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good evening. i'm dr. sanjay gupta. tonight on cnn we want to share with you a documentary that will change the way you think about this global pandemic we are now experiencing. "unseen enemy" is a story of the doctors, the scientists and the public health officials who saw this crisis coming and tried to stop it. their discoveries are vitally important. it's not too late to use their knowledge to contain the coronavirus. we want to be clear, this documentary is not specifically about coronavirus but even though this film aired on cnn three years ago, it's actually more relevant now than ever. if we can harness the power of the public and private sectors and work with governments across the globe, we can still save millions of lives. this is how. >> hello, good morning.

>> thanks for joining us. it's 5:00 a.m. in the east. let's get started. >> good morning. >> the centers for disease control today issued a health warning following a worldwide outbreak of a mysterious form of pneumonia. >> the highly contagious virus of sars killed nearly 300 people -- >> people around the world have come down with sars. [ speaking foreign language ] >> the world health organization has declared a swine flu pandemic. >> spread of the h1n1 swine flu. >> it cannot be contained. >> i think we can't contain spread -- >> the pandemic must be taken seriously. >> a big outbreak of a deadly

ebola virus has killed more than -- >> in the african country of new guinea it has spread -- >> people know nothing. there's no cure. >> they don't have the resources -- >> governments around the world are calling for new measures. >> the u.s. department of agriculture confirmed another case of bird flu. >> 1.5 million turkeys have been killed to prevent the spread -- >> it's critical that they control this. >> you have to respond to the challenge. >> three latest victims of the new respiratory virus calls mers has come from middle eastern countries. they believe it originated in bats or camels. >> it causes pneumonia and rapid kidney failure. >> as the zika virus continues to infect people across the globe -- >> a link to bird flu. >> the zika virus is transmitted by mosquitoes. >> when the weather warms up, more of those mosquitoes could start -- >> i believe there's such a thing as being too late. >> there's a concern --

>> our home, you can almost hear the biological chatter. >> aids, zika virus. >> contagious -- >> just when technology and science was supposed to make us safer, we suddenly seem more vulnerable to outbreaks. >> whether we like it or not, our world is globalizing ever more. that's not only true for markets and production, but it's also true for behaviors for diseases. so we're more vulnerable because of our mobility.

secondly, we have far more people, and we're living more and more in crowded cities. that's fantastic from the perspective of a virus because in no time, it can infect hundreds of thousands of people. >> over the last three decades, there have been about 30 newly emerging diseases that have the potential to be pandemics. if we do nothing, it's not a matter if there will be a global pandemic, it's just a matter when and which virus and how bad. >> the world changes around us at increasing speed. we cause a lot of that change, migrating to cities, stripping the earth of its resources and altering the primeval jungle. >> we're seeing whole entire ecologies, that which you see with your eye and that which you can only see with a microscope,

one system after another completely reshaped. in every case, this affords opportunities for viruses and bacteria to seek out new homes, cause new havoc, including disease for human beings. >> when contagion happens, life alters in an instant. we don't feel safe. we lose trust. >> fear spreads very quickly when you have an infectious disease outbreak. communication is so much more pervasive, people know what's happening in other parts of the world so much more quickly, so much more vividly than ever before. so the contagion of fear moves faster than the contagion of the pathogen, the disease itself. and the fabric of society starts to deteriorate. >> there's something that destroys the soul of a community

that happens when an epidemic is out of control. it's not just the large number of casualties and the deaths which are itself unthinkable, but it's what it does to the social fabric of the community, our nation. >> the war lasted for 14 years. i was quite little but i still remember vividly everything that i saw.

sometimes you're playing at night when the places are dark, you can see these bullets flying, like bolts of lightning across the sky. you can physically see them. my father would bundle all of us and we head the opposite direction. you know the bullets are coming from this way because you hear the sound coming. and you see the soldiers going that way to go and fight it. so you know you have to go the other way. but look at ebola. how are you going to protect yourself? you have an enemy you cannot hide from. you cannot run from ebola. where are you going to go? who are you going to run to?

>> we got confirmation yesterday that two are positive with the ebola virus. it is here. >> ebola is transmitted through bodily fluids, saliva, blood, urine, feces. it is an invisible foe. >> ebola first surfaced in west africa in a remote rural community. but in our increasing connected world, this ebola outbreak didn't stay in the countryside. the virus quickly found its way to the region's largest cities and health systems that were completely unprepared. >> i graduated from med school two years ago. the reason why i'm here is by

default because i was the only one available. i'm a general practitioner and i got one-day training to get prepared for this. come, sit up for me. swallow. all right, good. sorry. when we started admission on august 17th, the following morning, there were ambulances lined up at our gates. and we -- to tell you the truth -- were not prepared. tell your ambulance to come. come on in. one, two, three, four, how much patients go in? before we even knew it, we were already overwhelmed with so many patients. how many patients you got on

board? we can't take four. we just took seven. we only have nine spaces. so i will take one or two and go check. if i can create space, i'll take the other two. if no way, you have to take them away. >> it used to give me that impression i was in hades because it was a makeshift structure. the patients are vomiting, bleeding and having diarrhea on the floor. among them you see two, three persons have already died and their bodies are still there awaiting removal. in three days' time, the entire unit was full. meanwhile, there was still patients waiting outside the gate. >> wait. >> and they are begging. every time you go to the gate, they are begging to come in. >> we have a serious situation. we have 35 beds and already have 71 patients in the ward. that means 50% of the patients are lying on the floor. there's no space on the floor to put a mattress any longer. >> you don't have beds, but you are facing a group of people who are dying. you know they are dying.

