>> this program was provided in part by aarp the foundation for excellence in louisiana public broadcast and by viewers like you. ♪ >> good evening. welcome to the campus of centenary college in shreveport louisiana. for the first statewide televised u.s. senate debate with the top three candidates. this debate is present by louisiana public broadcasting in the council for a better louisiana. we thank a public television and

radio partners statewide as well as w. jdl and batteries kpbs in shreveport c-span in the "pbs newshour" for sharing this evening's program with our viewers and listeners. >> i am very earned present the council for a better louisiana or cable and thank you for being with us tonight. over the next hour we will delve into many issues of importance to our state and country with their three invited candidates. >> participating tonight our commerce and bill cassidy retired colonel rob maness and senator mary landrieu. thanks to all of you for being with us this evening. >> a panel of journalists include shauna sanford coanchor and producer of lbb louisiana the state we are in, allen english editor of the times newspaper here in shreveport stephanie grace a columnist for the advocate and jeremy offer editor and publisher of politics.com. we drew names to determine the seating in order of questioning

and the format this evening is designed to learn more about where the candidates stand on key issues facing our state. our format tonight is a simple one. our panel of journalists will pose questions to the candidates in each candidate will have one minute to respond. the palace reserve the option to ask follow-up questions to ensure clarity of the answers and if time permits there'll be a lightning round of quick questions to all of the candidates. >> moderator: vigorito on many thanks to all of you. we had hundreds of questions for the candidates. via e-mail and twitter. you will certainly hear some of them tonight. we begin however with an icebreaker question. public opinion polls in louisiana track a national unfavorable view of congress as an institution. the very notion of public service has been questioned in an increasingly bitter election battle. would each of you tell us when and why you first decided to run for office. we begin with congressman cassidy.

cassidy: in 2005 katrina hit louisiana and there was a sense of their leadership had failed. there's a whole city that was unable to evacuate out of the category 4 storm at first and then as it turned out the leadership after the storm failed and then later on it later on it turns out perhaps levees failed because of lack of leadership. i think many of us in louisiana at that point chose to step forward. i spent my life in service for the last 25 years working in a public hospital for the uninsured teaching young doctors and medical students and residents how to be better doctors but along the way teaching others in treating the uninsured patient. after katrina i lead a volunteer group of 300 people to stand up a search hospital within three days to welcome those folks who were fleeing the floodwaters in new orleans. i think that formative experience at that time in my life led me to run for public office. i consider it a continuation of the service i have done us a doctor and working in a hospital

for the uninsured. >> moderator: thank you. colonel. maness: in late 2012 after i've been on the military for a year after retiring from 32 years and i saw my country may be on a policy pathway that would lead us to an america that my grandson wouldn't recognize. i wore the uniform of this country for 32 years. i fought terrorists over the skies of iraq and afghanistan. i did that because i love america. i love freedom freedom and every fear our constitution. america is the last great hope on earth. this election to me is not about power. it's about restoring our country and i believe that louisiana's deserve to vote for a conservative this november. as mark levin said last night, i am the conservative in this race. that is how he endorsed me and that is why i'm running. thank you. >> moderator: senator.

landrieu: thank you for having us all tonight. let me just say it wasn't until after college that i thought about running for public office and of course i come from a family that is has served for many years and honorably and well in the state. i'm the youngest of nine children. we had five boys and for girls. my mom stayed home and races for 30 years. i looked at mom and dad and i said i think maybe i'll go to public office. i ran for the legislature and didn't have much of a shot to win and i won and continued to take one step in front of the other. i'm very interested that one of my opponents congressman cassidy said after katrina in six years after the election he voted against disaster aid in his own district. i'm very proud to have represented the state honestly and transparently and i transparently and to think effectively and passionately to bring aid to victims to fight

for an energy policy for our country that will make us energy independent and a whole host of things that are important for leaders to support. >> moderator: thank you all very much and now we are going to turn things over to our panel of journalists and the first question will come from shauna sanford which we pose to colonel maness. >> our first question is about medicare. we received lots of questions about this topic. like the rest of the nation's louisiana's population of baby boomers is close to retirement age. medicare will be under enormous financial strain due to the rising cost of keeping older adults healthy. how would each of you put medicare on stronger financial grounds and protect today's seniors and future retirees from rising health costs and we will begin with you. cassidy. cassidy: the obama bill that

senator landrieu voted for in the ryan murray bill that senator cassidy voted for. despite how much she worked or didn't work for the people of louisiana are borne out when the mayor of washington d.c. says you are the senator for washington d.c.. we need to get medicare on track to be solvent and we have time to do that. the board of trustees shows that it's going to be solvent for about 20 years so we have the time. we all need to come to the table together and develop solutions that will work for the people of the 21st century. thank you very much. >> and can i follow up with that? do you have a solution to support? maness: we need to come to the table together and we have plenty time to do that as a nation. >> moderator: senator landrieu. landrieu: i support the medicare program. it's a very important program for safety for seniors.

my opponent has no plan as you just heard in congressman cassidy voted to end medicare as we know it, not cut it but ended and move to a voucher program. he voted for that consistently. it's one of the reasons he has shown up for the first time today because for 18 months he has been running away from his record which i hope will get out tonight. i voted for $700 million in efficiencies in the medicare program, the same boat that john mccain campaigned in yesterda yesterday. i put that money back into the medicare program to strengthen it and extended the life of the trust fund by about 12 years. now you are right there is still strain on medicare but i support the program as it is and i also believe that other people particularly people that are under 65 deserve health care and we will talk more about that later tonight. >> moderator: congressman cassidy.

cassidy: i viamente doctor working in a hospital for the publicly uninsured. my mother lives with us and she is 92 years old. i know the importance of medicare. that said obama when senator landrieu voted for obama $6,700,000,000,000 out of medicare. he didn't put it back into medicare and there's going to be some questions we will be posting posting on our web site go cassidy.com. it took $700 billion out and spend it elsewhere and i will return to the trust fund. on the other hand 20 years ago we see in his own senator came up with a bipartisan plan to save medicare. paul ryan and ron white dusted it off and brought it back up. it isn't a voucher system. it's like medicare part d. 85% of seniors like medicare part d. if you want to take traditional medicare you can but if you wish to choose a plan of your choice.

it's been estimated they will save money for beneficiaries and from the medicare trust fund. it's a good bipartisan genre plan. >> moderator: we are going to move on to allen english. you have another question we begin with senator landrieu. >> we are glad to see you here in northeast louisiana so thank you for being here. ryan is one of many viewers who submitted questions to guide and a number of questions centered on foreign security. your three tacked together as one question. they can know but we are looking for you explain what your position is. first, do you agree with president obama's military strategy concise as? secondly, as the president overstepped his authority and third, will you authorize the use of ground troops if that time comes? landrieu: issa should be enjoyed and we need to do everything we can to eliminate it. it's a serious threat not only against the united states but

the region which is an important region of our interests. secondly i do support the airstrikes against sizes and believe that all presidents should have the authority to act when they believe america is in danger. thirdly i would support the use of force. i think i would stop short at this point for boots on the ground. i think we have made such an enormous sacrifice in a part of the world. america must continue to lead. we have to be strong. we have got to work with our coalition partners but i do support the use of force. isis is a threat and that must be eliminated. >> moderator: dr. cassidy. so by the president has not submitted a strategy. he pulled troops from iraq even though it was suggested by his generals that he keep them there. he missed the warning ear and a half ago of the gathering of strength and began to invade iraq.

when they captured a weapons depot instead of illegally bombing the depot he waited allowing them to distribute weapons across the region. he has no strategy. what he is presented to us or the beginnings of a plan. i support the plan because it's the only plan out there. i'm not sure it's going to be adequate. we flew 93 sorties recently in on the opening day to a few -- flew 2000 sorties monday. that said if he has a plan involving our troops i would have to look at it. i don't trust the president i think is a poor commander in chief. before a commit our men and women overseas i would like to see what the strategy is. >> moderator: do you think he overstepped his authority? maness: he was authorized by congress for the initial steps he had done. as he goes forward i would expect him to come back to congress to get additional authorization.

