Transcripts For MSNBCW MSNBC Live 20141012

Dallas nurse is positive for ebola. Shes in isolation at the hospital where she helped treat Thomas Duncan. One other person is being monitored as having potential contact with her. They are monitoring every Single Health care worker in duncans care circle including those in full gear who followed procedures. The care of ebola can be done safely but it is hard. It requires skroop lus attention to infection control. A simple slip can result in contamination. Nbc outside the hospital in dallas. Kristen welker is covering the story. We heard the words coming prosecute the cdc this breach. Its early on. They are asking how this happened. What do we know about what the breach is . Good afternoon. Officials are confident a breach did happen. In the past people follow iing say if you follow the protocols you wont be infected. They are confident that it happened. They have asked this young woman, they have interviewed her. She has not been able to specify when this might have happened. Isolating the breach is key now. They are asking the hospital to use the minimum number of staff in there because their reasoning is if one person was exposed more could be exposed. They are continuing to monitor 48 people who had contact with duncan before he checked in on september 28. Different than the people who are being asked to self monitor. Like this patient in this case. She was the first one to figure out she had a fever. She contacted health authorities, followed protocols put into place in case of a situation like this. From the time she called to when she was in isolation getting tested, only 90 minutes. 90 minutes. We look at the timeline now showing ebola symptoms on friday. Later today we expect the final results. Youre also following this, sarah. Thats what we are doing at her apartment. Are they scouring it as they did with Thomas Duncan . They began the work last night. Crews cleaned up the common area and open areas in the apartment complex. They have a crew expected to go in later this afternoon and decontaminate the inside of her apartment. They will check on a pet she has. This will be the same crew that went inside the apartment where duncan stayed. They did a good job on the first case. They are bringing them to this apartment complex which is 15 minutes prosecute the hospital. They said 48. They are watching that the list from duncan. Are they putting together a new list then for the new patient . Reporter thats the key, the cdc says, to breaking the links of transmission. Thats the key to stopping the further spread of ebola. Here is who they have identifieded thats had contact with this patient. 18 people who have had some type of contact with her and one person who has had close contact. That person already in isolation being monitored and the 18 people not in isolation are being monitored now. The very latest from dallas. Sarah, thank you very much for the story. Shell be back later to give us perspective. Now seven months into the global outbreak. Thank you very much, sarah. Lets bring in nbc News White House correspondent Kristen Welker at the north lawn live for us. We understand president obama has been briefed on the second patient that sarah was telling us about. What can you tell us . He was briefed earlier today by lisa monaco, his adviser in homeland security. He had a phone call with Sylvia Matthews burr well. In the phone call we are told president obama directed burr well to make sure the investigation into the apparent breach in protocol happened quickly, happened expeditiously to make sure the federal government is working with state and local officials to get them the help and information they need to make sure this type of breach doesnt happen again and to make sure hospitals around the country are clear. This comes as National Security adviser susan rice on meet the press said other countries need to do more. Heres what she said to chuck todd. Listen. No. They have to do more to contain the spread and provide appropriate care to those who need it. Reporter when i spoke with an Administration Official about what specifically she meant, what the administration wants from other countries, i was told they want more aid when it comes to setting up treatment centers, more Health Care Officials to be sent to west africa and more supplies. Thats key. The administration continues to make the point that ending this and dealing with the crisis, you have to go to west africa to stop the spread of the disease there. Kristen, you have been watching and reporting. Airport screenings expand this week. Four additional airports here. What are you hearing in terms of what Administration Officials are saying about how the screenings at jfk have been and as we move forward . So far they have been going smoothly, richard. As you point out later this week they will expand to four more airports. They make the point that this is not going to create a log jam. They are not dealing with hundreds of people but several dozen people they anticipate will come through the airports that they have to screen. So far they have been going smoothly. Cdc officials point out of course you cant get the risk down to zero. This is one more level of protection but of course Everyone Needs to follow protocols and be reminded how the disease is spread in first place. Be careful in that context. So far, the reports are that the screenings that have been taking place at jfk have been going smoothly. Thank you so much. We go to natalie azar with the Medical Center in new york. You have heard the reporting so far. The idea of a breach, im not sure what it is now. What is this . I think it is important to remind everybody that it is possible and dr. Frieden stated this morning it is possible to take care of an