you see they are very sick. they're so weak. and what if they go home? what about the taxi cab these patients are going to ride to go home to die? everyone in the taxi gets infected. then what about the home, the community these people go into? so maybe, yeah, we should just open the gate and let them come and lie on the floor to die. so we just open the gate and just let them in, sometimes 16 persons, sometimes 20 persons. and we'll be there for three, four, five hours trying to give them fluids, antibiotics and all of the medicines. and then it never ends. as you are walking out, a new patient is walking in.

and then when you go home and come back the following morning, there are seven, eight deaths overnight. >> i think we all underestimated absolutely everybody. i know that one case of ebola is an emergency. every new case can give rise to more cases. so it's really act now or pay later. >> right now the world health organization and other doctors are saying it is out of control in this area of west africa. it's the worst outbreak ever that they've recorded in this part of the work. >> it's unprecedented for several reasons.

one, the first time in west africa that we have such an outbreak. secondly, this is the first time that three countries are involved. and thirdly, it's the first time that we have outbreaks in capital cities. >> this could explode into a really mega crisis. >> i think so. and it already is a mega crisis -- >> i thought how can this epidemic be controlled in the usual way when there are so many outbreaks different places. the three countries in west africa that are affected by the ebola outbreak have some of the worst health indicators in the world. there are not enough doctors. there are not enough nurses. it is a system that is understaffed, underfunded and where the infrastructure is very, very old. >> let's go back to 1976 when you're a younger man and you actually co-discovered this virus. it was zaire, now the democratic

republic of the congo. >> they said this was a mysterious epidemic. they said it was very lethal. high mortality. there were nuns who had died. a small group would go to the mission where the epidemic had started, apparently. they asked for volunteers and i think i was about the first one to raise my hand. although i had absolutely zero experience in doing this. [ speaking foreign language ] >> our mission was to want to put in place some basic measures to contain it and using quarantine, that's what we thought. and, two, to find out how is this transmitted. because that's the key to stop epidemics, to know exactly what the risk is, how is it

transmitted. it's really a detective work. so we tested whole villages, talked to the population and then have a very primitive questionnaire, how old, where have they been, have they traveled. and what we found is that there were very few survivors, very few, and that, indeed, what we call the case fatality rate was over 90%. [ speaking foreign language ] >> nearly all new viruses come from animals. we're also an animal. we're human primates. so during the outbreak we

started collecting samples from all kinds of animals. i even took blood from pigs because a number of pigs had died at the beginning of the epidemic. we said, you never know. but we didn't find any trace of ebola. my boss at the time had always told me, watch out for the bats. and it became a bit of a joke. but the old man was right. because the only reservoir that we think where ebola is hiding are some kind of fruit-eating bats. >> when i was a child, i really liked to read all these, you know, science fictions. i realize science really fantastic. you can find something new.

so this is why i'm working on emerging and re-emerging bacteria and viruses. i think for the ebola, when you put all the data together, the transmission route or cycle is clear. so definitely, it's from bats. then you have an intermediate host. it could be some mammals in the african region, and then to the human beings. it could also be directly from bats to humans. you can see ebola, sars, and mers, all of these viruses, they're from bats. so bats are a very serious problem. >> if we look around the world, we can see that bat populations are being severely stressed by climate change. some of them because they live in the upper tiers of

rainforests and feed on wild fruit, but the upper tiers of the rainforest are getting the most impact of this heat increase and increase uv radiation. add to that that humans are encroaching into the rainforest, into bat habitats, precious caves, they're very shy creatures. they do not seek you out no matter what vampire movies you ever saw. as humans encroach, we see more and more bat populations starving and coming into human habitation areas to feed on our agricultural production. and in the process, they're passing their virus onto other animals and to humans. we are imposing changes in the microbial world willy-nilly, thoughtlessly, and we do so at our peril. >> we have dramatically

increased our contact with animals in a variety of ways, through deforestation, industrialization of agricultural and vastly increased consumption of animals. hiv spread out of africa from a few monkeys and chimpanzees to infect millions of people on every continent. sars jumped from a bat to a cat to a villager in china to more than 30 countries in a matter of weeks. animal and human health are completely linked. in the 21st century 75% of all new infectious diseases have come from animals. sometimes directly, in other cases through intermediaries like mosquitos. >> if anyone had sat down and

done a fantasy hit parade of emerging diseases that might come to the americas from africa or from asia, zika would never have been on the list. zika virus originated in africa. it had never been off the african continent until it started making it way across asia and south pacific, ending up in french polynesia and yap. yap is a small place that most people have never heard of. when zika hit it, 70% of the population got infected. that was really quite startling. if anybody had been paying attention. >> but they weren't. zika jumped from the south pacific to brazil in 2013, two years before it was identified there. the timeline corresponds to an increase in travel between the south pacific and brazil including visitors who attended

a preworld cup soccer tournament, the federation cup. >> goal! >> someone was carrying the zika virus and some mosquitos bit that individual, absorbed the virus and that's the beginning of this saga. and then undoubtedly the el nino weather event provided the necessary ingredients, rainfall, drought, that fundamentally changed the conditions on the ground and allowed for the spread of this virus. >> i was a young doctor in africa when aids hit. i saw how the first responders, doctors, nurses and health care workers made the difference. diseases are a global trend.

the unseen enemy is a compelling urgent film that encourages the important conversation about what we all can do to protect our families from these diseases. this is also hal's heart. and his relief, knowing he's covered by blue cross blue shield. this is hal's heart. and it's beating better than ever. this is what medicare from blue cross blue shield does for hal. and with easy access to quality healthcare, imagine what we can do for you. this is the benefit of blue. what if your clothes could stay fresh for weeks?t smell clean? now they can! this towel has already been used and it still smells fresh. pour a cap of downy unstopables into your washing machine before each load and enjoy fresher smelling laundry for up to 12-weeks.