maness: i flew in operation desert storm. you are absolutely right we need to have an air campaign is connected to a strategy. this president has not presented us with a strategy. he is not defined the objectives of this operation. he is not defined success and he is not defined an exit strategy that puts american sons and daughters in great danger while they're in harm's way. he has overstepped his authority. he should be engaged with congress and as a matter of fact congress has given them a blank check to fight in a declared war and the two members of congress sitting next to me should be back in washington calling for a debate in congress instead of allowing a recess to occur to kick the can down the road. a declaration of war needs to be satisfied or not and we need to figure out how to pay for this war because we can't continue put these things on a credit card. what i authorize ground troops

if the president could satisfy all those questions and address the exit strategy and address the need for it for coalition and maybe their nations a particularly the kurds will but maybe the free syrian army whoever they are might step up but eventually ground forces will be used. mods are returned to stephanie grace and she will pose a question to congressman cassidy. >> congressman cassidy and fellow panelists we heard from a lot of viewers about health care including mr. david looked and felt. his question is specific to congressman cassidy and colonel maness. require coverage for pre-existing conditions, do you favor this coverage and if so how do you propose to pay for it without an individual mandate and for senator landrieu you defended the affordable care

act. what aspect of the health care law would you change? cassidy: is a position i oppose the affordable care act. the patient has the power however when a bureaucrat has the power it lines up to serve the bureaucrat. as it turns out as a bureaucrat telling people what they must purchase. somebody whose insurance just renewed went from $725 per month to $1200 per month, a 56% increase. now blue cross this past week increase rates by 20% so clearly this is the unaffordable health care act. how do you address pre-existing conditions? republicans have proposed that everyone in the nation will get a tax credit only to be used for purchasing health insurance. if an insurance company receives part of this tax credit they would be required to give everybody the same age the same rate. it doesn't matter if you have a liver transplant you would still get the same age rate premium.

that way we take care of pre-existing and give the patient a power by the way different than the health care law that senator landrieu was the deciding vote on. >> moderator: colonel maness. maness: obama carries an abomination we don't need to only be found at the up by the roots. my plan turns to the free market for solutions. first of all consumer should be allowed to buy insurance that fits what they need. a man who is not going to have a baby shouldn't be forced to buy maternity care insurance. state programs before obama came into existence were responsible for health care issue return to that. we should be up to cross-state lines to purchase insurance. that increases the market and increases competition drives costs down and keeps costs low.

finally we need affordability with insurance policies of policy stay with the individual and you don't have to worry about going from job to job and losing your insurance. i will address the pre-existing condition for most americans. thank you very much. >> moderator: senator landrieu. landrieu: congressman cassidy introduced a version of the affordable care act himself under his name when he was a legislator in louisiana which he doesn't want anyone to know and the mandated businesses under 50 employees could provide direct coverage. he will not fess up to that and all he talks about his president obama. he hasn't answered for his own record. number two, our country has struggled for 50 years over the question of how to survive affordable coverage and quality coverage to people in america who work 40 and 50 hours. it is unjust, unfair and wildly

offensive for a nation have to treat people in emergency rooms when it costs everybody so much more money. affordable care act is not perfect. he needs to be fixed. a copper plant could help make it a little bit more affordable, raise the subsidy for additional subsidies and also allow insurance agents to -- other ways to fi fix it. we have to keep it and not under any circumstance repeal it. >> moderator: jeremy has a question for colonel maness. >> let's turn to campaign-finance for a moment and talk about the money that feels politics. there are third third party independent groups most notably super pacs allow to raise unlimited amounts of money to influence elections. how did each of you feel about that system? also if you could change one campaign-finance law right now what would it be?

>> moderator: colonel maness. maness: politics which i've learned in my short time in business is a racket for sure. there's too much money involved but the federal government shouldn't get further involved by limiting our free speech. i agree with the citizens united decision as things stand right now and unless things were to be able to change i would make any changes to current campaign finance laws. >> moderator: senator landrieu. landrieu: while the koch brothers and bill cassidy have literally orchestrated a 25 million-dollar bogus campaign run on television. this is the first debate that he has agreed to show up and maybe he's running away from his record and wants to just use the power of unlimited undisclosed bogus television ads to make his way to the united states senate. i would overturn citizens unit

united. corporations are not people. they should not be given unlimited rights to speech. the richer you are the louder you get to speak. our democracy is based on one man, one vote, one woman, one vote in the power belongs to the people. not the rich having the power but all power equally. this restores a democracy and you can see it playing out in this race in louisiana. i want to run on my record of 18 years. i'm proud of my record. hard to get your voice over those bogus ads and something needs to change. >> moderator: congressman cassidy. cassidy: they were outstanding in our campaign five to one before labor day and obviously let's be honest mayor mike bloomberg is all about gun control but $50 million into harry reid's pack. have you noticed the five commercials before labor day and

three to one after labor day after labor day? i with senator reid. he didn't know that because he has a pager majority. they do whatever they can to get senator landrieu reelected because mayor bloomberg likes her because she agrees to restrictions to second amendment rights. the nra has third-party money coming from me but at least but at least no who they are, the nra. i like transparency. when harry reid pays for an ad instead of hiding behind some patriotic tea party sounding name and he says this is harry reid and i'm supporting senator landrieu. >> moderator: moving on to shauna sanford and this will go to senator landrieu. >> pay equity. >> bay equities and import issue that has the attention of our viewers. pay equity. a lot has been written lately about rising economic inequality

here in the united states. the richest 1% now owns more wealth than the bottom 90%. this is a three-part question for you. are you concerned about this the 1% versus 90%? would raising the minimum wage help the working poor of which so many in the louisiana belong to that category and if not what policy should congress adopt to address gender and pay equality in general? senator landrieu we begin with you. landrieu: i'm concerned about the inequities in the population of the united states and we all should be because this country is founded on strong middle class. we really have to think carefully about how to grow this middle class. as president chair of the energy committee and as a leader in many areas i'm looking forward to using my clout to build a stronger middle class. i support pay equity. my opponents do not. i support paying women the same amount of money for equal work.

i support raising the minimum wage. my opponents do not. there are so many women that children depend on their salaries as well as their love and support. they depend on them money -- i think it's almost criminal that my opponents will not support the increase in the minimum wage. i support pay equity since women are still making 67 cents on the dollar and for african-american women are -- women it's even lower. these are things we can do now to strengthen the middle class and close that pay equity gap. cassidy: under this present income inequality has increased. if you own stock under this present you have made a lot of money. under obamacare they are clearly established that those low income workers the bottom fifth if you will have had their hours reduced from 40 to 30 or even

laid off as workers have tried to avoid the penalty of obamacare. the school board recently took 400 custodial and food service workers and converted them to -- from full-time to part-time. explicitly because the school board did not have the tax base to pay the penalty of obamacare. if we want to do something about income inequality we should repeal obamacare and restore full employment. right now the best way to increase wages for those that are less wealthy is to use america's natural resources like oil and gas. we need to use her energy resources create the good paying energy job. maness: first of all here you guys go again. that last question, they're both complaining about the corporate dollars and their campaign war chest and i'm supported by 41,000 individual donors. that's income and protection racket that i was talking about,

but pay equity i'm proud to have proud to have served with maam women in the united states air force for 30 plus years who got equal pay to me and i absolutely support equal pay for women and equal pay for equal work. but that's not the issue here. the issue is we have a law on the books that needs to be enforced. the equal pay act used to be in force. i am not for a national minimum wage raise but i've stated before i believe it should be at the state level and elected leaders of the state in the voters this day should be able to experiment with setting a minimum wage. that would help the working poor in the state. >> i would like to follow. congressman cassidy you on record as voting against the lulu ledbetter fair pay act in the paycheck fairness act. why? if you believe in pay equity. cassidy: in 1963 that pay equity bill in the 1964 civil rights act already has laws on how you

pay somebody. the lulu ledbetter act is a trial attorney bailout bill. a small businesswoman who bought her business from another can be sued decades later for things that are allegedly occurring under previous owner. that is wrong is wrong for that owner and i oppose that bill. >> moderator: her next question, allen. >> as we sit on the campus tonight we can ignore the pressing issue of student loan debt. certainly it has the attention of michael byers and others who submitted questions in the budgets of colleges and universities public and private. they are under strain and stress and we have seen major stresses in the last couple of years. students are paying higher tuition and the costs causing to graduate into debt. how are you going to address this problem? >> i still teach but i'm not involved -- so i'm aware that

student loan debt is a major problem. part of it though is the amount of money available increases as universities increase their tuition. that has been well-documented. there's a lot of fraud in some of the programs such as the pell grant, over a billion dollars a year thought to be lost in fraud due to pell grants. now if we can somehow figure out how to keep the universities from breaking the price when money becomes available to borrow and secondly eliminate the fraud we can redirect those dollars to those who need it. part of the problem as well his students are graduating in job markets which are awful. they can earn money. we need a better economy than the obamacare economy. senator landrieu when she voted for obamacare in a sense put a wet blanket over that economy.