infected patient and not get infected yourself. We have seen that historically. We have seen it happen in west africa and we have seen it with cases brought to the higher level containment units in the United States. What we are saying is the risk will never be zero. If protocol is followed it should not happen. What we were speaking about before is there is a protocol remember, for surgeons and nurses going into the o. R. To put on clothes, gowns so they dont infect patients. It needs to be practiced. Is it possible care takers now taking care of patients havent been trained properly in terms of disrobing what comes first . The mask, then the gown and gloves. If there is a small misstep in the series. So youre saying its a matter of practice. Did they practice the practice . Correct. The question was posed this morning. Are we suggesting there is another way this person became infected . . No. Mistakes can happen but the discussion about buddy systems, et cetera to observe if they are trained properly. The protocol has been laid out. How easy is it for one to contract the disease based on what might be called a slimimpl slipup. The disposal of a suit, for instance. Exactly. Again thats the other question. We are talking about it from the moment a patient enters the emergency room are they appropriately identified, triaged in that initial setting appropriately, put into an isolation room. What happens after that . The sheets the patient was lying on, the needles used to draw blood, every hospital technically and theoretically has Infection Prevention and control procedures in place. It is, again, the onus is on each individual hospital in this country to make sure they have reassessed their management protocols and communicated it effectively to the staff. I want to get to that in a second. Now we have a new patient, a new index patient if you will. Yes. We are just getting the information this morning. 18 people in contact. One close contact. 19 individuals. That could grow. We saw up to a hundred with Thomas Duncan. Right. Thats the thing that makes us most concerned. Exponential growth of it. I think to remind, again, that i dont think any of us thought we wouldnt see cases in this country. I would say a parallel situation, mr. Duncan presenting in liberia, the number of infected and potentially exposed people would be exponentially high than it is in this country. I dont think any of us is particularly shocked by this. I dont particularly think the number is overwhelming for us to manage. We have had the mrs virus and srs, respiratory viruses, hospitals and physicians have a protocol for dealing with viral hemorrhagic fever which is ebola. We have been dealing with communicable respiratory diseases. Infection control procedures have been in place for decades. The fact that she worked in a hospital, high contact with numerous individuals, the numbers appear to be low. 19 considering that she probably had contact with many, many different individuals. She probably did. Importantly, and i think as we get word today from this particular nurse we are just learning. He or she did notify officials at the first sign of fever. We are hoping that what we are telling people is true. Youre not contagious in the asymptomatic period. In spite p of the fact she may have been with other patients and interacted with family and friends, at the first sign she was potentially contagious he or she brought herself to be evaluated and isolated. The fact she discovered it early and the fact she went to the hospital and said, i have symptoms. Its really, i guess, the saving gra grace. We can hope she could survive this. Again with beginning Supportive Care early and hopefully if there is experimental treatment she can receive. So the u. S. Has just four hospitals equipped with specialized Isolation Units. Correct. We have a view from kate snow last week. Nebraska, maryland and atlanta specifically. Do we need this is the big debate. Right. Do you focus on the super hospitals, if you will. Right. And not have every hospital ready to handle ebola . Its unrealistic to think we can up scale every single hospital to become a bio safety level four containment unit. I would like to say a lot of the level four hospitals are actually meant mostly for those aerosolized virus where is you need a double door and people with suits have their own oxygen supply. We are not talking about that level of containment with ebola. On that note, since you bring it up, when it comes to the latest nursed patient now contracting ebola was it an issue of the suits we have been seeing . What all our hospitals are whats necessary to have for the hospitals now is simply a face mask , gown and gloves. What we are talking about not the suit we have been seeing. I should say the hazmat suit is all great. If you are wearing a gown or glove and you have blood on you the gown works as well as a hazmat suit. People have to take the hazmat suit also. The vast majority of exposures happen when the suits are taken off or the gowns are taken off. How they are handled . They have to be disinfected prior to taking it off and they have to be taken off carefully. The nurse in spain said she touched her face with her glove. Inadvertently. You can have the most expensive hazmat sewnth suit on but you could be exposing yourself. Out of dallas she did test positive for ebola. We expect today to get final test results from the cdc. Dr. Azar of nyu, thank you. Youre welcome. There are two cases of ebola diagnose thosed in the u. S. An Infectious Disease specialist will tell us if there will be more. Plus the war against isis is being fought on many fronts. New developments from iraq. A tense night between police and protesters in st. Louis. A down side to a peaceful weekend of resistance. To st. Louis for a look ahead. I take prilosec otc each morning for my frequent heartburn. Because it gives me. Zero heartburn prilosec otc. 