♪ [ speaking foreign language ] [ speaking foreign language ]

[ speaking foreign language ] [ speaking foreign language ] [ speaking foreign language ]

[ baby crying ] [ speaking foreign language ] ♪ >> in 2015 the zika virus suddenly spread across brazil, primarily through the bite of one type of mosquito. the medical establishment only

began to comprehend zika's danger as the number of the babies born with the birth defect microcephaly started to dramatically increase. [ speaking foreign language ] [ speaking foreign language ] [ speaking foreign language ]

[ speaking foreign language ] [ speaking foreign language ] >> since the alarm went sounding around the world from brazil, we have seen almost every day another revelation about this

virus. what we now know is this is a very dangerous virus. we grossly underestimated it. >> what they share in common is how fast check move. randomly attacking some, while sparing others. some epidemics grab our attention while others in spite of the larger number of victims remain more hidden. ♪ >> those in need of a flu shot may still get them.

>> owatonna, minnesota, it's a beautiful town. to me it's like mayberry r.i.p., opie taylor's town. >> the name "owatonna" comes from an indian princess who was sick and the chief brought her here because of the healing waters. >> when we moved here, it just felt like home. i think we got lucky. the good lord just gave us two good kids. sarah was always the princess and shannon was opposite. she was a tomboy. she loved skateboarding and she loved video games. >> shannon was a complete surprise. sarah was almost 16 and i was 40. she was a joy. right from the get-go she was a joy for everybody.

>> we were a tight, tight family. >> first time out by herself. oh, my gosh. >> i remember when she got her permit, she was just so tickled. >> there she goes, by herself. >> i was so proud of her. >> oh, my gosh. oh, my gosh. somebody is driving. >> hi, girl. hi. >> shannon was in her senior year of high school. >> she came home wednesday night and said i think i got the flu at school. >> that was wednesday and thursday she seemed to be baseline for being sick. but she wasn't getting better. and that's when terry and i agreed we've got to take her.

>> when i took her that sunday to go to the hospital, we waited two hours. it was that packed. that's when i knew there was a big epidemic of flu going on. she's sitting next to me and she has her head on me. and i took a selfie and sent it to her mom saying we're still waiting. >> the doctor said it was just the flu. it had to run its course. they gave her some cough medicine just for comfort and terry went and got it while i got her back up in her bed. >> it's about 5:00 in the morning. i was sitting in the living room

and i heard her moving around upstairs and i thought, wow, she's getting out of bed. i got up and i went to the i got up and i went to the coffeemaker and i saw in my peripheral that she got up and she went to the bathroom. she tapped on the shower curtain and i said, you want to take a shower and she nodded yes. i said okay. i was filling the water up and i got about so full, she laid back that her knees kept buckling. she kept pushing on the end of the tub from sliding under. and then i saw her eyes and -- i pounded on the wall and woke terry up. >> she said she's not breathing. and i come running down. i still remember her on the floor. her mom giving her cpr. >> i never had to do that before.

and it's nothing like they teach you in class. >> all i can do is dial 911. >> 911. what's going on there? >> my daughter is 17 years old. she's not breathing. >> she's not breathing? >> not breathing. >> okay. i'm sending the paramedics. stay on the line with me, okay? >> breathe, shannon. oh, lord. go ahead. >> i don't remember any kind of time passing. i remember a pair of blue pants that kneeled down on the other side of her and he told me they would take over and i stepped away. >> even when they said we're flying her to rochester, i waved at the helicopter, you know, thinking everything is fine.

i had no clue. [ beeping ] >> you know, when they told us that she didn't make it and i said i want to see her. and they said, you'd never recognize her from what we had to do to her because the flu actually killed all of her organs long before she actually died. i still think she ought to be coming home. ♪ >> the biggest pain in the world as a parent is losing their child.

this is the most unnatural thing to happen to a human being and you stand next to it and you think, my goodness, i am there to prevent this from happening and sometimes i cannot. and sometimes i don't know why i cannot. [ speaking foreign language ] >> the question of how and why one particular person may die from influenza is the million dollar question that we absolutely need to tackle. >> it is surprising how much we still need to learn about flu, a disease which causes worldwide epidemics every year. >> she had a little raspiness in her chest. >> the flu test came back positive. i actually remember saying, okay, it's just the flu. like it was no big deal. >> it spreads across the globe hospitalizing three to five million.

>> within 24 hours, she was intubated. >> killing at least 200,000 every year. >> we went in as they were coding her. >> my baby girl scarlet was pronounced dead. >> the majority of the adult influenza patients have something that we call a risk factor. they have very weak immune system or diabetes or obesity. pregnant women have a risk for both themselves as well as the child. we know these factors. but this is a virus that can mess up your body to a degree that even the most healthy young and happy playful person is taken away from this planet within a couple days. >> every year we struggle to fight seasonal flu. but what experts are really afraid of is a new strain of

flu. one that the human population hasn't been exposed to before. one that almost no one will have any immunity against. and having. i didn't realize that having kids would be the hard part. so we planned to start ivf treatments. ♪ now i'm ready for someone to call me "mom." at northwestern mutual, our version of financial planning helps you live your dreams today. find a northwestern mutual advisor at nm dot com. helps you live yswhere my hobbits at? play lord of the rings. play my "straight outta the shire" playlist. i want to see the king. find lebron. search more cartoons. play the last o.g. take me to the streets, play sesame street.

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when we think about the threat of a disease spreading around the world as a pandemic threat, obviously airborne infections are at the very top, things like sars and flu are something that we know is difficult to control because of the way it spreads through aerosols.

most people become infectious with the flu before they even have symptoms. anybody can travel clearly across the world with an infectious disease incubating in them without them even knowing that they're sick yet. >> in 2009 a flu emerged, h1n1, also known as swine flu. we now know it first appeared in the u.s. in the pig industry initially infecting people at state and county fairs. in a little over a year swine flu infected around 1.3 billion people. it was the most common shared experience on earth. flu poses a strong pandemic threat because it has the ability to be both very contagious and very deadly.