>> colonel maness. maness: college graduates rates are sky-high and the only solution to the debt problem for college loans is too full. create the jobs. we need to pull obamacare of up by the roots and restore jobs in our state. all 64 parishes and small business owners that have less than 100 employees tell me the same story. they are struggling to meet the requirements of obamacare and struggling to create more jobs that they need to create or they are struggling to redefine full-time job employees down to part-time job employees. that's a disaster. our college graduates need to go to those jobs that are sustainable long-term jobs. we would be creating those jobs. not just in certain parts of the state but all over the state.

i have also supported the hero at the higher education reform opportunity act that will spread accreditation in the state and increase the market and competition drive costs down. >> moderator: senator landrieu. landrieu: those amendments would be very helpful i believe to the 600,000 people in louisiana that have outstanding student loans. it's a serious burden and a serious challenge to all of us. it's not just a private luxury. it's a public good for people that have strong education. the frightening thing is to think about one or two of these gentlemen being in the senate than standing in line with governor jindal to raise education the state to $700 million the largest cuts in the state of the union. i have fought against those cuts and i've done a lot to make sure at least we support hundreds of millions of dollars to her

hbcu's which i'm proud of. mandate of lowering of student loans. you should be able to refinance your student loans savings to does a thousand dollars. number two double pell grants. they are now worth less than 30% of the value. when they were first passed neither one of them were supported. they should. >> one quick follow-up for congressman cassidy. looking at a student in the face is trying to decide at a vote here what can you do for me tomorrow or in the first year to help me out with my lung stress? cassidy: young people want freedom. they want their future mortgaged by debt and deficit. first you have to understand their motivation. oh my gosh i don't mind somebody refinancing their student loans. i just don't think the taxpayer

should have to pay for pay taxpayers are struggling. are we going to ask them to struggle more for taxpayer financed refunds? if they can can get a better deal they should. i don't think the taxpayer should pay for it. >> moderator: moving along. stephanie gets the next question for colonel maness. >> is well know, gore has become a controversial issue in louisiana and around the country. their state superintendent of education is a supporter of the standard. our governor contends the initiative represents federal overreach. regardless of your stand on this point should the federal government play a role in k-12 education and if so what should that ruled the? colonel maness. maness: thank you stephanie. the constitution has no role for education and k-12 for the federal government did not believe the department of

education at the federal level should be dismantled not believe, gore which i'm opposed to completely is a system that is being imposed at the federal level for the national testing standards system that's unacceptable for the parents teachers and local elected officials. that is where if the federal government wants to play a role block grant the dollars down to the state and local to use those dollars as these see fit to help their children. >> moderator: senator landrieu. landrieu: it should be secondary to the state and local contributions and abuse. it represents less than 10% of the funding but as you know there such a discrepancy in zip codes around the country. your citgo shouldn't determine your future. the federal government has a role to equalize opportunity not guarantee success.

but guarantee opportunity to succeed. that is what the federal government got into funding. i worked with george bush, not a democrat or republican to bring funding to our public school system and i have worked with all presidents of all parties. i've i have been with three presidents and six governors. i support faith-based standards which, in gore is. it's not a national mandate. in fact our governor was a supporter before he decided to run for president of the tea party which rob maness is a part of. they are local standards. >> moderator: thank you. congressman cassidy. cassidy: stephanie of a multipronged question here. my daughter is dyslexic and the one-size-fits-all mode of

education would not fit my daughter. my daughter is fantastic but i do -- do i think one-size-fits-all -- the state can fight among itself. the federal government should not force, and core upon the state. it shouldn't. by the way although was a state initiative to begin with the kind of obama my ties the federal government was going to -- arne duncan began to require states to adopt common core if they were going to get any federal assistance. i opposed up, absolutely. the federal government should not be forcing us upon the state. >> moderator: i think stephanie had a follow-up. >> what world do you think the federal government should play in k-12 education? cassidy: is that mine? the government -- it should be

the mother of a father that makes billions decisions about the child's education. the government should play a role only if there are federal funds disbursed to the state ideally being in a best practices model. as it turns out the federal government will pick and choose what program to endorse. i think that's wrong. >> moderator: jeremy have the next question and we begin with senator landrieu. >> some of the most contentious issues debate him hell about the federal budget and spending bills. tell us who you believe to be the key federal funding areas for louisiana that need to be protected? also if it comes up for next term and it looks like it may well would you vote in favor or against raising the debt ceiling? landrieu: first of all disaster planning is very important. i have been a leader of disaster funding in the congress both for our recovery in the gulf coast

and for help with sandy as well around the country. my opponent congressman cassidy voted against funding for his own district when isaac hit. he sided with the republican party and the republican study committee who said sorry we can't afford aid for isaac. we can't afford offsets for people to make over $1 million but not for disaster aid. i've fought hard for the state that was in the bulls-eye of disasters. i also think revenue sharing is an important thing to fight for it. i have secured it as a junior member of the energy committee. i'm now chair of the energy committee. that funding must be protected. when did savor koizumi to build energy jobs and that is what is at stake in this election. >> moderator: would you also voted in favor or against

raising the debt limit? landrieu: i voted for america to pay its bills. my opponent voted to shut the government down and i did not in there's a big difference in the record. cassidy: i've voted for hurricane sandy coverage but i didn't vote for $30 billion. what i didn't vote for her was not related to hurricane sandy money. governor cuomo ran an ad enticing other businesses states to move to new york. that is not the best use of taxpayer dollars for louisiana. the disaster relief she speaks of was not mentioned in the disaster relief bill. as we are going to speak about revenue sharing it with pete domicci's though which bobby jindal were come on outside. i would also think carefully about that. i passed a bill in the house of representatives that would double what louisiana would receive from revenue sharing. was bipartisan from drilling on the undercurrent of shelf.

in the senate would not even consider it. senator landrieu still wasn't brought up either. if she had taken my bill and pass it could have been signed into law but it turns out not her bill was considered and having protect that funding. i have said before to my constituents i will vote for in the debt ceiling deal that actually begins to address the debt ceiling problem. if it lowers their indebtedness i will vote for debt ceiling deal. if you cut out the credit card he still eat but if you're going to keep those credit cards open my gosh i'm not going to do that. >> moderator: colonel maness. maness: let's get to the debt ceiling first-grader not going to vote to raise the debt ceiling. we are 17.5 gillian dollars in debt and that national crisis levels in both of my opponents have voted to raise the debt ceiling consistently previously.

as far as disaster flamingos we should make sure disaster funding is taking care of and that is why i proposed a standing disaster fund so dollars would go immediately to victims of disaster so they wouldn't be this debating and washington nonsense like what happened with the katrina bill which had a 50 million-dollar indoor rainforest for iowa. why did the people in louisiana have to wait to get aid because of that? there is no reason anybody can justify for that waiting time. let's get the standing disaster funds together for the people of louisiana and make sure they get buried immediately. as far aas far as as protectingr coastline louisiana's coastline is the most important nation and senator landrieu the president's policies are on the ballot and they are on your person. we talk about energy jobs a moment ago and they are hurting in energy jobs. >> moderator: tayshana with the next question.

shauna gets the next question and it goes to congressman cassidy. it's hard to keep up with those two. >> nearly all louisiana residents age 65 or older receive social security to the program generates a $2.2 billion in economic output for louisiana yet year after year the social security trustees tell us that the program faces financial challenges. how would each of you protect this vital program for today's seniors and strengthen it for future generations? congressman cassidy. cassidy: my mother lives with us. she is 92 years old and we are aware of the importance of social security. turns out the trust fund is going bankrupt. in 12 years if you are currently on social social security or benefits will decrease. her current benefits will decrease by 25 to 30%.

those are for folks who are currently receiving that tip o'neill and ronald reagan 30 years ago went to those far younger and gradually increase the age of eligibility to preserve benefits for those who are on and about to be but also to strengthen the program for those coming along. ideally you do it as little as possible like someone who is not yet born. the reality is you've got to make changes someplace. we are all living longer. i'm committed to preserving benefits, social security benefits for those that are on it, those who are soon to retire and those who will see in the future. we can gradually increase aid for those far younger. senator landrieu has previously endorsed the concept and we will post her endorsement of that on our web site. maness: social security is a very important benefit that most of us pay into and pay for expect to get that so let's talk from a principle perspective first.