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[light instrumental music] female announcer recycle your old fridge and get 50. Schedule your free pickup at no justice. No peace no justice. No peace no justice. No peace that was a familiar sound coming out of ferguson, missouri, last night where more than 1,000 mostly Peaceful Protesters continue what organizers call a weekend of resistance. Leslie mcspadden was there participating. Things got tense in st. Louis where protesters staged a sitin at a gas station near the location of a Police Involved shooting from last week. Officers had red sox and bottles thrown at them last night. Protest leaders deny that. Police used pepper spray and teargas and arrested 17 people at the gas station for Unlawful Assembly on private property. Organizer statements saying, quote, today protesters in st. Louis showed the best of our democracy and the st. Louis police demonstrated the worst of their out of control Law Enforcement agency. More events including a hiphop concert. Amanda was there and lets start with what happened last night and the mood thereafter in that conflict with the 17 individuals. What do you know . Hi, richard. It was almost a spontaneous gathering thats not a formal part of the weekend of resistance bringing together supporters from across the country. Last night there were roughly a hundred protesters in the area. They staged a sitin in front of the Convenience Store of a quick trip here. They were sitting there peacefully and chanting, but the police say they were throwing rocks at the Police Authorities which the protesters refute. Now the energy here today is a bit of a mix. They are now halfway through the weekend of resistance which has been physically and emotionally training for protesters, particularly organizers who are clearly pouring their hearts and souls into making this a movement, calling for social justice, justice for Michael Brown and also an end to Police Violence. As we talk about whats happening in ferguson, missouri, whats happening in the United States, i was leafing through the International Business times. It was the main story, the top story on their site this afternoon. Weve got the hiphop concert today, the next big event planned for tomorrow. Are they aware that its not only eyes across the United States but eyes across the world watching to see whats hang and their reaction to that. I was just at the hiphop concert. It was full of protesters who have been there on the ground since day one. They are really trying to make it a movement thats a National Scale and to resonate beyond what happened to mike brown. Also calling for this end of Police Violence and they really are aware the National Spotlight is on them. Perhaps an interNational Spotlight. There are journalists here from around the world. They know this is a time for people to really show exactly what is happening here in st. Louis. You have covered many of the protests there in ferguson. You and i were working therement i remember that these would go late into the evening. You were out there on the streets with them. Tell me how the conversations are different now. You know, i think people are worried about what the next step will be. They are wondering whats going to be next in Michael Browns case. The latest second shooting, another young black man shot down by police. Its just igniting the fire again. And calls for justice. Thank you for the latest from st. Louis. Abductions, rapes, forced marriages. The Islamic State or isis an enemy to women. Women across the globe are joining isis. Hundreds of them, in fact, by some accounts. Our friends at now this news looks at how and why. So ally bank really has no hidden fees on savings accounts . Thats right. Its just that im worried about you know hidden things. Ok, whys that . No hidden fees, from the bank where no branches equals great rates. But ive managed. E Crohns Disease is tough, except that managing my symptoms was all i was doing. And when i finally told my doctor, he said humira is for adults like me who have tried other medications but still experience the symptoms of moderate to severe Crohns Disease. And that in clinical studies, the majority of patients on humira saw significant symptom relief. And many achieved remission. Humira can lower your ability to fight infections, including tuberculosis. Serious, sometimes fatal infections and cancers, including lymphoma, have happened; as have blood, liver, and nervous system problems, serious allergic reactions, and new or worsening heart failure. Before treatment, get tested for tb. Tell your doctor if youve been to areas where certain fungal infections are common, and if youve had tb, hepatitis b, are prone to infections, or have flulike symptoms or sores. Dont start humira if you have an infection. Ask your gastroenterologist about humira. With humira, remission is possible. 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Polident kills 99. 