have given us we wont be able to track them as the reasoning for why we should not implement travel restrictions. I do believe we can. As far as customs and Border Patrol, do you believe theres a way to implement tracking . Tracking . Tracking of individuals if we do not allow them we have ways to determine a persons itinerary. Its easier when they come in on a direct ticket from those places. Thank you, mr. Chairman. I thank you for indulging my over time here. We are going to pull away into this. Were almost three hours into this committee hearing. Pretty tough questions for members of the medical community. Were going to talk to one of the ranking members who called this hearing at the top of the next hour. There has been a lot of substance. A lot of questions. Very good questions about preparedness or lack thereof and questions about the ppes, personal protective equipment and was enough of that used and did nurses and medical professionals at the dallas hospital know how to use it and questions about transmission with pets. It ran the gamut. Some of it was political theater this is d. C. This is politics. Lets get to the substance with sanjay in just a second. Let me back up. If you are just joining us here, let me tell you about these two nurses. These two ebola patients. First you have nina pham, first of two dallas nurses that contracted ebola. As we have been reporting today, shes now moved out of dallas to the nih to the National Institutes of health. Shell be flown to maryland one day after amber was transferred to atlanta to be treated for ebola. So both of these nurses leaving dallas. Vincen is the nurse who took that commercial airplane, that Frontier Airlines flight from cleveland to dallas one day before she was diagnosed with ebola. Turns out she had the cdcs okay to fly. Questions were asked of cdc director tom frieden today at this hearing and this was his response to that. Dr. Frieden, a second nurse affected with ebola took a flight to cleveland after she registered a fever. We have reports that says she contacted the cdc and was told she could fly. Did she in fact call the cdc and ask for guidance on boarding a commercial flight as far as you know . My understanding is she did contact cdc and discussed with her symptoms and other evaluation. Were you part of that conversation . No, i was not. Was there a preplan suggesting limiting her contact with other persons . The protocol for movement and monitoring of people potentially exposed to ebola identifies as high risk someone who did not wear appropriate personal protective equipment during the time they cared for a patient with ebola. Let me ask this then. What specifically did she tell you. Mr. Duncans medical team was not under same restrictions of people he came into contact with. What did she tell you her symptoms were . Ive not seen the transcript of the conversation. My understanding is she reporting no symptoms to us. Let me bring in dr. Sanjay gupta. Here he is once again at Emory University hospital in atlanta where we know that second nurse, ms. Vinson is being treated. You have been blunt about the assessment of the cdcs response. Listening to this almost threehour hearing in d. C. , did it change anything for you . It made me feel bad for dr. Frieden. They have been going at it. Theyre still going at it with him and asking him lots of questions. Okay. Were going to work on getting him back up. Okay. Im going to pause and bring in a doctor who is with me on set. Its live tv. What are you going to do . You are with nyu med center. Listening to it and talking about travel bans and preparedness and ppes. You felt bad for dr. Frieden as well. Hes done a good job of keeping the American Public up to date on whats going on. He doesnt have all of the answers. No one does but hes keeping everyone involved. I didnt feel surprised by the hearing. One thing that i think looking at all of this is just in terms of incentives for the hospital. Theres a few things. They dont have an incentive to be up to date with protocols because in order to do all of these drills and to be totally prepared, they really have to take their doctors and nurses and everybody and move them into actually these drills and not taking care of patients. Let me jump in to connect the dots here. What were talking about and much has been made and you pick up any major paper in the country today and there are illustrations on what the personal protective equipment, the gowns, face masks, what they should and should not be wearing. Questions have been asked about how they had been trained or not trained for ebola and your point being its tough to do that without short staffing a hospital. Exactly. You have other patients who have other problems who are not being treated while Healthcare Workers are trained for ebola. If you look at what people are affected by in terms of viruses, flu is a big one. People come in from a car accident or something else. You need e. R. Staff to be there not necessarily in drills. It seems almost unthinkable a month ago i would sit here with you. We know president obama went to the cdc and says its unlikely this would reach our shores and fast forward a couple weeks. The other thing is the learning curve. People get better with practice. How can hospitals be fully prepared to take care of something theyve never seen before. We were talking before about computers. I had a pc. I switched to a mac. It took a while for me to get up to speed to everything. The same is true here. They are using personal protective equipment and using protocols they have with other diseases but they havent dealt with ebola. When you have questions, what you usually do you dont look at manuals. I asked friends or i tried to google the answer. Theyre not going to find the answers on the internet. Thank you so much. I really appreciate it. Well stay on this. Sanjay will be back. I can promise you that. We have Anderson Cooper standing by in dallas. Hell join me in a second as well. Also ahead, a nurse who works at this dallas hospital is now coming forward showing her face blasting the hospitals response to all of this. Youre about to hear from her and why she says the handling of Thomas Eric Duncan was a disaster. 