congressman cassidy you have voted to raise the retirement age and i worked in operational fields with votes in the field for many years. there's no way a lot of these skills can be done up until age 70 and i disagree with that. we shouldn't demand current recipients of social security should take reduced benefits. we have to protect that and that would be one of my principles. the other thing we have got going is a commerce mentioned is we have 12 years that we have got time in the folks coming into social security that are 10 years out and have their benefits protected too. what we need to go to work on his disability and social security fund. and increase dramatically the number of folks that are on disability. it's hard to imagine which the way safety standards are today there are that many injuries on the job. we need to look really hard at that for fraud waste and abuse in that trust fund will run out of two years. >> moderator: senator landrieu. landrieu: there are 550,000

people in our state on social security and some additional arun disability. i agree with the colonel i don't think we should raise the social security age like congressman cassidy did. there are some jobs that are hard and people cannot work until 70. i think that's a very bad policies. that's one of the things that is at stake in this election. let me finish please. i also believe social security is not an entitlement. it's an earned benefit. people work hard their whole life and pay into the fund and they should be able to take it out. and madison parish african-americans life expectancy is -- years old so when people say people are living longer, maybe people in connecticut and new york are but i plan in my state who are living longer get their health care is not very good. i'm not raising the social security age.

>> moderator: i think shauna had asked follow-up. >> racing pages come up by senator landrieu and senator maness. we have questions from our viewers about your wanting to rates -- raise the issue 70. cassidy: people don't talk about it because it doesn't hurt anybody. if you pick an age of someone who is 40 now and they would become eligible at 67 and a month if they are 39 they become eligible at 67 and two months. if they are in so doing they have time to plan for their change in retirement but for those who are currently on those about to be nothing changes. >> moderator: i think we are out of time. sorry about that. this. >> moderator: here's a question and allen i know probably everyone will want to answer it right?

>> since this debate is being held in the area home of the barksdale air force base would have you done and what will you do to keep barksdale are made based and -- critical to louisiana's economy viable and enough the base closing list and let me add safe as you might feel any one day the next day you could be the target of a budget cut. landrieu: -- >> moderator: colonel maness. maness: i have helped created us air force strike command as the program requirements to establish the first budget shepherded through the approval process and my team wrote the plan that is operating today. i have done that work on the ground and is a wing is a wing commander and installation commander of air force i have worked with congressional delegations and local governments and local committees

to keep the base viable so it's appropriate to the national security of the united states. we have to constantly be working with all of the communities and all the bases in the department of defense to ensure there are viable missions and is a continuous process that requires hard work and coronation between not just the department of defense and service departments but the local governments and community leaders that want to stand for keeping their bases viable. >> moderator: senator landrieu. landrieu: is the first democratic woman appointed to the armed services committee of the united states have been a strong supporter of our military for many years. i also served for 12 years on the military construction committee and have supported literally millions and millions of dollars in construction for barksdale and belle chase.

specifically as the leader of our delegation of global strike command which is not a three-star but a four-star general at barksdale. we have protected it and that will be announced soon so it's exciting. since it was so successful we created -- that saved 5000 jobs at fort polk. our military is very important and that is why we need leadership and strength in washington to protect the spaces and the senate is not going to do it. >> moderator: dr. cassidy. cassidy: john mccain. [inaudible] the short answer was not much. i am quoting john mccain. the debt and deficit is what is killing our defense budgets and

there is something called sequester which is automatic budget cuts put in place to decrease our debt and deficit. house republicans on two occasions advance builds up within these cuts for storing money to support belle chase as well as barksdale. harry reid never took this up. now we know why. the president wants these cuts to go into place because he wants to cut the military. as long as harry reid senate majority leader these will be in nature. senator landrieu said she would elect harry reid. it shouldn't surprise us senator landrieu supports barack obama 97% of the time. >> moderator: we are short on time. this is going to be our last question in this round augusta stephanie. >> another question on climate

change this time. do you believe that climate change is real and it's a threat to low-lying areas such as south louisiana? >> think human activity contributes to it and what if any policies of the federal government used to combat climate change? senator landrieu. landrieu: i do believe our climate is changing and i do believe humans contribute however we have to be very careful about the policies that we promote. i'm a strong supporter of fossil fuels and natural gas particularly. it's a 50% cleaner burning fuel. we have had 200 years of it. america will do itself a great service and great security increase our security by promoting more domestic energy exploration and production. i've been a strong supporter. i opened up -- in the gulf and secured expedited permits on

land. i do not agree with president obama on his energy policy. a head have now served with three president six governors as well as supported some of their policies. we have to be careful about what we do but we can build a strong energy future with canada and mexico and be energy independent. >> moderator: thank you senator. dr. cassidy. cassidy: there might be climate change but we are not seeing that reflected the temperatures. we are losing our coastline but that is relative to sea level rise. that is related to our loving on our river taking sediment from restoring our coasts as well as other factors that causes the land to sink as much as water rising. in florida they continue to see rising water relative to the beach. if you want to preserve our coastline i'm not sure climate change is the issue as much as it is getting that sediment out of the mississippi river putting it into the marshes were a can

rebuild and that's what's important. i will point out the first vote is for senator harry reid. senator harry reid will never allow a no our guest gas bill to come to before the senate. she is already said that would be your first vote. maness: is evident that the wording around the globe has occurred over the last 100 years but there hasn't been anything in the last 16 years and some say even the last 19 years or even 26 years so i think we have a lot more to learn about climate of what makes a change. i know the president and senator landrieu's policy is we need urgent action on climate change but if we don't know how the climate changes and we are not seeing any warming i think that leaves that endow. there are other priorities like

eliminating isis energy independence for both of my opponents spoke about in getting our stagnant economy going again. our policies have long-term sustainable well-paying jobs to go to to pay off the student loans. >> moderator: are right we have time for just a few yes and no lightning round questions and one-word answers and we have a lot of them. we will begin with you dr. cassidy. are you in favor of legalizing marijuana for medicinal purses -- purposes yes or no? cassidy: medicinal purposes? no. landrieu. landrieu: no back. >> moderator: as health care fundamental right? cassidy: no. landrieu: yes.

>> moderator: do you favor a balanced budget amendment? >> absolutely. >> of course. >> not an amendment by the budget balance. >> moderator: this is the last one yes or no. i want wanted to rate on a scale of one to 10, two people. president obama and governor jindal. [laughter] [applause] are right cassidy. two people, president obama and governor jindal. cassidy: no. [laughter] obama is a zero. obama is going to go down as one of the worst presidents. governor jindal is taken some tough flicks. >> moderator: maness. maness: zero and five. >> moderator: and senator? landrieu: i would give governor jindal barely a three.

i worked with six governors and i would give president obama a 67. i think he has had some tough issues to deal with. >> moderator: thank you very much. it's time for us to move to closing statements as we did before we did a drawing and selected the order mullahs there were senator landrieu. we are down to a minute and a half in the closing statements because of timing. closing statement for me to canada starting with senator landrieu. landrieu: first of all i want to thank lbg and the coalition and a better louisiana for hosting us and being back at centenary. i have had the pleasure to represent the state for 18 years in the united states senate and while president obama is not on the ballot the future of louisiana is. collecting a senator that can get the job done when it comes to energy building a middle class in our country and in

louisiana supporting more domestic production, supporting the keystone pipeline, supporting the changes in the pipeline that kept 25,000 plus people with natural gas using my influence in my clout which is the people's influence and clout in louisiana. i think fighting hard for state when it comes to disaster reli relief, loan forgiveness, supporting her your university and bringing billions of dollars to the state when it was necessary. i also believe supporting our seniors not raising the retirement age to 70, keeping medicare as we know it, supporting health care for people that work and let's not repeal the law. let's improve it and i have suggestions to do so. finally coso frustration. whatever you do in louisiana won't be worth anything if we can savor coast. the bill that i passed the

sustainability efforts on our coasts are paying off. let's keep going. i ask for your vote. >> moderator: congressman cassidy. cassidy: a woman will lie awake unable to sleep. she's not sure the family can pay their bills. she is either gasoline or groceries and utilities all those bills up at a 20% increase and their health care premiums are due to the book -- affordable care act. this is not despite president obama's agenda but it's because of that agenda and agenda that senator landrieu supports 97% of the time. she represents barack obama and i represent you. for 25 years i worked in the hospital for the indentured caring for families who have had nothing or at least very little. i set up a vaccination program to vaccinate children in school, 36,000 against hepatitis c at the school so their moms didn't have to miss work so that child had no cost.

