not normally vote in. i think there is this myth, and some of it is based in reality, the democrats vote big on presidential's and not in midterms. i think that signals that this election is a big deal. how big a liability as he?

to my this goes back whole thing on the national environment. is the president particularly popular? no. -- the president isn't on the ballot. are mary landrieu or kay hagan, you vote for a bill not because it is the president's bill. it's because you vote for what is right for your state. something like equal pay for women. something like raising the minimum wage. these are all important issues that have been championed by the president. he is the head of the party. also by our members. they know it is right for their state. republicans, it's funny. reported on it just this week. the republicans thought they were going to win this whole

election by talking about the economy. the economy is getting better. is there more to do? absolutely. we must do more. obamacare. you see that a lot. obamacare is working. the website is getting better. people are getting coverage. they are trying to create a sense of fear and distrust. and that is a sad thing for a party that you don't have a vision you are advocating for. you are saying be afraid. be scared. vote for our guys. is that a messaging strategy that has been effective? >> i think what has been effective is showing voters what are the consequences of what i would deem it a very reckless and irresponsible agenda that republicans are advocating, and orther there in washington, the republican study committee, which is a powerful faction,

they are going to raise medicare or social security. carolina, if you were going to cut education, if you are going to cut things like our and income tax credit, if you are going to make this ideological crusade against women's rights, that is with the messaging is. it's saying to people this is the reality of what is at stake for this election. >> what state has been most helpful or effective? judging attle like game in the fourth quarter. --hink north carolina >> how much of you spent? million -- $60 million. that is just television. we will expand the ways and

reachingt we are voters. americans for prosperity really made north carolina ground zero. in the state government, art pope was the head of the budget. 30 --pent i want to say $30 million to $40 million on television. they have 40 to 50 full-time staffers there. they have been on air since about thanksgiving time. maybe even earlier. i think there is one case that we have acted as a bulwark against the money. so that hagan would get swamped early so she can make her case. she is efficiently and effectively done. >> and save her money. >> and be able to marshal her resources for the end. like that. so she doesn't always have to be

on tv. that is really our role. when these outside groups come in, whether it be the crossroads , it's making sure we are there to fight back. we will never be able to outspend them. we will never compete dollar for dollar. but in 2010, whether wasn't a c, in thejority pa five most competitive races, our incumbents or candidates were outspent about eight to one. those were races we probably should have one. and we just didn't. errors to make sure the are at least competitive. >> eight minutes. >> what a talk about your job. i don't think there is a lot of attention for that. what are you doing on the ground? >> i would expand that how we are reaching voters. it is more than just tv ads.

if you guys live in the virginia your tv getsea, full pretty quick. people grab a sandwich during the football game. we have to make sure we are reaching voters where they are. your facebookn to page, if you flip on pandora or hulu, just really expanding. segmentedbecome more and how they get their information. you have to make sure you are reaching and where they are. aggressivee a very mail program. we have done a very aggressive digital program. is the bulk of what we do. but it is not all that we do. because people do get their information from so many other places. >> 80 get people binge watching campaign commercials. [laughter] >> on the ground, are you

aligned with mostly democratic groups. >> we don't really do much for typical field programs. other than as a just mentioned, making sure to reach voters were they are. foresee in 2016? will the group keep going. ? senator reid will be up for redirection -- reelection. have you talked about this? >> we are focused on the next one he five days. 2016 will take care of itself. this was the most favorable environment for republicans. no cycle will be very favorable on paper to democrats. incumbentsulnerable in pennsylvania, and ohio, and wisconsin. in 2010.at they won

they have two members that are running for president. rob portman ohio has been eyed for vp. they will probably be great opportunities for the senate democrats to further expand the majority that we are going to hold in two dozen 14. as far as us, we haven't gotten there. >> we haven't mentioned mcconnell grimes. that,portant as achieving just thinking back to senator daschle. ? >> both kentucky and georgia and south dakota, but those are really the two best opportunities for pickups. mitch mcconnell, it's a very hard race. he is going to spend probably $50 million or $60 million. he has a whole army of outside groups. but we have been very involved there. we have spent more than $5 million making sure the the