99 of odorcausing bacteria and helps dissolve stains. For a cleaner, fresher, brighter denture everyday. So i can reach ally bank 24 7, but there are24 7branches . Its just im a little reluctant to try new things. Whats wrong with trying new things . Feel that in your muscles . Yeah. I do. Try a new way to bank, where no branches equals great rates. First of all, they are winning and were not. The iraqis arent winning. The peshmerga, the kurds arent winning. There has to be a fundamental reevaluation of what we are doing. We are not degrading and destroying isis senator john mccain as we look at the war against isis. Renewed fighting in kobani today. The kurds have been supported by u. S. Air strikes. The u. S. , saudi and United Arab Emirates war planes hit isis targets today. Also today u. S. And United Kingdom war planes striking targets in iraq. A High Ranking Police official in Anbar Province was among those killed this morning. The attacks come a day after yesterdays car bombings in and around baghdad that killed at least 43 people. Richard engel is in Northern Iraq for us. Richard . Reporter there are multiple active fronts in the war against isis starting in iraq. Leaders are calling for american intervention, for International Air strikes to set back isis. Without them, the leaders are saying many more parts of the province could fall giving isis a large swath of territory but pringing them to the edge of the capital and close to the baghdad International Airport. The Turkish Border is under siege. Today its been under attack in street to street fighting and with heavy artillery from the south and east. Fighters in kobani say they need International Help and without it the city could be overrun. There could be a massacre on the scale of cheberditsa, the worst since world war ii. There are perhaps a thousand people in kobani and if nothing is done the u. N. Worries they could be killeded. So far no real action has been taken. The u. S. Has carried out air strikes. Turkey, a few hundred yards away has tanks, troops in the area. So far, not acted to save the city. Richard engel. Thank you for that. The parents of peter kasig are speaking out. He was seized a year ago while delivering food and aide aid in syria. They spoke to Peter Alexander to send a message of hope to their son. Im hoping that he will somehow hear of this and other conversations we have had or other times we have spoken in public. That way hell know we havent forgotten him. We havent abandoned him. We certainly do love him. See more of Peter Alexanders interview tomorrow on the today show. A second case of ebola diagnosed in the u. S. Its the first time the virus has been transmitted in the United States. Should we worry about more cases . We speak with an Infectious Disease specialist next. Here i am. Rock you like a hurricane. Fiber one now makes cookies. Find them in the cookie aisle. 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I use the explorer card to earn miles in order to go visit my family which means a lot to me. There is no risk to people outside of that circle, of the Health Care Workers who cared for the individual patient and the initial 48 patients or contacts who had definite or possible contact with the index patient who we have already identified. Cdc director tom frieden this morning. After a second patient, a Health Care Worker, tested positive for the ebola virus in texas. Officials havent identified the patient. We are told she wore full protective gear while caring for Thomas Duncan who died last week. Here is a look at some of the stories topping the sunday headlines. Well have more on ebola shortly. Now in st. Louis, missouri, people are attending a hiphop for justice concert, part of events surrounding whats being billed as a weekend of resistance to eliminate racial profiling and Police Violence in the wake of the shooting of Michael Brown. It follows protests last night including one where 17 people were arrested by police for Unlawful Assembly. Meanwhile russian president Vladimir Putin has ordered troop return to their bases. The troops which were stationed in vostav were participating in drills. Fighters, claims of previous withdrawals have been countered by nato saying the moves werent carried out. The Iowa Senate Race hot and heavy between joanie ernst and bruce brayly. A new Des Moines Register poll shows ernst hanging on to her onepoint lead. As we learn of the first transmitted case of ebola a more detailed timeline of oh Thomas Duncan thousand available. September 25, he went to the hospital complaining of a headache and abdominal pain. Health workers recorded a 103 degree fever but sent him home. Day four he was admitted to the hospital. Experiencing diarrhea and vomiting uncontrollably. He was later too tired to use the restroom and experienced kidney and liver damage. Day six he tests for ebola. The tests came back positive. He did become able to eat crackers and drink sprite. They thought it was an improvement but his kidneys were deteriorating. By day ten he was given a new drug but his organs were failing and he was on a breathing tube. Day 14, duncan dies. Dr. Morgan, professor at the mailmin school of Public Health joins us now. We laid out the timeline here. As we look at the progress, as we might say of ebola in Thomas Duncans body we wonder with the new case, are we already in some part of the timeline or is it it just day one . She was obviously exposed earlier. It takes a few days and mr. Duncan died a few days ago. It takes a few days before the disease expresses itself i think they were monitoring the fever and they thought it might be ebola and put into it isolation. How does ebola break down the body . We laid out the timeline. What are things we should be watching for in this new case . You have seen many examples already of serious and fairly usual progression of ebola. What does it go after in the body . For one thing you usually die of multi organ failure because of shock. Essentially. You saw the word sepsis on the timeline. Essentially shock the due to the fact that there are a lot of abnormalities in circulation, blood clotting, blood goes through capillaries, through blood vessels. It may pool in parts of the body including the lungs and many other organs dont get the blood they need as the kidneys in duncans case. Reporter the information we got from the cdc from dr. Frieden this morning was that the evidence of the virus in this new patients body is low. What does low mean . I