i've been serving families like that for 25 years. when you walk into the voting booth on november 4 think about that family. it might be yours. do you want senator landrieu to take barack obama's agenda? if so, vote for her. if you want someone is going to push to repeal and replace obamacare and push for energy policy to create better jobs with better benefits for that family with better wages, if you want someone who wants washington to serve you instead of you serving washington d.c. than vote for bill cassidy. >> moderator: colonel maness. maness: i would like to thank the coalition louisiana public broadcasting and the college for inviting us in the opportunity to participate at different profits before so many louisianians don't know me. i'm the son of a air force master sergeant and at 79 listed myself. i rose to the ranks and went to high school and became an officer and aviator. i thought america's enemies in

the skies over iraq and afghanistan. i have chase terrorists on secret missions in countries i can't name. i've commenced america's finest young men and women in life-and-death situations. our country honored me with a bronze star for leadership. our future is in danger from poor leadership like career politicians. if our leaders could anchor themselves more to the people they serve and be more devoted to our constitution we can put america back on track. instead of decline, we can claim an american renaissance for a century of greatness. my belief is that americans are the last best hope sustained me throughout my years of service. i believe that our best days can still be ahead of us and our people will rise up and make their voices heard. i'm offering my service and asking for your vote to create a

government that is once again worthy of the american people. i love you, i love god. god bless louisiana in these united states and thank you very much. >> moderator: thank you all for participating and thank you panelist, thank you audience. we thank you so very much. [applause] on behalf of lcb and louisiana public broadcasting thank you. goodnight. [applause]

.. >> this is a half-hour. >> good afternoon, everyone.

today we are going to focus on two aspects of the response to ebola. first, what we are doing to improve the safety in our health care settings, and second, what is going on with contact tracing and dallas. i'm delighted to be joined by doctor david lakey, he is in texas from the state health department along with the staff from the cdc for helping with all aspects of the response. in dallas, what we have done over the past 48 hours to improve infection control they are, is to send a team into the field and we have and cdc's most experienced staff, people who have worked on ebola outbreaks for decades. people who have stopped the outbreaks of ebola in difficult situations in africa. people who are experts leading the world in everything from

laboratory science to infection control to hospital in administration. and we're working hand-in-hand glub i'd love, side by side with the folks at the hospital and the teams from the health department and the state. and some of the things of the teams are doing to improve safety in is looking at every step in the procedures. and those experts are making immediate advancements in what is being done. i will mention three in particular, although there are three of just a large series. the first and most important is ensuring that every hour of the day there is a site manager there who is overseeing aspects of infection control. that individual make sure that the personal protective equipment is put on correctly and taken off correctly.

in fact, in our work stopping ebola in africa, this is the single most important position. to protect health workers. a single site manager whose expert and overseas every aspect of the process. second, we are enhancing training. ongoing, refresher, repeat training, including by two nurses from emory university cared for ebola patience and are assisting in training nurses and other staff at the hospital in dallas. third, we are recommending that the number of staff who go in for care be limited. we want to limit the number of staff are providing care so that they can become more familiar and more systematic and how they put on and take off protective equipment and they can become more comfortable in a healthy way with providing care and the isolation unit.

those three general steps are very important, and we're also doing many other things such as looking at everything from the type of personal protective equipment used to the procedure for putting it on and the procedure for taking it off. now i have been hearing loud and clear from health care workers from around the country that they are worried. but they don't feel prepared to take care of a patient with ebola. but they are very distressed that one of our colleagues has now contracted ebola and is fighting the infection in dallas. a single infection in a health care worker is unacceptable. and what we're doing at this point is looking at everything we can do to minimize that risk so those who are caring for her do that safely and effectively.

there are certain additional things that we will be doing going forward. one thing that we want to make sure a is that whatever is done with where care is provided, every hospital in the country needs to be ready to diagnose ebola. that means that every doctor, every nurse and staff person in an emergency department who cares for someone with fever or other signs of infection needs at, where have you been in the past month? where have you been in the past 21 days? have you been to liberia to sierra leone or getting? and that will reduce the risk that someone will come into the hospital and not be diagnosed. the fact is that usually infections in health care settings read from someone who is not yet diagnosed. so we have to shore up the diagnosis of people who have symptoms and to have traveled. the second thing that we will be doing today starting today is

establishing a cdc ebola response team. for any hospital anywhere in the country that has a confirmed case of ebola, we will put a team on the ground within hours with some of the world's leading experts in how to take care and protect health care workers from the ebola infection. that will include experts in infection control, laboratory science, personal protective equipment, management of ebola units. experts who will assist with experimental therapies, public education, and environmental controls. we have at cdc some of the absolute best experts in the world. they have devoted their lives to stopping ebola. many of them like myself are physicians, trained in infectious diseases and public health and others are specialists in laboratory

science or experts from everything from contact tracing to epidemiology to what it takes to stop an outbreak. they will look at everything from the physical layout of care to the personal protective equipment used and they will bring supplies of personal protective equipment and they will assist with the transport of patients should that become necessary. they will assist with waste management and became decontamination experts. in addition, we will be ramping up webinars, support for hospitals, conference calls, associations, professional associations, state and local health department and more. i would like to now turn to the situation in dallas in terms of infection control. and i'm sorry in terms of contacts. to just outline where we are.

first our understanding that the nurse remains in stable condition and we are thinking of her. i am thinking of her constantly and hoping for her steady recovery. with the first station, the index patient as we call him, there were 48 contracts. those contacts have now passed more than two thirds of their risk. knock. they have all passed more than 14 days. and while it would not be impossible that some of them could develop the disease, they have passed through the highest risk time and it is decreasingly likely that any of them will develop ebola. second, for the nurse was hospitalized now, there was one and only one contact. that is a representation of what happens when you do active monitoring, and you do contact training and tracing, and when you encourage people to come in for care promptly.

in the first haitian who had ebola in the united states, 40 a potential contacts and in the second one, one potential contacts. that individual had contact before the nurse was severely ill. the nurse is not severely build now and generally people are not highly infectious at that point. so we will hope that he does not develop infection. third, since the nurse to develop infection we cannot rule out that other people who care for the individual, the first patient, the index case, had exposure. our teams have been working very hard to cast a wide net and identify everyone who might have been exposed in that circumstance. that includes anyone who went into the room and that includes people who might have handled specimens of love that were taken from him. at this point the team has identified 76 individuals who might have had exposure to the

index patient. of those 76 individuals, all will be monitored for fever or symptoms on a daily basis actively. i know it's in the media, and there are several of those individuals who have been concerned about their health and have come in for care and have been evaluated. dr. lakey will outline the result of the evaluation i will share with you that it is very anxiety provoking to have been dashed to have had a potential exposure to ebola. when i got back west africa, i had gone into ebola treatment units and let me tell you, every time i had the lightest sore throat and headache i was concerned. and that is what we want. that is what we want to health care workers to do. be concerned about their health as they are in this group of 76 individuals. and if so, come in for care rapidly so that you can be assessed. we would much rather be a false

alarm for someone who lets their illness go on for a day of potentially get sicker and potentially expose others. so that's the system as it should work. we want people to come in if they have any symptoms. given that there was one patient, the second patient, the nurse did get in fact did, if possible we will see other people become ill, but we hope that's not the case. and i don't want anyone to take out of this that there were 76 exposed people. there were 76 people who had some level of contact and are therefore being actively monitor. so i will stop there and turn it over to dr. lakey for details of those individuals and anything else you would like to say. david? >> thank you, dr. frieden. it's been 14 days since our first case of ebola diagnosed in the united states and we've had a very busy time here. since the passing of mr. duncan,

we have unfortunately had one additional case. and we know that's one too many areas and we knew that that was a possibility. if she's listening, again we are thinking about you are doing everything we can to make sure they get the treatment that you need. we had a unit on the ground to make sure that this is contained in texas. we have state leadership on the ground here in dallas on a teams from the cdc and the hospital nonlocal partners all working together to confront this. health care workers are understandably worried and our top priority is their safety and health of everyone in texas. i had the opportunity yesterday to go to the hospital and talk in detail with a team that is there on the ground at the presbyterian hospital and that consist of the cdc individuals from the state epidemiologist from the local health department and we are fortunate to have two horses from emory here on the

ground and working in tandem with the hospital. and truly they are looking at every detail, and they have international experts here on the ground at presbyterian. the group of people originally been identified from the 48 individuals have passed the knuckle period as dr. frieden outlined in they are doing well. obviously we need to continue to monitor them and as they continue to do well. and the one close contact of the health care worker was diagnosed this weekend and is also doing well and has incomes. that person is eating actively monitored. we're also caring for the health care workers dogs and that is going well. we are actively monitoring the group of health care workers as the doctor noted, who were previously self-monitoring and had contact with mr. duncan. they are all doing well. if symptoms are detected, even minimal ones, those individuals will be isolated and very likely be tested or ebola.