biggest group is on the democratic side. i know that the president is not r in kentucky.a in 2008, john mccain beat barack obama by 19 points. beat his mcconnell opponent by five. he has a history of underperforming. he rarely gets over 50% of the vote. 96.race against loan and he has this feeling. alison grimes is running a very smart strategic campaign. will it be a hard race? absolutely. mitch mcconnell is relentless. he has a whole army of outside money. we will be in a position to win. same with georgia. david pretty was had one of the most devastating pieces of

legislation come out about him when he said he was proud to be an outsourcer. that is deficit. have mored louisiana difficult. >> would you be playing in those? >> georgia, we have been active. we are going for the november 4 win. be the case, we are prepared for the runoff. in georgia, our allies have been strong. thend they go to a runoff, -- >> what we do? >> they think either prices will go up, or the airways will be too crowded. we will be able to battle back to both of those things. some groups are trying to do reserving airtime now.

>> in louisiana, senator landrieu shook up heard campaign, made some changes. most people think a runoff is almost inevitable at this point for. are you doing anything to ramp up in the final days? goi think it will probably to a runoff because of the ballot system. resources tothe continue to be involved there in a heavyweight. it will probably just continue what we have done. >> we won't know the senate majority may be until january. >> that is a real possibility. the new congress could be sworn in before we know who is in the majority. as exciting for people like us. i think we are probably unique in that situation. everyone else would scratch their head. for political junkies, it could ruin christmas and new year's, and ruin the championship game.

kansas, it will decide -- >> he's caucusing on which way he wants to go. i have to say we are kind of wrapping up. is thateen fascinating republican said the incumbents would be off the map. we would be charging virginia, new hampshire, michigan, oregon, minnesota, and they haven't been able to. that is a testament to what we have done, but more important, our candidates and their vision. it's been an interesting cycle. november 4 will be a time we see if our field program -- what they are able to college. we outperform national trends? is making surey,

we keep that democratic majority so that we can continue to build on the work we have done. making sure women have access to health care. students have access to homes. people can retire with dignity. that's why we love the game of it all. >> you mentioned health care a couple of times. year, beginning of the that was the main issue. >> over the last five years, we are probably seen about $1 billion spent around the health care bill. in the bill.hat is you are not going to move it a lot of undecideds. who hate theple bill. destroy not going to the bill. realize thatmiddle the health care system is getting better. prices are going down. saying things like seniors

getting visits. these things are starting to get into effect. if no idea of the scary unknown, coming actual policy into effect. you get republicans going out there is saying we are going to take this away from you. i don't think that is a message that is going to resonate. we have to improve upon it? absolutely. it they don't want to rip out by the root and branch. specifically, i don't the gets the most effective method. >> that's it for our time. ty matsdorf , thanks for being here. >> newsmakers is back with carl hulse. he is pretty bullish on this

come on his chances for achieving his goals. he referenced that most of the polls out there suggested is a tough road for democrats. what is the reality? >> it is close, but doable. some people thought that wouldn't even be possible. i think republicans give a lot of credit to the senate majority pac. i had a republican who went on for three or four minutes. that was off the record, because i can't have a big story about me praising harry reid's pac. they are credited with keeping the democrats in this to a great extent. >> definitely. even going back to 2012, when democrats started using this big , they realize they had to be efficient with their money. have towhat republicans do a lot.

democrats are more efficient and how they spend their money and when they reserve their time on the airways. more efficient. republicans are starting to get nervous about this. slam's certainly not the dunk they hoped it would be at the beginning with mark pryor in arkansas, mary landrieu in louisiana, kay hagan in north carolina. just places where they thought it was going to be a wash, it hasn't turned out to be that. you could still break. i think the problem for democrats is coming to i a lot and coming to colorado. places where they thought they were going to be fine. they had a strong candidate in iowa. it very popular candidate in colorado. the races i amf watching to see what happens there. those could be the kinds of races that decide things. both sides have pretty much dropped away from michigan at

this point. they only got is going to be a competitive race. >> that is a hypocrisy question about spending this kind of money when senator reid has been critical of it. was we don't like the rules, but as long as the rules are in place, we are going to play by them. >> and a really good at it. >> when he responds that way, what is your analysis of his position on some thing like this? >> right now, i think it is bringing in a lot of money for them. for a lot of small donors, even a lot of big donors, a key issue is money and politics. the fact that democrats keep saying that they are opposed to big money helps them get the big checks. which seems ironic, but so much so, that we are seeing the groups that started spending in south dakota on behalf of brett williams. >> they are spending big money. >> it is ironic. they will keep getting asked that question unless they do