think that depends on actually doing the quantitative test. Right. There are ways to quantify the amount of virus. I dont know what low means either. I think since its not highly symptomatic at this point its an early stage when the virus hasnt really had a chance to reproduce that much. I think it is in general better to treat it as early as you can. So many hoped Thomas Duncan would be the last as well as the first case. Tom frieden addresses that. It is possible in the coming days well see additional cases of ebola this is because the Health Care Workers who cared for the individual may have had a breach of the same nature as those who appeared to have preliminary positive tests. We had as many as a hundred contacts with Thomas Duncans case. Now they are saying 19 contacted individuals potentially. Whats your perception of what you have heard and the numbers provid provided. I dont know exactly when she started having a fever. I think they are at low risk and most of the family members are probably at low risk. She was put into isolation early. They were monitoring that. Then there is the personal protective equipment. He mentions a breach. In most cases unless somebody has something obvious like a needle stick. Usually you are aware of that immediately. Usually its a mistake in taking off the personal protective equipment. Most people have put it on correctly and are careful. After you have been there tan hour or so you cant wait to get out of it. The idea of the buddy system where one watch it is other. If you have finished treating duncan i will assist you removing protective garments. Yes. Thats a very good idea. People watch each other. Its amazing when you do that you can see even experienced people make mistakes. They will touch their face before they have decontaminated the gloves for example. Common, everyday things you might do not realizing that you should have protective garments refused first. There is a discussion here according to what we are hearing. They are looking at her pet. We saw this also in spain. Red herring or something to be concerned about . We are still learning about that. There are a lot of opinions about the dog. Right. Apparently dogs may be able to be infected with ebola. They dont show symptoms. We dont have any cases of people becoming infected from their pet dogs or cats or whatever. On the other hand, this is an unusual situation. I think i would test first but obviously this is being this was treated this spain, much like a rabies case where you euthanize first and ask questions later, to be safe. Yes. We are in a situation where something is happening so quickly across the world. Some doctors i have heard publically saying you shouldnt worry about it jumping from humans to pets. But when we look at bird where it moves species to species. It mutates. Is that a possibility. One has to ask going through the cautious steps. There are many possibilities that all of the viruses mutated a fair amount. We only know a little bit about ebola. All the information about this has only recently become available when people could do sequencing of the full genomes. We have no context in which to understand it. I think the notion for example that it will mutate to airborne transmission is still more for hollywood than for the real world. Obviously we have never experienced this kind of outbreak before. People want to be cautious. I would be surprised if we see anything happening with ebola beyond what we have already seen. One is hoping for what you said there. Dr. Steven morse, thank you very much for your time. Lets look back on this day. It was october 12, 2000 when terrorists attacked the u. S. S. Cole in yemen killing 17 say lukas rossi and wounding 38 others. The Navy Destroyer was headed to the persian gulf and stopped to refuel when the ship was bombed. That blew a massive hole. Never prosecuted. Heres part of president clintons speech to the nation on the day of the attack. If, as it now appears, this was an act of terrorism it was a despicable and cowardly act. We will find out who was responsible. And hold them accountable. If their intentions were to deter us from our mission of promoting peace in the middle east they will fail utterly. In life there are things you want to touch and some you just dont. Introducing the Kohler Touchless toilet. Ameriprise asked people a simple question in retirement, will you have enough money to live life on your terms . I sure hope so. With healthcare costs, who knows. Umm. Everyone has retirement questions. So ameriprise created the exclusive confident retirement approach. Now you and your ameripise advisor. Can get the real answers you need. Start building your confident retirement today. Ring ring . Progresso its ok that your soup tastes like my homemade. Its our slow simmered vegetables and tender white meat chicken. Apology accepted. Im watching you soup people. Make it progresso or make it yourself prof. 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He had this to say to habitat for humanity about why he does his annual build there. One of the fundamental human rights is to have a place to live, food to eat, education and health care. I grew up during the depression years in south georgia and during the segregation years. All of my neighbors were africanamericans. I learned from them ultimately how devastating the segregation rules were. They couldnt vote, serve on a jury. They had to have their own schools and that sort of thing. When i got older i began to realize this was a blight not only on their lives being deprived but on the white people depriving them. Thats where i got ideas about equality, civil rights and human rights. U. S. National security adviser susan rice saying other countries have not done enough to help fight the ebola outbreak. Will it change . The answer is coming up. This third shift is rough. Its just a few more weeks max what are you doing up . Its late. I just wanted to have breakast wih you. 