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For drivers with accident forgiveness, Liberty Mutual wont raise your rates due to your first accident. See Car Insurance in a whole new light. Call Liberty Mutual insurance. A nurse is at risk of losing her job by discussing the care of duncan. They talks about mistakes they made including putting duncan into a room with seven other patients. The nurse spoke to the today show and shell speak to Anderson Cooper tonight so tune in at 8 00 eastern. She never provided care for duncan. She has cared for nina pham and she said this about what she would do if she herself contracted the virus. Knowing what i know, i would try anything and everything to refuse to go there to be treated. I would feel at risk by going there. If i dont have ebola, i may contract it there. With me now, founder and executive director of the truth about nursing. Sandy, nice to have you on. Welcome. Thank you, brooke. So we are now hearing from this cdc doctor who spent two weeks at this dallas hospital and this is what he told cnn. People are scared to go there. Apparently not even half of the beds are full right now. Scared was his word. Let me ask you, reality check for all of us. If you were a nurse or a patient in dallas, would you be scared as well . The nurses did raise a lot of concerns about the way the virus was being handled, the lack of bright line on the floor to cross between whats clean and whats dirty and trash piling up and it was very sad to hear that Infection Control policies were very low. Apparently they were following cdc guidelines and im happy to see the cdc guidelines have ratcheted up their precautions but still on their website i do not find anywhere for hazmat boots or protective gear. When patients are sick with ebola, they have a lot of vomiting and diarrhea and there are body fluids everywhere including falling off the bed onto your shoes and ankles and pants and nurses need hazmat boots and rubber aprons. Its possible that nina pham and amber vinson got it from taking off their shoes and socks because it doesnt seem like there was foot protection. They are trying to figure out how this went from the patient to two nurses. You paint a very ugly picture of this particular virus and in response to all of that from these nurses, you know, this hospital in dallas released this blow by blow countering these multiple accusations and overall this hospital says it follows cdc protocol and there were fears about duncans Lab Specimens containing other patients and they say it didnt leak or spill. They said the nurses next were exposed. Listen to one more thing this nurse in dallas said. Ill be honest. I throw a fit. I just couldnt believe it. I just flat out asked several Infectious Disease nurses and asked the cdc, why would i wear two pairs of gloves, three pairs of booties and plastic suit covering my entire body and leave my neck hanging out this much so that something can potentially go close to my mouth or nose. That was kind of the point you were making. Heres my question. I know that sanjay has been talking to a federal official who says we know both nurses are not at this dallas hospital and one of the reasons as explained is there are real fears that these nurses will walk out. Do you think they should or that they would . Im sorry, the nurses on staff would walk out . Thats one of the fears, correct. Right. Its a concern that the hospital did not appear to be up to date. I believe the vast majority of hospitals across the nation have not prepared their staffs to be up to date if a patient should walk in the door. Every hospital needs to be prepared for a patient to walk in with ebola. Thats what happened to texas presbyterian. They didnt get advance notice as emory got when they received two patients that someone would be walking into their e. R. We all need to be on alert and look out for ebola. You know that nurses are compassionate people. Do you see these nurses as perhaps fearful or anxious or angry as they may be . Do you actually see them walking out . Well, nurses do not lightly abandon their patients thats for sure. Its very sad that nurses are not listened to. And in our book, the portrayal of nursing puts us all at risk. We talk about how society undervalues nursing because people dont understand what nurses do to save lives and improve patient outcomes. Hospital administrators dont understand what nurses do in their every day practice. They do 24 7 surveillance and intervention. They advocate for patients and it seems as though the nurses at texas presbyterian were trying to advocate for better care, better Public Health for mr. Duncan and the patients who surround eed him at the hospita and they were not listened to. A nursing supervisor tried to put mr. Duncan in isolation and met with resistance. There was not proper equipment provided to the nurses to protect nurses and to protect Public Health. They are working to get to the bottom of it. Sandy, thank you. Executive director of the truth about nursing. Appreciate you. Thanks so much. We continue on top of the hour. Im brooke baldwin. You are watching cnn. A second ebola stricken nurse is now being flown out of dallas to this hospital in maryland one day after a nurse amber vinson, was transferred to Emory University in atlanta to be treated to ebola. Vinson took the flight from cleveland to dallas the day before she was diagnosed before the virus. It turns out she did call the cdc and reported this lowgrade fever. Did make them aware of this plane she was about to get on and they did not say no. Cdc director tom frieden was asked about that today as he testified before members