>> this room is only flu. >> what we're most worried about right now is this bird flu that we know is highly pathogenic. >> the h5n1 kills between 50% and 60% of the people it infects. >> currently this deadly new bird flu doesn't spread easily between people, but it is spreading rapidly among wild birds and poultry. experts are afraid this could be a pandemic threat. >> it's a live poultry market so the birds are alive. when they're sold, they're sold alive because people value the fact that it's very fresh meat.

so you buy your chicken or your duck alive and then it is killed and cleaned and emptied, of course, eviscerated. the viscera go into some of the buckets here and the birds are put in hot water and then put in these drums where these little plastic tubings help get rid of the feathers. and then when the birds have been defeathered, eviscerated and cleaned, then they're cut up and given back to the person who bought it. the issue here is that the water is the same to clean all the ducks and chickens. the other issue is that these people are wading in viscera, feathers and the water that serve to clean them.

so there's really a lot of, a lot of virus here. >> in 2011 when the pasteur started monitoring the wash water, 18% of the water samples were positive for h5n1. four years later, 66% of samples were positive. >> we know that bird flu is very, very deadly. and we know swine flu spreads very quickly. what we worry about is if those two re-assort and we could have a new strain that literally could spread as quickly as the swine flu did but have the mortality rate of the bird flu. that's the big fear. that we have now created the petri dish that we have all worried about and both of those viruses are sitting in there at the same time. >> pandemics are one of the

biggest risks we face. this is an issue of human lives. it should be thought of in the same way that we think of terrorism, protection against natural disasters, against national defense. this is a human security issue and it is also an economic security issue. >> the outbreak of sars could trigger a global downturn. >> fear of the sars virus has caused serious financial damages to businesses, cities, even entire countries. >> during the height of sars, nobody was going to restaurants, people didn't want to go shopping. at one point at the peak of the sars crisis, air travel in hong kong was down 80% and retail sales were down 50%. businesses are going to run out of money. estimates of the impact of sars have been from an economic impact with iran 40 billion or so. if a global pandemic took place, you're looking at an economic

impact measured in the trillions of dollars, not tens or hundreds of billions. it has such a big impact on business and life. >> you hope the world has the capacity to see an outbreak, mobilize forces, and contain it. right? unfortunately, we rarely do that. especially if the outbreak occurs in a poor country. >> well, here we are in liberia. that's sierra leone and there's the border crossing. do you see security? do you see military? do you see anyone who would stop someone coming across this border? >> and then it not only spreads beyond the borders of the original country, as occurred with ebola in west africa, but it crosses seas.

it crosses continents and that constitutes a pandemic. endemic is your worst-case scenario. so you fail to control the outbreak, you fail to control the epidemic and you fail to control the pandemic, and now that microbe is a permanent feature in the biological landscape that humans are living in. the worst example of that is hiv. we started off with tiny outbreaks in a handful of places and the world responded completely incorrectly. it became pandemic and now endemic, so we have 37 million people living infected with hiv and there is no country on the planet without this virus. i think you really need a dedication to

understand things. to solve things, to make it work. because otherwise, i'm afraid that at 5 o'clock in the afternoon i will think, "well now i've, i've, i've done enough for humankind," you know, "i, i should go home and, and, and, and eat something or sleep." but only when you are, i think when you really want to know. when you're so fascinated by, uh, the virus or by a problem, only then you, you just forget about everything and you, you just continue. the goal is, we want to make a vaccine to prevent hiv. to prevent hiv infection. to prevent aids. we have, uh, uh, people, uh, uh, in different european countries.

people in us and people in, uh, in africa. and in asia also, collaborating with us. hundreds and hundreds. hundreds of people. sometimes i am afraid. things can go faster. infectious diseases travel. they take the plane. they, they are everywhere. you really want to surprise, uh, yeah. create a surprise so that it cannot be transmitted anymore. we need to be more smart than nature to, to beat it. i definitely would like a better world. and i want try to do something useful for it. so, that's what i think. and i think it's also impacted by, uh, um, by having kids. so more and more that's something you, you want to give them something better, at the end of the day.

i'm dr. sanjay gupta. you're watching "unskeen enemy," a documentary about what is being done by doctors and scientists and researchers working around the world to mitigate the impact of a global pandemic like the one we're experiencing right now. this film originally aired on cnn three years ago, but it is more relevant now than ever. we're airing it tonight because if we can harness the power of

the public and private sectors to work with governments across the globe tens of thousands of lives or more could be saved. this is how. before the devastation of aids, there was smallpox. smallpox killed 500 million people in the 20th century alone. more than all the wars in that century combined. whenever an infectious disease truly catches hold, it forces health workers to make impossible choices about the public's freedom and rights. >> i was the youngest person in the smallpox team and i was certainly the only person in the history of the united nations

recruited from the nim karoli baba ashram. >> we had eradicated smallpox. in much of pradesh, this big state in the middle of india. we were about to do our victory dance and suddenly across the border, we started getting new outbreaks. they all came from one place, a place called tatanagar. the first place we went was to the rail station. it was the scene from the worst nightmare you'd had in your life. there were dozens of people stretched out on the tracks, on the cement dead from smallpox. it smelled of death. the tatanagar was the home of the tatar iron and steel company. so i went to the company's house. it was almost midnight when i got there. i said i need jeeps, i need managers, i need doctors, i need vaccine.