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Watching whats happening on the ground and also, there are concerns about who else might have come in contact with this latest patient. That is correct. They call it breaking the links of transmission, making sure the virus doesnt spread to anybody else. Located 19 people that had contact with the new patient, thats 18 casual contacts and one close contact. Also placed that close contact in isolation for monitoring. And we also continue to monitor those 48 people who had contact with mr. Duncan. That includes ten people who had close contact with them. They at least have another week of this monitoring, i believe the 20th this month when the 21day waiting period up. So far, no one showing signs or symptoms of ebola now. What was that your sense there, sarah, you have been watching the story develop the last several weeks . When they came out, those hospital officials early this morning and later on, the cdc, their sense of, if you will, confidence or lack thereof . Did you get any sense of that . I would definitely say they are very concerned. There is worry right now, they dont know where this infection occurred. This was a Health Care Worker who was fully suited up, supposedly following all the cdc protocols. Right now, they really want to isolate where this breach of protocol occurred and answer some very important questions, were more than one person exposed . Happened more than one time . How can we prevent it from happening again in the future . That is the key right now for them isolating and identifying this breach of protocol. This Health Care Worker told interviewers that she, herself, didnt know where it occurred. Go to you now, kelly. Susan rice making that comment that more countries need to Work Together to be able to combat this virus and youre there in london, watching not only the steps taken in the uk, but then theres also the case in europe in spain. Reporter thats right and some conflicting information about that case in spain tonight. First of all, we have heard that the nurse is doing better. She is still serious, but is showing signs of improvement. And there were reports that shes been treated with zmapp. This is medicine,er piquesmental medicine used on a couple of ebola survivors now, shown to be fairly effective. Conflicting reports, the government says no, we have no record of her being treated with that. She is being treated with some antibodies from people who have survived ebola, but they do say that they have zmabb, with a b, one of the components going into zmapp. Now, in terms of contributions, the uk is preparing to send about 750 troops to set up hospitals. They are sending troops to sierra leone. France has pledged troops and medical staff to guinea. So, there is quite a bit of work going on on this side of the pond to send more help to west africa. Kelly, whats happening in hospital there is in europe, there in the uk . We have been talking about it in the United States. We have those four specialized hospitals with the Isolation Units here in the United States. What steps are we aware of that are being taken there in europe . Well, over the weekend in the uk, at least, there are quite a few quite a few efforts to see how well prepared the hospitals here are. They have been given the protective gear that they believe they will need, if they have a potential case here. Neff also run drills, happened over the weekend where they had actors playing ebola patients, ran all sorts of different scenarios, calling from the street, coming into an emergency room and running through the process of getting that person into an Isolation Unit and making sure that all of the procedures are in place in case an ebola patient does show up in the uk. The chief medical officer in the uk says we should be expecting to see at least a handful of cases in the uk in the coming months, its just sort of inevitable at this point. Sarah, in the minute we have left here, seven months since this latest outbreak, as we go back to march of ebola virus across the world, the United States feeling the latest cases that we have been talking about and you have been reporting on. Give us a bigger sense, if you will, of what has been happening and the mood of those in dallas and we deal with this outbreak . The mood is very introspective. This really drove home the point to people that ebola can and does pop up anywhere in the country. And its really pushing people to prepare for possible eventual future ebola patients. I will give you one example of that preparation. National nurses united, they are going to hold a Conference Call later this week after doing a survey of their nurses and finding out the majority felt unprepared to deal with an ebola patient, be it with preparation, instruction or equipment. Really just bringing home the point that ebola is now in the United States and medical workers need to be prepared to identify and treat and they need to be able to be sure that they can follow these protocols as we have seen so very important. Sarah daloff, thank you so much. Kelly, great reporting from both of you much appreciate your time today. And thats our show for this sunday. Thanks for much with aing with us this afternoon. We will be back next saturday, 2 p. M. Eastern time. Until then, keep it here for the latest news updates right here on msnbc. Have a fantastic weekend evening. Here i am. Rock you like a hurricane. Fiber one now makes cookies. Find them in the cookie aisle. prof. Burke the more you learn the more gaps you may find. 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