we really do want to err on the side of caution. when people exhibit symptoms, they are identified quickly due to the monitoring and i want to assure individuals at no additional cases of ebola have been detected. we understand that there's a lot of anxiety among workers and we want to calm their fears and to attack a case as quickly as possible. we will quickly announce any positive results. we are committed to giving you that information. we have a large number of individuals under active turbulence now, but that seems to be going well due to the partnership between the federal government the state government and the local government working at the hospital. we are all very committed to fighting ebola here in dallas and it is our singular focus with experts across the state and country. so with that, dr. frieden, i would like to hand it back over to you. >> thank you. we will now take questions in

the room. >> hello, from "the new york times." how many of the 76 were health care workers in a we know he meant. >> those are all health care workers. all of the people exposed to the second patient were health care workers except the one that close contact that i mentioned. >> so -- you matter i'm sorry to my said that wrong. the 76 while exposed to -- let me say it again so we get it all ride because there a are a lot of numbers and let's get them straight. first off come the first patient, the index patient before he was hospitalized, had exposures are potential exposures to 40 people. second, once he was hospitalized and released 76 people who might have come into contact with him or his blood, and who are being monitored now. we may identify a few more people as we go through records and identify other information.

but that was the number who may have been participating in some way in the care of the index patient. there is also one individual who was exposed to the second patient before she was isolated. >> janice mcdonald, abc. we understand that each hospital has to be able to diagnose a ebola patient. but once they are diagnosed, why not then transfer them to one of the higher level containment centers? >> we are absolutely looking at all the options. we are looking at the possibility of transferring patients when necessary. that is one of the things that the ebola response team will consider. >> .start with nbc news. it's my understanding that the nurse was identified and infected and had received a certification about critical care about two months ago. are you couple that level of experience in treating ebola?

>> i think that we are dealing with is a disease that is unfamiliar in the united states. and it is hard to care for it. we want to make sure that the protocol that we have and the support we have for health care workers are there on the ground so that we can assist. and, you know, i've thought often about it. i wish we put a team like this on the ground the day the patient, the first patient, was diagnosed. that might have prevented this infection. but we will do that from today onward with any case anywhere in the united states or on the phone. >> thank you on the phones. if you'd like to ask a question, press star juan and then record your name clearly. to remove yourself from the queue press star two. one moment please. >> the first question comes from cnbc. you may ask your question. >> hello, i'm just wondering if

you're concerned about health care workers feeling safe and well prepared on the job. concerned at all that folks will be afraid to come the work? >> we are concerned that health care workers are free to come to work or patients are free to go to hospitals or health care settings that we could see wider health care impacts. that is why it is so important that we focus on what will work here. we know how to stop ebola. we know that care has been provided in hospitals drought africa without infection. but we know it's hard. and we know that a single breach can cause an infection. we know that a single slip can cause an infection. that is why we are looking at every aspect of the procedures so that we can make them safer. and we are empowering health care workers with information because when you're concerned about something, when you're worried about it, i find it's always helpful to get more information about if you can understand that more fully. we understand that ebola does not spread from someone who does not have symptoms, that helps us

understand where the risk is. of health care workers at the fact that they have to take a travel history from anyone with fever or signs of infection, that gives them the tools to protect themselves. and for the health care workers caring for the nurse in dallas, concrete information on what they can do to keep their risk to the absolute minimum can address that fear and keep us able to respond to the needs of the community. next question on the phone. >> thank you. the next question comes from cnn medical news. you may ask your question. >> hello, i want to get clarification and then a question. did you say the 48 of the 48 people people who were in contact with the index patient, because of their past the two thirds mark passed for 14 the 14 days they are unlikely to get ebola? >> yes. two thirds of the incubation period is far more than two thirds of the risk. and in most of the cases, they happen within those eight to

ten-day windows. we put it on 21 days to be on the safe side. it doesn't rule out that there could be cases coming up among those individuals but it would be unusual. your question? >> thank you. the next question comes from jackie with "newsweek." you may ask your question. >> hello, i would like to find out what, if anything, the cdc has learned from the outbreak response in west africa by organizations like doctors without borders? >> we work very closely with msf, doctors without borders, and we have in fact undergone a participated and replicated their training course here. we work side by side with them in africa and one of the challenges is that the african environment and the u.s. environment are different in terms of health care. so the things that are done routinely in africa and ebola words are not necessarily transportable to the environment in the u.s.

but we think that they do a terrific job and we work very closely with him. the next question on the phone. >> one moment please. >> the next question comes from jack fink with cbs 11 dallas. you may ask your question. >> thank you, everyone. i appreciate it. i wanted to find out have you been able to identify the breach and protocol that led to the nurse getting infected. how crucial is that and exactly how are you going about figuring all of that out? >> we have not yet identified a specific interaction that resulted in the exposure and infection of the nurse. the way we do that is to review in great detail everything that occurred. she has been terrific at assisting our investigators in going through the steps so that we can all try to learn together how to keep health care workers safer against the virus. it's something that we don't always come to a conclusion, but

we always identify things that we can do to improve the process and improve the safety of health care workers there. dr. lakey, anything you would like at this to . >> i don't think so, dr. frieden. again, the patient has been working with the team. looking at the procedure. there's no specific error that has been identified very at we are looking for a closely up the protocols and how we can maximize the ability to contain the virus. there's been no identified item at this time. thank you. >> thank you. next question on the phone. >> our next question comes from alice park with "time" magazine you may ask your question. >> hello, you said you mentioned that you have no sense wondered whether you should have sent the team immediately when mr. duncan was diagnosed. can you talk about why that wasn't done then? >> we did send a team and superb

epidemiologists. we assisted with the texas contact tracing and investigation and monitoring of all aspects of the response. we did not -- we did send some expertise in respect infection control, but i think with 2020 mankind site, we could have sent a more robust inspection control team and then more hands on with the hospital from day they won with how this should be managed. ebola is unfamiliar and it's scary. getting it right is really, really important because the stakes are so high. so some of the things that the hospital might do that they might think would make things worse or safe, might make them less safe, such as using additional layers of protective equipment. so i think that when we look back, we say yes, they definitely should put an even larger team on the ground immediately and we will do that from now on anytime there is a confirmed case. the next question on the phone.

>> thank you. the next question comes from crisper as with the "new york post." you may ask your question. >> [inaudible] >> please check your mute feature. >> we will go on with the next question. this question is from the telemundo network. you may ask her questions. >> my question has to do with the four hospitals in the u.s. that specialize in treating the highly contagious diseases. why are there only four of these vial containing units two as a follow-up, he said that if necessary would transport a patient one of these specialized hospitals. can you explain the procedure or protocol for that transport the map. >> the hospitals, excuse me -- a hospitals that have specialized rooms are specialized facilities were created because of the risk that there might be a new pathogen. not ebola, but something that is unknown and we don't know how it spreads. that is why at cdc and other parts of the federal government

we supported the creation of units that would be particularly suitable to unknown diseases. ebola can be cared for in hospitals as long as there is a core set of training facilities and oversight in place. in terms of transport, we have transported patients from africa. it's a lot easier to transport patients from the united states. in the room, are there other questions? okay, well, back to the phone now with the last two questions. two last questions. >> thank you. our next question is ums news. you may ask your question. >> to give her taking my call. dr. frieden, some are confused on the way some have recovered from ebola and how some have died from the disease even though there is no vaccine. you know that according to your knowledge why some people survive the disease and others do not remap. >> we are not sure if all of the reasons why some people do better than others. but we know the people who are