the next day i had a hundred jeeps. we set up training programs and used maps to develop strategy and took the hundred jeeps and built our little army. we were doing great. we found 2,000 cases of smallpox. we were stopping the disease in tatanagar but still, as we're vaccinating everybody, the trains were carrying people away. we were still exporting smallpox. we closed the railway station. we closed the buses. we quarantined the city of 600,000 people. nobody could leave the city unless they were vaccinated. we eliminated smallpox in that entire area around tatanagar in less than six months. but it kept coming back. we traced it to a tribal group

called the ho tribe. so i went and visited the members of that tribe and i said, well, you've got to take smallpox vaccine. you've got to stop this transmission. he said i won't take it. i do whatever god's will is. if i'm to get smallpox, i'll get it. after a while, more cases kept coming out from the ho community and we all agreed that we were going to have to forcibly vaccinate these ho tribesmen. in the middle of the night we went out into the villages into the jungle and we surrounded them and pulled them out of their houses and we vaccinated them. then and after we had broken into their house, pulled them out of bed, forcibly vaccinated them, this dignified tribal

elder looked at me and reached over to the vine and there was one fruit, a cucumber, a kind of gourd. he pulled it off and he cut it and he put it on a leaf and he offered it to us to eat. he said, "i don't like what you did. i think you're wrong. but that's over now. now i see that you are a guest in my house. and the only thing i have to offer is this cucumber." and so you ask yourself, were we right? we did a lot of things that in their individual isolation, if i put the harshest light of truth on it right now, i would be begging to find an alternative way to do it. and i asked myself, did i exaggerate the importance of what i did? did i place myself above some

kind of moral compass? did i quit too early trying to find a way to accomplish the same thing? but that's sort of between right now me and god and me and my conscience. smallpox has been eradicated, and i'm thrilled about that. >> the idea of night raids or forcible vaccination today is just unthinkable.

there's a few big things that are very different. internal politics, global politics, extremism, the whole issue of human rights. you have to be transparent because the wrong information can actually contribute to the spread of the disease. i'm particularly interested in looking at rumors. the way that rumors replicate and spread are very similar to how viruses spread. they need a host, they need to be supported to stay alive and thrive. >> oh, there we go. >> there we are. okay. hi. >> rumors have been around since man existed. but i think right now what's changed with technology and particularly social media and the internet is the global spread and the speed. i mean, look at twitter. you needed 140 characters or something. and that's all you need to spread some of the rumors and perceptions that we're certainly tracking.

and one of the things we found is that rumors thrive in times of uncertainty. they thrive in times where people need an answer or are eager for an answer. >> the old model of how you respond to an infectious disease outbreak is you issue some sort of firm warning to the public and tell them what they should and shouldn't do. that doesn't work anymore. because people are responding to rumors on twitter or facebook and they want to engage and they want to challenge and they want to have their own opinions about what's going on. >> the agenda. >> okay. >> when an epidemic occurs, there is a clinical management. but there is also the reactions

of society. and managing that can be as important as actually dealing with the epidemic itself. >> okay. good afternoon, everybody. this is the third meeting of our task force on ebola. would you like to give ab update where we are with the epidemic? i'm very worried, to be honest. >> president alan johnson salith likened the outbreak to a war. >> death continues to surge. riots are breaking out. >> as ebola continued to spread across west africa, the governments implemented massive quarantines. distrust exploded. >> security forces blocked roads with scrap wood and barbed wire. >> in an isolation ward hundreds clashed with police who fired live rounds and tear gas. >> liberia has tried, we have used our own resources. but obviously we have limitations.

and we hope that the international community see this as an international catastrophe. >> two americans who have been infected -- >> -- will be sent home for care in atlanta. >> [ speaking foreign language ]. >> became infected whilst working as a nurse in eastern sierra leone. >> a news photographer for nbc just diagnosed with ebola. >> much like the other americans before him, he will be flown back to the united states for treatment. >> that's him? >> mm-hmm. >> oh, my god. he's from west africa, right? >> no, he's from the states. he's from here. he's from maryland. >> oh, my god. >> in a repeating pattern, the world only really started to pay attention to the ebola epidemic when foreign workers began to fall sick. >> the international response is continuing to ramp up.

>> we're going to create an air bridge to get health workers and medical supplies into west africa faster. >> over a billion euros across europe will be galvanized. >> [ speaking foreign language ]. >> china is sending healthcare professionals. >> [ speaking foreign language ]. >> there are 84 flights a week leaving these affected countries. >> the first time the ebola virus is in the united states. >> contracted ebola in liberia before flying to dallas, texas. >> he lied on his exit form so he could leave liberia. >> why not just shut down the flights and secure the borders? >> a travel ban may make sense. >> we should not be allowing these folks in. period. >> as of today, one case came from liberia. one. there'll be more. but right now one. and in response to that they say let's close the borders. nobody from africa will be allowed in.

they don't even know where west or east or south africa is. nobody from africa should be allowed in. and close our airports. i mean, that's a combination of ignorance and arrogance that could create ruination for our economic system, our financial system. >> please be advised that a health care worker that lives in your area has tested positive for the ebola virus. >> today testing confirmed that a patient here in new york city has tested positive for ebola. >> craig spencer treated ebola patients in guinea. >> 12 hours before he detected his fever, he was in an uber car, he was on the "l" train, he was on the a train, weighs on the 1 train. he went to two bowling alleys and he went to a restaurant as no quarantine was required. late this afternoon the governors of new york and new jersey decided to change that. >> after returning from treating

ebola patients in sierra leone, casey hickok was forcibly quarantined even though she tested negative for ebola twice. >> we have the legal authority to do it, we're doing it. >> it was pretty clear that the united states epidemic was overwhelmingly an epidemic of fear. we got a practice run on how americans will respond. and boy, we got an "f." >> in addition, we have renewed our determination to remain -- >> we are spending a lot of time with a community. >> rid our beloved country of this dreadful unwanted guest, ebola. >> community leaders with our colleagues to assess how to

