Thank you for your question. Thats actually very important question and weve been discussing it over the past week. There had been plans to build a certain number of etus in every country based on findings of that are about two months old. The situation is evolving rapidly. And we need to make sure that as it evolves we do not stick to the old plans that actually we adapt and were flexible enough to, if theres no need for an etu, lets not even build that etu. If theres a need for mobile teams that would go out and get patients to an ebola treatment unit hat that has empty beds, lets do that. Because weve seen weve see the tab overflow of patience and found the bullet treatments and we need to make sure we balance that. So i heard about that too when i thought one of the reasons was because the population must come the you know, afraid to come forward. The best cases they are not needed, but that wasnt the a few. So why do you have that discrepancy . What you are saying is what dr. Mans was saying that etus is not the way to go right now. Versatile, the virus is moving. You get it under control and work between the treatment approach. Its getting under control, but then its another country, another county. That is why a larger number of insurgency and those need to be coordinated. We support the Community Effort because that the end of the day, this is where it is, at the Community Level. We need to make sure the Community Centers can actually the staff are welltrained to isolate so they can refer to the treatment units for further treatment and those that can be discharged back into the community. This is what the strengthening of the work being done. So, you know how i said in my opening i was interested to know in the building would they stay . I have just seen them on tv. Is there any value to the etus been left there for other Infectious Diseases or other companies . You know, some of those etus are not built to last. They are built with temporary materials that will last a few months and that is good to know. One of the approaches his work trying to build a more permanent structure that could be later on turned into something else. It could be turned into a Training Center or clinic and that is the obtainable aspect of it and what we are encouraging. There will be a need for isolation wards. So Isolation Units in west africa even after we contain ebola because there might be other diseases that might resurface. There is a need for the facility as well as equipment and Training Staff there. So, it was the first time i had heard him talk about the only time a Health Care Worker can be with the patient is one to two hours. I seem equipment and the stories, but that implies a large number of Health Care Workers. Though if you are only with the patient for an hour and you believe, do you have for leave . You understand what im saying . How does that work . In our ebola treatment center, we have 230 staff members. Wild. Woodworker roundtheclock by ship. When a doctor goes out, another one will be in quickly. So when the person theyve been there an hour or two, they take a break of how god and i imagine they go back. It depends on the level of exhaustion and dehydration. Usually not less than three to four hours. They need to recover before you bring them back in. Well, okay. Dr. Mans, maybe you could respond to this if you want to add anything about this etus. Also, i know there is an issue around the health around the Health Care Workers at one point and then being paid. I was wondering what the situation was with that, if that is improved. Thank you. I completely agree about it Emergency Treatment Center and there are some certainly challenges training and we have seen the 100 bed Emergency Treatment Center, three miles operating with the Chinese Government has built one in between and get communities where there are hot spots. Not very accessible by road to get into any of those. So again, the challenge of planning or ordination. How does that happen quite it is important from the responsibility of government. So i think finding ways again has probably summed up so well, making sure that there is a more mobile response to be able to get people into the facilities where they need support. Because what worries me in this is the gaps that i see him talking to liberians is about the big numbers that they hear committed to ebola an actual response taking place on the ground. It is extremely important to be sure the planning is done in effect to play in that communication is out there and citizens in these countries and expectations can be better managed. The other thing i just wanted to add about training, which i think is extremely. We think a lot about Community Health workers and of course the big challenges so few. Yours and 420. Yours. But it is a big challenge i think to provide not just more training for medical personnel, the son of this preservice training at the technical level is desperately needed and could be done pretty quickly. I think that there are institutions here in the United States that can provide the kind of support that wanted to ramp up preservice training as well as inservice training by institutions in the affected countries. Both of you all of you made reference to the need to take it to the community and have the community be involved. I wanted to know if maybe you could be specific about that. I understand the Community Peace in terms of Contact Tracing, identifying people that are in fact did. If there is not etcs, etus, then what . You identified a person and then what. Do you follow me . I can try to answer that. The role of the community is critical. As you mentioned, Contact Tracing is critical. Informing the authorities is very important so they can enter the body, but also to educate the community about what to do if they see someone presenting with symptoms. How to isolate the person and make sure they have of these gloves are thanks to protect themselves. But make sure they isolate and inform the different