Him to. Nt so its a fault issue. I understand it had political resonance in the primary. Now when it comes down to a general election, the issue is, do you want somebody you know vote, whoe going to has voted many times and time again in support of the majority that the vast kansas people hold . Or do you want somebody who obamacare, for greater gun control . I just think theres a clear, here. Difference somebody that we know versus somebody that would be a significant risk, and the risk in the direction of things that most kansas people would find aboutable. Moran on senator jerry newsmakers. Now, a discussion on the u. S. Ebola epidemic, both at home and abroad. From todays washington is about an hour. Were joined now by dr. Gavin macgregorskinner. Infectious disease expert with the elizabeth r. Griffin foundation. Doctor, i also just want to note some of your other history, because i think its very interesting. You recently returned from nigeria, where you were treating withnts on the ground ebola. Previously you had worked in preventing and controlling pandemic influenza outbreaks. You also worked in helping 2004nt disease after the tsunami. You have an extensive background here in dealing with these outbreaks. So id like to get your thoughts, off the bat, about latest headlines weve heard out of the ebola. Utbreak the glass officials have narrowed down to ten the list of who might be infected with ebola. We see the death toll worldwide is now over 3300. Epidemic ining this the right way . Thats a really good question. U. S. Healthin the care system wonderful trained andth care staff, both paid voluntary. Not just including doctors and the auxiliary staff, administration staff. What we really have at the is a type of approach to controlling ebola. The cdc in the center. And then we have all the health it be thems, whether hospitals, the Urgent Health care, the travel clinics, throughout the country. We havent created a functional network. And thats what we need to create. Need to be able to share experiences. Had emory hospital in atlanta. Theyve treated patients successfully. Theyre champions at the moment. They should be telling us the challenges they face. We know, its not easy treating ebola patients. Stressful, intense. It requires Good Management and good implementation. Withvery day, youre faced new challenges. We arent hearing the challenges at emory. Hearing the challenges at nebraska. They arent teaching texas patient. Tomorrow, this is going to happen, and this is what we did consider itneed to now. Were not sharing experiences. Youre saying theres a lack of communication with the hospitals dealing with this disease . There is a need for better communication. There is a need for teamwork. And we arent working as a team. State, i teach Public Health prepareness, and the answers, all the time, to all my students i teach graduate students. Theyre in their 40s, 50s. Theyve had many years of experience. Telling them you dont work as individuals. Here in the u. S. , we have a wonderful democracy, where we promote individual thought, creativity, innovation. But when it comes down to disasterrings and emergencies and disasters and emergencies and highly Infectious Diseased, get all the team together. And we havent got the whole team together. Seems like part of the issue education. I think theres a lot of confusion, perhaps misperception exactly how ebola is spread. Can you break it down for us how this disease travels from one to another . What should we be concerned about . Its important, because weve heard the cdc director, dr. Tom weve heard from dr. Anthony fauci. Theyve said its really hard to get this disease. Its true. Having dealt personally with ebola patients, how do i feel . Im scared. Ive got to be honest. The people in my team are scared. Toall Work Together to try give each other confidence. What we do know, if we put on proper protection, the suits, the gloves, the shields, thatace shields, we know the virus is in the bodily fluids. We need to really define what talkmeans, because we about bodily fluids and i have my two children going, dad, bodily fluid . We could have it in saliva. Of virus ines lots blood. We know that people that have ebola, they vomit. They are sick. So theres virus in the vomit. A person who a patient that has ebola has to go to the toilet. When they go to the toilet, there is vomit. Feces, when, in the they have diarrhea, theres virus in the diarrhea. Get as they get worse and worse and worse, theres more virus and we start to see sweat. Us in the the other really important thing that we havent talked about is semen. In the semen. Irus and theres virus in breast milk. And we havent talked about that. And so, at the early stages of the disease, when people are treatingck and were them, we have virus in all these bodily fluids. The fluids weve just described. You have to touch those bodily fluids. Doesnt float in the air. Them. Uch then it has to get into your body. Doesnt go through the skin. Have to put your hands in your mouth, your nose, your eyes. Fun things at home in my family. How many times do you touch your face in a day . Its a lot and people are out here, in universities and academics, studies. How many times do we touch our face . Its a lot, a lot throughout the day. With nurses and doctors and physicians and other specialists in the hospitals, touch your face so when i do training in a them, theand i teach hospital Infection Control precautions, dont raise your hands above your shoulders. Thats really hard to do. So how much of the virus get infected . To i mean, just i mean, if you you said just touching perhaps touching the bodily fluids of someone else could be enough . At whenlook youve got ebola and we look at, again, the blood in your body, blood sample, theres billions of virus in there. Vomits,eone with ebola theres billions of ebola virus ground. Someone has diarrhea and the sheets are covered, theres billions of virus. Need . Ch do we probably one. Not very