healthy going into the infection are more likely to come out of it. we also know that health care, standard medical care, can make a really big difference and at least double the likelihood that a patient will survive. helping a patient fluids balance, electrolyte replacement after being lost, it is be -- it is being given and it's being done in dallas is needed. this is something they can make a really big difference. there are also experimental treatments that may or may not help and make them treated for this. it may be that this person gets the treatment, but it's up to the treating physicians to make that decision. last question on the phone. >> thank you. greg schneider with the atlanta journal-constitution. >> hello, dr. frieden, thank

you. i wanted to get a sense as to what degree the team, you have been talking about, has been sent over to emory university in atlanta or if there is art he won at emory? is that has become the model of what you're doing to put this all together for elsewhere? >> both emory and the hospital and nebraska have very sound protocols and now have experienced treating ebola. two nurses from emory already in dallas helping them. these are two facilities and we are all now working together to learn what works best and what is more practical to stop ebola in the hospital. before i make any concluding remarks, dr. lakey, would you like to say anything? >> thank you, dr. frieden. again, i really do appreciate the teamwork and the support from the federal government and the response right now. and also in dallas. the epidemiologists are working really hard to map out needs to be monitored, monitoring those individuals and the hospitals working really hard to make sure a patient gets the best care possible. we're doing everything we can to

ensure that this does not spread further from the individual that is currently infected and anybody that's already been exposed and doing everything we can do to ensure no other individuals are exposed from currently being infected, we are doing everything we can to make sure that no other individuals are exposed here in the texas. take you very much. >> thank you. just to wrap up, first we are focusing on dallas, supporting the patient in the hospital and minimizing risk that there will be any further exposures with a very robust expert team on the ground, working around the clock with one of the hospitals and the public health teams there. second, we are increasing our education and information to help health care workers threat the united states. we are also initiating immediate response team from cdc to any future case of confirmed ebola in the united states so that we will be there with hands-on training within hours to help the hospital deal with the situation if there is another

case. and third, we are continuing to follow up with dallas on contact tracing and identifying everyone who may be at risk so that the same kind of decreased from 48 people to one persons can be continued if there are any further cases. take you all very much for your interest. >> we will have more about ebola from the cdc director tom frieden on thursday. coming up next, and oversight hearing and we will also hear from anthony fauchi, the head of the national institute of infectious diseases. live coverage begins at noon on c-span. >> be part of the campaign 2014 coverage. follow us on twitter back like us on facebook to get debate schedules and video clips of

moments and debate previews from our politics team. c-span is running you over 100 senate, house, and governor debates and you can share your reactions instantly to what candidates the candidates are saying. the battle for control of congress. stay in touch and engage following is on twitter and like us on facebook at facebook.com/c-span. >> a conference on ebola at johns hopkins in baltimore. health experts discuss the differences between the various strains of the disease and what means to diagnose and treat ebola. this is an hour and 15 minutes. >> and one come everyone. i am at the bloomberg school of health. i would like to welcome everyone

to do symposium today. everyone in the room and everyone was watching on the internet. as you know, the title of this symposium in is ebola, crisis, context and response. our school was founded 99 years ago and since then we have stood ready to confront the world's most pressing global health challenges and ebola is no exception. currently our school and the john hopkins university school of medicine and nursing have faculty and staff in central africa that are working to reduce transmission of ebola, prevent death, and ill trust for families and communities. the ebola virus is threatening the lives of people living in west africa and creating uncertain tea and fear in our country and other countries around the world. thus, this is a critical time for thought leaders and experts from multiple sectors as well as the johns hopkins community to educate about the virus.

today we will discuss the impact of the epidemic in west africa. parents and responses. the therapy is and recommendations on containment strategies to prevent the spread of the disease. i would like to knowledge our alumni who work around the world and especially those that are working with doctors on the frontline of this crisis. and especially i am pleased to recognize our doctor that is here with us today. he's the international order nader who is at the school for the 25th reunion of the 1988 mta class. so welcome to the doctor and the 1998 class. [applause] .not and i also welcome our spes and went to thank them for being with us on short notice. i am grateful to the departments

of microbiology and immunology who organized the program and to keep elliott and his team who provided the logistical and organizational support. thank you both for your leadership. it was just about a week ago that the director of the malaria research institute are at the bloomberg school contacted me to suggest that we invited speaker to discuss the epidemic. that idea grew into a symposium but it was her universities president, ron daniels, who talked about bringing this to as large an audience as possible. one is the 40th president of johns hopkins university. a former pro-west at the university of pennsylvania he was professor of law at the university of toronto. since his arrival since 2009, he has brought an appreciation of global impact with his programs

in 120 countries while emphasizing the importance of johns hopkins as an institute in baltimore. he has articulated strategic goals for the university and lead and pushed us to become one university. he is a scholar at the intersection of law and governance and economic development. he is an elected fellow of the american academy of arts and sciences and has received many awards and honors including an honorary doctorate from the university of toronto. it's my pleasure to welcome ron daniels to the podium. [applause] [applause] >> thank you so much, mike. and thank you for your great and inspired leadership. what a remarkable louisburg school of public health. i want to thank the faculty and staff of the bloomberg school will have worked to bring together the remarkable assembly of colleagues from across the

nation to share their experiences and expertise. to speak with which this symposium came together is tough because of the debt and breadth of our capacity across the divisions from bluebird to the school of nursing to the school of medicine to our affiliated partners to human capital to help understand mounting public health crises and inform the response. this is, simply put, what are people do and india have always done. as a member of the public health service, johns hopkins professor compiled and analyzed data on the app epidemic of 1918 to 1919, providing the foundation for tracking still by the public agency today. the first step in controlling an epidemic is accurate diagnosis. time and time again, johns hopkins individuals have identified from polio to fevers

that are vulnerable on populations. the bloomberg school mom and i led the who campaign to rid the world of smallpox and then returned to the school. in the early years of the aids crisis, playing pivotal roles in identifying the population in sponsoring the spread of disease in hospitals and clinics from baltimore to uganda. now as the numbers of ebola cases and the death toll rises, as nations and communities across west africa struggle with basic health care needs of populations in addition to managing acute care for patients, as we consider the daunting implications if this outbreak is not met with an international response, we are acutely aware of the obligations with the intellectual and moral bounty is the community wrestles

with this unpredictable epidemic. an epidemic that who director general yesterday declared a crisis for international security. and so with this across the african continent and our expertise including public health and international public policy, we are well-positioned to help ignite ideas around best practices and most importantly turn those ideas into actions, working in concert with our many partners. building on our past work and efforts, they are as we said a few moments ago, well under way as across to aid in the response and to work with the ministries of health. these collaborative efforts range from implementing training programs that would put 1000 health workers in liberia to assist with care and academic

management. they are developing a robust and realistic analytical model that will help those leading the fight make better strategic decisions and in the present. and to create a communication strategy to educate and empower workers and to put the most current information in the hands of the population. of course as a research university we play as evidenced here today another essential role, we are told convener of importance in these controversial conversations. in these conversations with today's speaker, michael osterholm has extolled us to do, we ask questions that the world is most afraid to ask. and we can create a scaffold to discipline an informed debate and we reckon with the answers no matter how daunting or complex or how unnerving they

are. once again, this is a moment where they must be present and for hopkins, this is more than a professional obligation and it demands that we continue to deploy personal courage and grit that defines us. so for all of these reasons to be here today, your president and your engagement inspires optimism and i know that this will be a productive day and i think each of you for being part of the important work that lies ahead. i hope and trust that we will be able to do more to lead the our experts and energy to the african continent. so now i would like to turn the program over to the associate professor of molecular your biology at the bloomberg school of public health and research is focused on influenza but it's

emerging research has led to research on other viruses including the enterovirus d-68 and ebola. recognizing the discoveries can be an important part of communicating effectively with the media and the broader public. in addition to the instrumental invaluable role in organizing this symposium, he will be monitoring today's program. andrew pekosz, thank you for your extraordinary efforts to bring us together. take you both for being here today. [applause] [applause] >> thank you for the speaker's web kindly agreed to be here and speak on tort notice. welcome to the audience and for everyone who is reading this online as well. putting together a broad wide-ranging and informative symposium that we are told every

one can appreciate, we are into general sessions ominous warnings session will be five presentations on a variety of topics related to response preparedness dealing with the epidemic and we will take a short break and then we will have our featured speaker here giving his keynote address. then we will convene a panel. at that point in time we really hope to engage the audience in terms of asking any range of questions that they have regarding challenges for the intervention mitigation strategy for the outbreak. we want to focus our questions here as it's going on right now in west africa and honestly concerns about this outside are things that we touch on as well. and so without further ado, i would like to introduce the first speaker. dave peters is a professor of