better handle thebla ethis ebol epidemic. >> is this a wakeup call for you also the international community to start looking at all the potential viruses that may come to harm us as vulnerable as we are in the future, so that we start putting things in place now for us to prevent us getting those types of diseases? >> to be honest, in this 38 years we have collectively failed, and every time when there's a big epidemic we say never again and we are going to set -- put in place mechanisms to do this and that. and it doesn't happen. and so we have to now really fight that it will happen this time and there are better systems in place. >> in the fall of 2014, significant aid and manpower finally started arriving in the region. in liberia there were

medicins sans frontiers, canada, china, cuba, germany, sweden and the united states. >> this is an extrapolation. >> exactly. >> it was chaotic and coordination was often difficult. but makeshift etus were finally replaced with purpose-built field hospitals. >> i communicated with the ministry that jfk should close down. so we just transferred a team from jfk to m.o.d. >> you need to scrub and clean my office. >> i created something called a

coordination team. >> good morning. yesterday i started getting complaints. there were two patients that were brought to the triage and they were lying in triage for more than an hour. waiting to be taken to the ward. and nurses were informed. i mean every patient that comes here think about your relative being in that position, you don't treat patients like that, you can't have patients waiting in triage for one hour before they get care. we need to be vigilant about it. >> i have seen so many people die and sometimes i'm afraid being a medical doctor. one laboratory technician working for us at jfk got infected. and my hygienist who got into a physical fight before the patient became infected.

then two securities got infected at home. then dr. scotland got infected. after i joined jfk, three intern doctors came including dr. scotland. dr. scotland always wanted to work side by side in a unit with me. and every time i was working for four or five hours, it was scotland that would stay. i mean, this was the perfect friend, a perfect colleague. one day he took the day off, and then that evening i called him to see how he was doing. he said oh, doc, you know what? i just have sudden chills. i said shh. i said okay, keep your calm, come to the unit and we'll take

a sample. that night his first inclination was to call me. he said dr. moses, guess what, my results came back positive. he started to cry, he started to shed tears. and i told him, i will do everything in my power to make sure you're okay. i will get an ambulance. and then the ambulance came to receive him, we booked him in. i did everything i could to do for him, to preserve him that night. i kept calling all through the night, i didn't get him, he didn't talk to me. the following morning he just dropped and died. he just dropped and died. he just dropped and died. yeah.

many patients don't survive in our unit. but up until now when i think about it i feel like i've done nothing. i mean, i didn't save scotland. ♪ ♪

♪ ♪ >> my whole family got ebola. eight died, two survived. >> [ speaking foreign language ]. >> after i survived, i

voluntarily decided to give care to these children. >> hello, everybody. lunch is ready, we're going to have our lunch. >> these children are here because they have lost their relatives from ebola and the community are afraid of them to take care of them. in taking care of these children, they are risking their lives. since we are survivors, we cannot infect them and we cannot get infected by them. so these children are brought here to be under quarantine. in entering the home, they can really, really be afraid. not wanting to talk to anybody, not wanting to share their problems. they don't know who to trust. but as time goes by, while talking to them, one-on-one,

hearing our stories, they start talking back to us. >> when ebola ends, every day is going to change, families are apart for good. my daughter is 4 years old. i call her my best friend in life. and my son is also very brilliant, energetic, lovely boy. because i was so afraid of them becoming infected, i had to stay away from them for a long while. >> how are you? >> people only see the deaths, but the consequences are far more than that. in africa we drink together, we drink from one cup, we share from one spoon and then we eat from the same plate.

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i know we are talking about the prevention of the emerging virus, it's three factors important. early identification, precision

of the diagnosis, and immediate action. >> we're trying to find some small molecules or some anti-bodies to inhibit the ebola virus to enter the cells. >> the 21st century can be characterized by a race between the dangers of modernization and the advances. our only chances of winning the race is to use 20th century tools to fight epidemics, ideally even to prevent them with vaccines. >> viruses are bad. but in terms of research providing critical tools

>> viruss are bad, but in terms of reaches they provide critical tools. they have been with us for millions and millions of years. if we can ask the right questions, then we may be able to find out some useful information. if we can ask the right questions, maybe we can find out some useful information. we have surveillance projects, we have viruses from humans, from animals, from twine, that birds, finding out what are the mechanisms for spread. >> when you are talking about vaccine development, we knew even less for flu than we knew for the ebola. so we need to have a universal flu vaccine soon, so everybody's working on that. >> can you tell me the slice that you have prepared? >> this is the slice. >> oh, yeah. okay. >> currently we create a new flu vaccine every year, adjusting it to match the circulating strains of flu. it takes months to make that vaccine. >> yes, it looks quite nice. >> what scientists are trying to develop is a universal flu vaccine, one that could work against all strains of flu,

seasonal and pandemic. >> right now it takes at least nine months to develop a vaccine. that's too much time. >> if there's a pandemic, a lot of people will die before a vaccine is ready. >> go this way? okay, goodbye, hope to see you soon. the problem is not just vaccines, we also need better diagnosis. >> better diagnostics are critical to preventing outbreaks from becoming epidemics. we frequently misdiagnose influenza. and initially in the field we misidentified both ebola and zika. confusing them with other diseases. we lost valuable time to contain them. >> thank you, you have been identified.