much at all. When youre working with ebola 100 , you have to get it correct every time. How long does a virus stay theve once its outside of body . It really depends on the surface that its on. To emphasize right now, its not days. Dies. S virus it is killed on dry surfaces. On to a surface and it may only last up to 30 minutes. Other porous to surfaces and last one to two hours. Period, we really believe from the evidence, the evidence that we have, the research and the samples weve hospitals, that over a 24hour period, if its outside dead. Dy, the virus is and its not contagious. And therefore, it cant be transmitted. So its not days. Its more like hours. Thoughtst to hear your on this outbreak to outbreak response to it. And you can call us on the telephone. Find us on social media, on facebook at facebook. Com cspan or send us an email. Earlier this week, the director National Institutes of collins,francis cloil was here on the washington journal to talk about her work developing a vaccine for ebola. The vaccines are moving forward at an unprecedented rate. This is an effort we started 13 years ago, anticipating there a vaccine,need for because ebola has been around since 1976, albeit in small outbreaks. The fifthgeneration ebola vaccine. It looks very good in the animal models where it seems to be completely protective. Dont knowrse, you until you try this out on human patients, whether its going to be safe and whether it will work. We did start just three weeks ago, whats called a phase 1 vaccine. This 20 individuals have now been injected with that. The are volunteers here at n. I. H. Clinical center. So far, all is going well. No red flags to indicate theres problem with the vaccine. But it will take now a couple of months to see whether those individuals mount an immune response that you would think against protective acquiring the disease. Once we have those data, if they tok promising, then we need move quickly to get this into what youd call a phase 2 trial in west africa, in individuals, who are at risk. All of that is very complicated ina circumstance where, liberia and sierra leone and guinea, theres a great deal of massage as can you can imagine, on the Health Care System. But were determined to figure out a way to do this. Then,ts the timeline, doctor . What are you going at . Well, it will be november the evidencee about whether the vaccine is looking promising in this phase 1 trial. Good, then shortly after that and there are meetings going on exactly about how to do the design we would try to set up this more africave trial in west that would determine whether the vaccine is effective or not. Dr. Francis collins from the National Institutes of about theking agencys work in developing a vaccine for ebola. Dr. Macgregorskinner, what is your take on how close we are to actually finding a cure and prevention . Im not directly involved in the Vaccine Research. We know thats a billion, billion dollar industry out there. And its out there for diseases that are really common. So you have to take this from a business perspective. Are those pharmaceutical companies, those Vaccine Research companies, as well as government, are they in the bids business toy the make money or to save lives . Weve heard this is a fifthgeneration vaccine. Through ive been involved in vaccine trials andinfluenza, for bird flu for pandemic influenza, and some of those vaccines looked failed. G, others so at the moment, we the treatment, the drugs we have, ehave,cines with were we have, were really at the modeling stage. All thet started trials that we need to do. And a real important thing about u. S. Health care system is we practice evidencebased medicine. Make guesses. We dont risk peoples lives with the unknown. Empiricalave the evidence, the data, that our experts have analyzed, weve got werecareful about what saying about the future for a vaccine. Vaccine, we may not have another Ebola Outbreak for years. So where do people regroup the cost . Is this whats needed . We will turn now to your phone calls. Paul, fromrt with florida. Om ahead. O ive done serious work in statistics myself and i think underestimating the true danger to the public. Number 1re to take the times,ble it 307 30 youd have some idea of how quickly one becomes millions. And any doubling in this system spread like could wildfire. Thats i think thats the held truth thats being back. Very good question, paul. My i was talking to daughter is in the middle school. We were talking about this. She said, dad, would you like me 1 million or pay you a penny that doubles every day for 30 days . And its just like we were talking in the context of ebola. We do know we do have the resources. We do have the tools in the toolbox here. What we need to do is improve the communication, the awareness. Were very careful in this tontry, and this is working our detriment at the moment, that we need to identify where the hospitals that are ready and the hospitals arent ready, where the Health Clinics that may be getting ebola and contact. Ey so, again, theres two ways that we really two activities we here. O focus on its Early Detection and then its that contact tracing. The Early Detection correct and we get the resources out for contact tracing, we know from previous experiences with going to beatre this disease. Next up, robin on the democratic line. Robin, youre on the air with dr. Macgregorskinner. Thank you for taking my call. I am very worried about what is going on here with this ebola. Youre on the air. Okay. About whatm worried happens what happened already with the case in texas. I dont think were ready for this. The hospitals dropped the ball. And what if this happens in other hospitals . And theyre lying coming over liberia. Africa and thats a really good question, robin. Share similar concerns. I think we have to be very careful within the u. S. Health and all the different processes we have. Then tell you, difference i teach Emergency Management. We teach a whole Community