the school of public health. his seminar is entitled be helpful, be hopeful despite ebola. [applause] >> [inaudible] >> identify my wife, or you can find her. [laughter] >> okay, let's start at the beginning. okay, there we go. >> enqueue very much. and i am pleased to be able to talk with you about the community they strategy to fight ebola. it's an operation that we are privileged to be involved in. i would like to first put it in a little bit of context. of course we see the ebola disease being the center of this and this is a picture of the

emerging epidemic in terms of the number of cases and as you can see although it started sometime in december, we are now in the ex-potential part of the curve and so it is increasing concern about this and i think that others are going to talk more specifically about the patterns. but it's not just about the virus that started all of this. there are numbers of other types of epidemic that are going on in west africa as well. first of all most, after the virus of felt, a contagion of fear and distress. only within the country but also internationally. this has led to another several patterns and it's important to recognize what we are doing and why. so this has to do with a series of self reinforcing types of feedback situations that we to epidemic. one of them being with the

health system itself. it started off being a very with weak health system and they had four strikes before the ebola outbreak because of the inability to pay off workers. and when the epidemic struck of course we had a tragedy with those dead in liberia alone. the clinics have been closed and this leads to the worsening of health conditions and collateral damage not just for ebola, but also being like malaria, diarrhea and pneumonia. so this type of reinforcement is part of it. but also in terms of the economy and livelihood and these people are not always been harvested. there are lots of trade and comes and of course feedback around this area. and then another one around

social capital and institutions as the government has been unable to deliver services to the type of need with government institutions and a real damage to cohesiveness and culture that is reinforcing. part of the way of getting these cycles is to break the leadership. i wanted to highlight to the assistant minister of health in liberia, he is the person for the outbreak in liberia. he is also a graduate of the school of public health and he has written how it is important to pay international support in winning the public's trust to stop the outbreak. his statement is that we must be helpful and stay hopeful to his own staff and his own people. the slogan within liberia is to

be effective stay safe and keep serving. so part of the rationale of moving to a community-based strategy actually emerges from the area of liberia itself. and so it shows basically the cases over the months where monrovia, the capital is. but what you see is the one that started off in his axis turning to curtail off. this is one of the early counties where they have a problem with fear and a lot of distrust. what has happened is that communities are mobilizing in different ways organize them knows to try to address the epidemic. this has become the focus how the community care center is being managed out of these

emerging properties in the county itself. there are other rationales and these are some pictures from those who have known to us in the community care center hospitals. what he is showing here is in liberia there is not a lot of running water and this is the kind of creativity that they are trying to do so that people can wash hands. until actually trying to find ways to improve hygiene. so these are things that are sort of happening in the community themselves. a lot of innovation. there's analysis but also backs up the notion of the community approach including those that we were collaborating with a took the models and updated them and try to model some of the strategies here in the u.s. strategy of bringing of vets from hospitals. you can note the curve in the

production in february. and it's actually that you need a lot of extra will mobilization and a few add to this the ccc strategy you can come up with a lower projection. there's some analytic support to this as well to support this kind of approach. and so the other rational comes from experiences self. this is another one of the eight leaders that i think that we should recognize in the outbreak or a minister of health from the congo. and they have experienced seven prior epidemics and are currently managing them. in discussions he is having with us and others, the describing that the control depends on a community-based care strategy.

the touring the city offered to say that we have 120,000 doctors and nurses in congo and we have the experience and we have offered to bring a thousand of them to west africa and that is where we get involved work with, who and the others involved including the world bank. so part of the test was to facilitate how this works and it's useful to show his perspective how the outbreak is actually working. so this is from going back to these notions of vicious cycles. what you see is the source where the transmissions occurred when you have patience and you can't identify them, trying to transfer them. at the hospital level you do the

screening and a new sword and then you have the patient care to the exposure is low and then funerals aren't porton in every society, burials take ways in society and practice not just because of what happened but with dignity for the dead. but it's also long funerals in the next of kin and wash the body, many times they will wash in a common pot and it's a long funerals that can happen through all day and all night and it's a critical part of working in the community together. and so what he has noticed here is that there is an epidemiological component in this context taking care of patients and contract. and it's important as a human

behavior component. what we are seeing is an approach that reinforces fear and stigmatizes survivors and reinforces the bad side of the control and care at all three levels. and so they are notion again of how it has worked successfully is basically by combining the human behavioral and epidemiologic aspects as all of the cool aspects where they try to reinforce ownership and integrate survivals and provide high quality of care and of course this is sort of the notion that is trying to be reinforce. what they have done with lots of experience with, one of this knowledge is passive knowledge and a lot of the roles that we

have laid is to formalize that in a way can be reinforced in a way that we can actually get it implemented further in west africa. so part of this notion was around putting together but the concept is, the community care center concept is. so this is a multidisciplinary team working to define and all three levels of communities, it depends on trained and paid workers and then a whole series of standard operating procedures that we are working with trying to operationalize as well as protect health workers and providing the separate areas as well as having outreach services

and logistics. so the package that has to come together and this is basically trying to codify the response in congo. so the concept has been evolving in liberia and they were originally having this that would later transport this and have this as is a place where you can take your patience and it's also planning to use committee members and volunteers and caregivers and they have transformed that into having paid health workers and the systematic in terms of how they come in. this also health care for those who don't have ebola and basically starting to team up for what looks like.

so just to give you an idea that the drc will have for their team, they have coordination, management and a treatment under with clinicians and biologists and the community outrage side and about half of the clinicians are nurses that are involved. on the liberian team it's about 60 people that will rely largely on community leaders and volunteers were care assistance and education in various types of management. and of course we will need with early translation although we are trying to get as many english speakers as possible into the program. so that is basically an idea of what the team looks like. i want to highlight some of our first responders if we can call them that. we are in the same day of finding out about this and we had three people that came over to work in congo and develop the concept together.

so i want to know particularly these three, nancy. ansi and to understand what the conflict is which is really part of standardized support to do this. trish perl who was currently able to jump across and work on developing the clinical and infection control. and also leadership there. and angela was a recent graduate from the school of public health and she was able to help the mobilization aspects. so we have an ongoing team and i just want to show you about the 30 or so people that are currently involved across the school of public health and just

in terms of who you should pay attention to in particular. trisha is the point person and tom quinn relies on other people to provide assistance. der cummings is taking the lead on the data that will be needed for the day-to-day management and trying to merge the protocols of management. and we have a large team that. we have about a dozen people who are already volunteering either to go to congo or liberia initially and so i wanted to able to talk about it. there's many people and we welcome more support on outside. so what this is here is basically why we are involved and how we can work together. and so one thing is that we are

an honest broker and can negotiate with the different agencies, some of which have lots of experiences. including alumni and other networks and that's important to be able to draw upon. we initially got involved with the analytic support and we will hear more about bad. but it's also a multidisciplinary type of support and implementation research. we are able to provide training and technical support although it's a real challenge to match up our responsibilities here with clinical teaching and the otherwise that we are somehow managing and of course a large area that is needed and we actually need to rely upon our good name to stand behind the protocols because a lot of these will not be the evidence to support them and there's a lot

of other agencies that will be able to stand behind them and it's really about making the most of what we have. so again, i want to and with a statement that had been given to his own staff and his own population, but i think it's just as important here. and the message is that we are neighbors and community leaders and global citizens united for the common good and witty we can accomplish even more. thank you very much. [applause] >> thank you very much. at this time we are going to focus and move on to this presentation our next presentation here. it's my great pleasure to introduce trish perl who is a professor of medicine at johns hopkins school of medicine in her presentation is entitled

rethinking care, lessons from the current and previous ebola outbreaks. [inaudible conversations] [inaudible conversations] >> thank you, and welcome everyone. i want to thank the organizer for this as well as president daniels. i am actually charged with talking a little bit about some of the epidemiologic background and the medical aspects of this particular disease. trying to tied into what the doctor discussed in making the argument that by improving care we can also improve engagements in the community. so just remind everybody that this is one of the viral

hemorrhagic fevers of which there are many. this is a virus coming from the french word [inaudible] and there are two viruses in this particular family, both ebola and of marburg. the ebola name actually came from the ebola river, which is in the republic of congo that was first discovered in 1970. there are five species of this virus and all of them reside in africa except for the one that is found in the philippines. that is the one that does not infect humans as far as we know. the strain is certainly one of the most feared with very high mortality. the outbreak primarily began in