>> this is the area where we have a lot of the diagnostic machinery that we're working on. so the general idea is your sample is going to get placed in here, and it will run across a chip. we close it up and then the cartridge can sit right here. right now the run time is somewhere in the order of half an hour. so what you can see on the screen here, this is the intact virus. maybe it's ebola, maybe it's influenza, maybe it's zika. you can imagine it being useful in your doctor's office. you can imagine it being useful in an airport. or you can imagine somebody wanting to bring it to a triage site if there is some disaster or some outbreak. >> today the president of brazil gave public health officials the

right to enter any home or business to try to eradicate mosquito breeding grounds. >> cases of the zika virus have been reported in dozens of countries across central and southern america. already puerto rico is in the crosshairs of the virus. >> zika is spreading rapidly around the world. at least 49 countries or territories in the western hemisphere have local zika transmission. >> we're already seeing mosquitos transmitting zika in the united states. it's really just a question of how many states, how widespread, and how many people will acquire infection as a result.

we are not prepared for zika. every outbreak we go to the capitol hill folks and beg, and every outbreak becomes very political. in the united states there are a patchwork of laws that guide health. there's no consistency in the level of funding or urgency or training or expertise. am i allowed as a public health official to go on your front lawn, your private property, and spray insecticide? in some cities yes, in some cities no. am i allowed to force you, compel you to drain a swampy-like condition in your back yard because it's breeding mosquitos? again, there's no consistent law. public health is a two-way trust. i have to trust that government's going to do the job.

but government can't do the job of public health unless the public is engaged. if government says mosquitoes are here and they're carrying a really dangerous disease, we need to come on your property, we need to have access to ways to eradicate those mosquitoes and you say i believe in the second amendment, cheek-cheeka, nobody's coming on my property, then there's no trust. and there's no public health. and similarly, if there's an epidemic that involves a vaccine, government doesn't line your children up, you line your children up. and if you're not willing to do so, then you're not part of the trust that is the basis of public health. if there's one hallmark of my lifetime on this planet, it is the erosion of trust in government.

and public health is paying the price at every level for that erosion of trust. >> each year terry gets the vaccine. i don't get it. and we gave shannon the choice, and she chose not to. i'm trying to understand the flu vaccine because i want to know if we got shannon vaccinated if it might have saved her life. there's so much information on the internet, i can go to 30 different websites and get 30 different answers. you don't know who to trust. >> there's something about the flu vaccine that conjures confusion. while not currently a perfect tool, and varying in effectiveness from year to year,

over the last decade the flu vaccine reduces the risk of getting the flu by at least 50%. it also reduces hospitalizations and deaths. >> a little over a year ago, a mom that lost a little girl put together a facebook page and she titled it flu moms. and when she hears of another mom or somebody finds us, they join. here's a mom, she had a booth at a fair and all of us -- all of our children were pictured. there's shannon. and when children came to the booth to get their faces painted, then the parent standing there waiting would get the information. they'd be told about these children who have died and the importance of vaccination and

that kind of thing. >> we have a new mom. julia. now wonderful to be part of a flu mom group. but it's great that we all are here for one another. shoot. we'll learn her story pretty soon. >> there's a huge amount of parents that are just utterly confused. and that's a big communication challenge when it comes to the vaccine. the question is does she have anything now? >> yeah, she does. >> vaccine hesitancy is something we observe to be on the rise, which is quite alarming. influenza is actually possibly preventible with a vaccine, that's great, but nobody uses it, that's not great.

one of the most common misperceptions about the flu vaccine is that people say you know, i'm in my best years, i'm healthy, i never get sick. but there's another aspect to vaccines and that's not just me, it's the people around me. because the potential of me giving something to somebody that might be serious to them even if it might not be serious to me at this moment, and i may very well sit in the subway next to somebody who has a very weak immune system. and they may not even know it and i may not know it but i may very well give somebody the flu. so there's the question of the common good versus the individual good. if we want any effectiveness of a vaccine, we need to get vaccinated.

>> the great influenza of 1917-18, that virus was said to have gone around the world four times without an airplane. that's 100 years ago now. at the end of the great influenza, 50 million or 100 million had died. that's against a global population at the time less than 2/7 of what it is today. multiply 50 or 100 million by three. you're talking about a number of deaths that's totally catastrophic, a hit to our economy that's unimaginable. in 2006 i brought the top epidemiologists from all over world together. and the vast majority felt that in the next 20 years, 30 years there will be a pandemic and it will have the potential to bring

humanity to its knees. >> new strains of influenza are already infecting birds in over 75 countries. and the way we are interacting with the animal world is putting us at risk. we encroach on wetlands, so wild birds mix more frequently with domestic poultry. our food trade is completely globalized. and factory farms are growing in scope and size. >> with all influenzas there's some critical moment when a virus circulating in one species of, say, birds manages to mutate in a form that allows it to get into, say, pigs, and then from there to spread easily between people. we have seen this over and over, it's going on all the time.

right at this moment. here's what a truly horrible worst-case scenario pandemic would look like. first there would be a jump from some animal species to humans. the first humans would be the people close to those animals. and then their families and the kids in the schools, and it would not be regionally confined for long at all. days, that's it. and let's assume that it kills 5% of the people it infects. well, 5% would be hundreds of millions of human beings. >> pandemic flu will soon reach this country. >> if you become sick while traveling, contact -- >> so once the epidemic has really begun to spread, you can't even begin to imagine the scale of this. >> you want to be as far away from the city as possible.

>> you'll huge numbers of people that are not coming to work, and that includes jobs we consider essential for public safety, like the guys that turn water systems on and off, the police, the fire department. then people start blasting their conspiracy theories out about where this disease came from, who caused it, why is it here? you would see a whole wave of shortages of goods and services all over the world, the stockouts of every single kind of drug, the overcrowding of hospitals, the overcrowding of the mortuaries, the sheer numbers of both sick and dying. what a really severe influenza pandemic would look like is something close to social collapse.