Approach. Its really important when we have a disaster, an emergency, whether it be a Natural Disaster like a hurricane, a tornado, or a highly Infectious Disease like ebola, we need everyone in the community to be involved. We need them to be equal shareholders. Whats important here now is at, again,d to look the tools and the toolbox, and we can improve our communication. I dont expect every nurse, every physician, every hospital country to be an agreat student when it comes to geography. They dont need to know where liberia or guinea or sierra leone is. In, say,we need to put hospital electric Electronic Medical records we heard from the people in dallas we think it was a failure in our Electronic Medical record system. I know if you put in any of those west african countries, the screen flash red and it means tell someone. What happened to oldfashioned communication between nurses and doctors . Dont blame that nurse dont put her on the fire a nurse in an Emergency Department. She has a thousand things going on in her head. Activities. Ousand shes really busy. Shes stressed every day. Weve been there. Lets facilitate the system. Where is the signs up at the front of the hospital, saying if recently traveled, call this number or dont come into come toital and well you. We havent done that yet. So there has been, to that point, some talk about exactly where do we start to catch potential infections or potential folks who may be contagious . In the financial times, there today that says they ban flights to ebola hot spots. Calling for action as infected man is held under armed guard. Who are joining this push are bobby jindal, the governor of louisiana, calling on the country to shut down flights withcountries afflicted ebola. Also, one said a ban on flights considered. And ted cruz attacked the white houses unclear approach and called for airports to take every precaution. Meanwhile, you have u. S. Senator John Connor John cornin to u. S. Customs and Border Protection commissioner to request Additional Information on the screening process for incoming passengers the confirmedter case of ebola in dallas. What are we doing in terms of screening, and is it enough . Ive just recently come back from nigeria. I was in nigeria, i went through two airports in nigeria. Thosewere nurses at airports. They took my temperature. They made me fill out a form. Questions, sod me i was interviewed, twice. I then flew through germany. As i got off the plane, they fromi had just come nigeria. We got off the plane. Everyone line up here, they said. They took our temperatures, we filled out forms, we got interviewed. A plane from germany to washington, d. C. And theres nothing at the airport. Now, we have the resources. We have the people. We have the skills. Training. E and no one gave me again, there was no one there taking my temperature. Asking me questions. I didnt fill out a form. Theres no data base. Meres no history of traveling from nigeria, after having worked with ebola patients and stating that to immigration officers. And i dont blame them. But what i do, i blame the system at the moment. I also there was nothing handed out saying, if you get sick, ring this number. Is that an argument for a full ban on flights to and from, for betterargument screening a better screening process . I think we need a better screening process, better followup. And im seeing universities the country have already taken this initiative. I work a lot with universities. I do want to talk about just the flights. A plane has two levels. Passengers at the top and the cargo at the bottom. I have a lot of friends working in west africa now, risking their lives on ebola. Theyre relying on minutes. Re theyre relying on medicines, personal protective equipment. Issue. A Food Security you ban the planes, my friends are going to suffer, as they through this. In Infectious Diseases, we dont isolate countries. Virus. Ate the and thats what we need to be focusing on. Marcel froms arlington, virginia, on the independent line. Yes. The first, earlier callers who are concerned about spread to the United States fairly correctly pointing to what may be real problem for the cdc, because within the last two or three weeks, they have commented in medical journals this outbreak could go over a Million People. 50 orven if it goes up to 60,000, its very hard to believe that it will not spread countries in west africa. Manylived over there for years at different times over 40 years. And their airports are not as secure. That may be the case in nigeria. Show upe people could in other places and come into United States. I think you very accurately have wented to a problem that have here as people come into our airports. That problem should be addressed immediately. Cdc really has a problem, because if this happens again, here will become hysterical. Thats my belief. Thank you so much. Think youre making a really good point. Youve mentioned the cdc. The cdc as ak at disease detective. I have a lot of friends there. The Epidemic Intelligence Service officers. We went out and investigated outbreaks of any disease. What im really concerned about, the hub and spoke. Public health preparedness. It takes a team. We have the best emergency in the world. I can honestly stay say that here in the u. S. Around the world teaching Emergency Management with the curriculum that we have. We what we need at the moment, look at the incident command system, which was modified,designed, strengthened. Its a great system for managing any disaster. Putting the cdc, who are the experts, in the center. Its bringing all the other assets within the government that can help us. Thats going to include homeland security. Going to include department of transport and all the other agencies we have and the have. Ments we and its actually we need good managers out there, people who can do good coordination, collaboration, good communication. And let the cdc do what they do, and theyre real experts at, but added pressure