authorities, the Health Workers, Community Health workers. This is critical because what is happening is there are people that have ebola thursday in the same room with five other people and that cannot happen. The isolation is critical and this is where the education at the Community Level becomes important because that is the only way we can contain it. Should there be smaller etcs . I understand isolating, but if you have treatment, the person will sit there and die. And many said they are maybe in inappropriate places or maybe not needed. In the places they are not needed, what happens to the person . That is a very valid question. The Community Care centers that are being established, which early quality treatment centers. The patients will be taken there. They will be isolated and cared for until the test is done. There are important things for them to have taken. One thing you mentioned initially about the just government and our discussions with the u. S. Military as well as with the usaid about the need for ebola treatment. They have been extremely flexible receptive. Theres no need for rest and move it there, they have been extremely responsive to recommendations and i would like to commend them for that. You might want to respond, but i want to ask you a series of questions about cultural practices. I would like to catch up a little bit. I would like to reiterate this flexibility on both the designation of where the etus are and in general the flexibility that in particular the usaid, dart and general response has been really fantastic and has allowed us to make sure we are able to position resources as quickly as possible. On the issue of the community, we spend a lot of time and have spent a lot of time since april going over the past way over the best way is to interact with the community. A lot of these dialogue sessions i have been talking about. It is really focused on making sure that we are not top down. We are not distributing leaflets in just doing radio shows, though we are doing that, but making sure it is a conversation with the community about what ebola is and what it is not. And having them, put their own solutions that we will work through. That has been able to allow us to make sure that the communities, when they have a suspected case that they put their Community Member in a separate location that the communities are doing a lot of their old monitoring and sure they make the old phone call is the phone call is the most bang. Sure that zack steffen were suspected victim is isolated and making the phone call is really huge. In the long term, you know, before we started we were doing these water and sanitation activities with the government. We were successful in working with over 350 communities on proper sanitation and proper hygiene. That effort was incredibly successful. In all 350 communities, which are some of the hardest hit counties, none of them have been effected by ebola. If you make a longterm investment and prepare the communities before it hits, it has a huge impact than i really prevent that from happening. I only wish we were able to hit all of the communities in liberia before the virus hit. So, i wanted to ask if you expand a little bit more. You are talking about the cultural practices. I do understand first of all you said it was something than 70 of the transmissions were contacts with people who had passed away. How long is the body contagious . My colleague was asking about the role of the faith community. I am wondering if leaders, since obviously the traditions are a part of peoples faith, if they were taking the lead in getting people to deviate, to differ from traditional practices. I would imagine that would be really hard. You said they have come up with ways to safely say goodbye. And i thought you said they did that with all of the protective gear on. I was wondering if that was what you meant. Finally, i want to know what happened to you. You were there, you came back. Did they hold you in a tent at the airport . Seriously. Im glad they didnt if they didnt, but how did you sneak back in . Thank you you a series of great questions. I will answer the last one first, which i was at the airport. There was an xmi piece of paper that pulled me over to this side. And so i connected an interview with the cdc. What airport . Toles. They were really great. This streamlines the process as quickly as possible, asked me about my level of my potential level of exposure, which was very offended did and took my temperature. And since then, i have been in daily contact with the d. C. Department of health. I lived in d. C. I am in contact with them everyday and myself monitor, take my temperature twice a day and monitor any symptoms of which i have not. What i would like to reiterate the cdc and the d. C. Department of health are really focused on the partnership aspect of it and the fact that we are working together on this and that they understand why i am there and why i went and that it is not an antagonistic relationship, that we Work Together and that allows not just me, but everyone coming back to feel free and happy to discuss our health with the department of health and with the cdc and that really opens up the dialogue and makes it much more impactful in terms of a monitoring tool. On your question about safely say goodbye, we dont allow the Community Members to dawn ppec as a prevention tool because it requires a lot of training. We do actually allowed them saw them to make them feel better. Because honestly, the burial teams are wearing full ppes. It is fully intimidating. If inexpensive better to wear some ppe, we allow them to do that, but we dont allow that anywhere near the body. Of burial teams you are describing. They might burial teams where the full ppes. A Community Members are allowed to attend the burial. If you want to, they can wear some limited ppes, that they are not allowed close. But that allows them to understand what is happening with imperialist to watch the process, which is incredibly