>> we're not effectively prepared as a world for pandemic. we don't have effective enough coordination and response. but the biggest thing is that the on the ground preparation and preparedness is full of holes. there's a pattern here of responding to an outbreak rather than investing in preparedness. preparedness is so much cheaper, so much more cost effective than responding after the event has happened. >> major nations around the world currently spend 10 to 25 times less on biosecurity than they do on homeland security, in spite of the likelihood of an epidemic causing even greater loss of life. we are overdue for an influenza

pandemic. on average they happen every 20 to 40 years. a lesser influenza pandemic, one equivalent to 1968, would likely now kill up to 2 million people. and influenza pandemic like 1918 could kill 200 million people, more than the entire population of germany, great britain and spain combined. to prevent pandemics, we need to do a much better job of controlling outbreaks. every recipe, every last detail; another fancy way to show your love. fancy feast. introducing savory centers. paté with a center of gravy! i wanted more from my copd medicine that's why i've got the power of 1, 2, 3 medicines with trelegy. the only fda-approved once-daily 3-in-1 copd treatment. ♪ trelegy ♪ the power of 1,2,3 ♪ trelegy

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good morning. >> good morning. >> we see a few patients now. but the staff are better prepared now to work. they are more trained. i think if we were this prepared back in august and september we would have done better. ♪ in december we had 16, 17

patients in the confirmed ward and about 14 patients, 14 of the 17 will go home soon. hello, baby. are you all right? how are you doing today? >> so with time we got better. no fever no, sick, everything all right right now? you're ready to go today. how are you feeling? any fever? any runny stomach? any vomiting? nothing. go home tomorrow. >> it's like a miracle, you see a patient and the patient is dying sick, and then two or three days onwards, the patient starts to regain strength, trying to grow and get stronger each day. and then the most exciting thing is that you put the patient out of the ward and you remove the

tyvek and the patient sees you. the patient knows dr. moses the name has seen dr. moses the entire time but doesn't know the person. and then some of them start to cry. and i say, wow. it gives me joy. yeah. it gives me joy. ♪ >> good morning. every time we are able to help one person to stay alive and leave this danger zone, they go home and give god the glory, right? now, this doesn't stop here. staying alive is a continuous challenge.

so these certificates are so that you can go home and people in your community, people in your family who are afraid to come around you thinking you still have ebola, show this to them. this is some evidence from the minister of health that you were tested and treated and now you are cured. okay? on behalf of the ministry of health, this certificate says that you have successfully undergone care and treatment related to ebola virus disease and after post treatment assessment, you are now declared free of ebola. you have been examined and confirmed in a negative laboratory test. and the certificate is given the 11th day of december 2014. and it's signed by me on behalf of the ministry of health. [ applause ] >> i want to present this certificate. emma.

emma, please talk to me. this is for you. take it from me now, baby. it's for you, yeah. [ applause ] >> when i see patients, i remember them. yeah. especially those that are sick that i really assess, i remember them. there's something in each individual body that makes that person survive and another person won't survive. because you see one patient is so sick and that patient lives, you see another patient who is not so sick and that patient dies. then you say why? what's the difference? they are getting the same treatment in a way, the same feeding, the same care. why?

>> when an outbreak catches hold, it affects every part of our lives. business and government, trust and freedom, equity and

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i in 1980 smallpox was declared eradicated from the world. and so far it's the only human disease ever eliminated by a public health campaign. if this could be eradicated what about sars and mers and never become a pandemic. i don't dispute it's hard and complicated, but we have the tools. we know what to do. it's merely the application of public will. go out and change the world. [ applause ] ♪ >> how are you? i love internal medicine. to help people to really make an impact you need to be someone

who loves to learn and practice health system management. i believe the health system here can be better than what it is. you know i'm going to go away. i'm going to a different country, right? for one whole year, but i will call you every day. you know i love you, right? also everybody needs to learn when it comes to health emergencies until the entire world is safe, nowhere is safe. good morning. what keeps me awake at night now is that we will deliver on our promises to the people of west africa. that we will support these countries to build systems to

make sure that when there's another case of ebola, which will happen, that it doesn't give rise to a big epidemic. the time has gone that we lived on islands or that we were protected. ask there and there's no way to stop it because fighting aids or fighting the flu and sars in asia benefits people in europe and in north america. so we need to act beyond the boundaries of our own countries. >> the networks that connect us accelerate everything, the spread of ideas, conflict, people, and microbes. there is no running away. there is no wall high enough. >> what's absolutely missing,

just not there, is trust. and so coming up with preparedness that looks like it could stand up to the microbes when the attack comes is really about each country carrying their own weight. yes, we always need to be watching. vigilance is permanent. >> the hallmark of the 21st century is that our world is simultaneously more connected. epidemics are a test of who we are. we can use our connections for good to make the world safer and healthier, or those connections will turn on us in an instant. >> we cannot just continue to be responding to every outbreak as it occurs. >> if we do not invest in better preparedness, we are setting ourselves up for future epidemics and pandemics that

will cost enormous amounts in terms of both lives and money. >> i constantly run into people who are fatalists and they say pandemics are inevitable so don't work on them. >> pandemics are not inevitable. outbreaks are inevitable. pandemics are option national. it's our option if we will be lazy. it's our option whether we will deny the risk. it's our option whether we will refuse to face the consequences. >> we have a chance to stop something that otherwise could be horrific. but it's going to take all of us. ♪ ♪

♪ ♪ ♪ ♪ ♪ ♪

♪ hello and welcome to our viewers here in the united states and all around the world. i'm michael holmes. and coming up here on "cnn newsroom" as the world struggles with the coronavirus, some hope in california. the u.s. government approving a test that promises results in under an hour. plus, thousands of americans trying to return to the states because of the virus, in limbo, stuck because of travel restrictions. we'll talk to a journalist trying to return from peru. and we'll take you inside one of italy's intensive care units to see how doctors and nurses are dealing with the overwhelming number of patients.