important to make sure they are engaged and the next time there is a victim, that they make that phone call. So that interaction takes the bulk of the time. With the burial teams interact with the Communities Community and make sure to stand in a dignified way is a huge part of their time. There were a couple of other a small item that i wanted to respond to was on the hazard pay, which is a really important aspect of the response because these are really brave people doing really important work. They do want make sure they are being compensated, so a part of our effort is to make sure that pay is happening on time and will working to ensure that. It is a small amount of money by our standards, but it is incredibly important that they understand they are valued in the work they are doing is important. Just quickly to the two last questions, which were how long is the body and if someone could address the abandoned children. Where are they with . Sure. On the length of time the body is contagious, we dont exactly know. The cdc and who are looking at this. And so that is why we are just focused on it is a long time. It is on the order of weeks. And so, that is why we make sure that the body is, you know, covered and chlorine, placed in a body back, covered and quarreling again when it is. It is alternating soil and chlorine so that there is no risk. The virus doesnt last very long in water even. So it is very low risk to the water tables, but we also make sure that the orioles have been above the water table just to make sure. Thank you. Just a few followup questions. In our september 17th hearing, dr. Kent brantley spoke about a number of the having lived to it and having survived. One point that he made was the 100 Isolation Unit and his hospital was turning away as many as 30 infectious individuals each day. I am wondering, has that changed, is the capacity growing . You might give us an update on how the United States military is doing in creating the capacity. He also made a very strong point about those who will stay in their home and be cared for by loved ones. Husbands, wives, children. He said without education and protective caregivers, mothers, daughters and sons to death simply because they chose not to let their loved ones died alone. I am wondering since obviously isolation is one of the keys to breaking the transmission chain and many of these affect people, infected people will stay home. If the outreach to the individual caregivers as robust as it should be . Let me also ask at our hearing, the second hearing, dr. Kochi from nih used the word exponential time and time again during his testimony. We had a group of top people, including the head of usaid and last week of the full committee. That wasnt uttered once. I asked them about are we seeing a turn. You know, cdc has said if the rate of increase continues at the pace in september, there could be as many as 1. 4 million cases by late january. Where are we in europe you in terms of the estimations of how large this epidemic may grow. Let me also ask you and one of the 10 points that you have suggested, mr. Torbay, is the importance of a capable ambulance network. I am wondering since so many people cant get to it etu or any other health facility, where is liberia and the other two countries as well that you know more about liberia in terms of an ambulance, capacity. And also that i could, all of you might want to touch on this. You know, dr. Brantley may have been helped. We still dont know. There are other drugs still in the pipeline in the vaccines and cured of potential drugs. You know, i was amazed and positively shocked when you said, mr. Torbay, that the rate of liberia is approximately 26 . That is far lower than the average fatality rate in the three affected countries. I am wondering, what is being done there to achieve those remarkable results in terms of mitigating fatality . So, if you could speak to those issues. Thank you, mr. Chairman. I would actually start with the last question about the low fatality rate of the ebola treatment unit. We are not using any miraculous drugs or any testing drugs they are. What we are doing is working with the community to make sure patients are referred to the unit as soon as possible. That has been one of the major errors in the wearing mortality rates. As you have seen in the u. S. , those caught early on and sent to the hospital survived and those that relate to not make it, unfortunately. For us that is extremely import. It is titration, balance of electrolytes, making sure people are actually healthy enough for them to fight the virus on their own. One very critical component of our success has been the u. S. Navy lab that was set up right next to our ebola treatment unit. It used to take us back to seven days before we got the test result. Now it takes five to seven hours. So basically, people are coming in. What if they are sent home and that comes down to the potential exposure as well. Excuse me. That would be people manifesting some symptom like correct. A put as a suspect case and then we decide whether its possible. If they are not manifesting a symptom, no testing is done quite no. This actually ties into your question about the ebola treatment capacity. Actually, the Lab Facilities are playing a Critical Role because the unit expects suspect case. That is why we are turning a lot of cases of because they did not have the capacity to test a lot of those patients. They have to keep them there until they are tested. With the additional numbers of lives being established, that is helping a lot and is no longer the case. Hardly any unit is pushing patients away. The situation in liberia and this is something that dr. Shaw mentioned here in his testimony. It is looking better than it looks a couple months ago. The numbers are lower. The new cases are lower than it was before. It is much better than what we estimated two months ago. If we continue on the right track and we have to not slow down, we will get it under control. The