something. >> i think the constant attacks on the koch brothers has been attacked -- and an effective issue. sellthink it is a tough when you are always running around complaining about dark money and the influence of big money in politics when you are playing the same game. but also, they would have to do it. they would have to unilaterally surrender. pac, i thinkuper this election would be different. >> this is the most disaggregated media election. you talked about the various ways a are trying to be everywhere, especially young voters. the effectiveness change when you are having to split the pie summary ways -- so many ways? >> there is so much analytics being done in terms of targeting

voters, even with direct mail. i have talked to a lot of direct mail people who have been doing this for years. they say the job has gotten more interesting. beendigital, mail has revived. then tocts the voters go online and look up more about the candidate. or they start getting ads on facebook. case a very interesting where things become more intertwined. >> tv stations should be worried. ins is a cash cow for tv high competition states like arkansas, iowa, places like that. the money has been pouring in. youi think his tie said, see it starting to fragment. and whether or not people in these coming cycles will keep pouring it all in to tv ads on network affiliates, i'm not sure it will be the same it. it's like pulling with cell

phones. >> we are just about out of time. which races are you watching? >> iowa and colorado are the two biggest ones. i'm personally covering the north carolina race. i have been covering up for the last year. i'm interested in seeing what happens there. i think it is going to come down to those two. >> south dakota and kansas are really fascinating. turning out to be something of a political junket. thanks for being here. >> be part of the campaign 20 14 coverage, follow us on twitter and like us on facebook to get debate schedules, video clips of key moments, debate previews from our politics team it. c-span brings you over 100 governoruse and debates. the battle for control of congress, stay in touch and gauged by following us on

twitter, and liking us on facebook. >> coming up at 11:00 eastern, the centers for space control will be holding a briefing in atlanta. -- the centers for disease control. we will have live coverage of the ebola diagnosis on c-span. >> on wednesday, maryland democrat representative donna edwards was the keynote speaker for the center of american progress. she spoke about the underrepresentation of women and people of color in elected office. following her remarks, a panel discussed the current makeup of elected officeholders and outlined ways to get more women and minorities to run for public office. this is about 90 minutes.

>> hello, everyone, and thank you for joining us today. i'm the executive vice president of external affairs here at the center for american progress or to i'm so pleased that you are all with us here today. you may know that women of all races make up just 18.5% of the united states congress. women of color makeup and abysmal 4% of the congress. these numbers exist in direct contradiction that women make up half of the population and are more likely to vote than their male counterparts. this afternoon, we will hear about the reflective democracy

campaigns new research which shows that this persistent underrepresentation of women and women of color exists throughout the country at all levels of government. over the summer, the reflective democracy campaign finished an unprecedented new database of more than 42,000 elected officials throughout the country. their survey showed the great disparity in gender, race and ethnicity between our elected lawmakers and those whom they represent. i would like to thank donna hall, president of the women donor network of which the reflective democracy campaign is a part and brenda carter, director of the reflective democracy campaign for bringing their new research to share with us today. thank you so very much. [applause] at the center for mac in

-- american progress, we believe our growing diversity is an asset and that our democracy is strength when -- strengthened when elected officials reflect the constituencies they serve. evidence suggests there is much to became from encouraging a -- be gained from encouraging a greater number of women and people of color to run for office as well. studies including the one we will discuss today continue to suggest that places with more reflective lawmakers produce more progressive policy outcomes. this data from the reflected democracy campaign is a new starting point for a necessary discussion as we look ahead, not just to november midterm elections, but more importantly, 2016 and beyond. how can we understand, address and ultimately reverse the chronic underrepresentation of women and people of color in politics?

here to address these issues is ,ur keynote speaker representative donna edwards. she represents maryland's fourth district, comprising portions of prince georges county and anne arundel county. she was sworn in in june of 2008, becoming the first african-american woman to represent maryland in congress. i find that stunning and startling. the first african-american woman to represent maryland in congress. she has enjoyed a diverse career as a nonprofit executive director of the national network to end domestic violence. if she led the effort to pass the violence against women act that was signed into law by president clinton. since being sworn in, she has secured a number of legislative accompaniments to improve the lives of working families in her congressional district and around the country. her first act as a member of congress was to add maryland to the afterschool suppers program,

ensuring access to nutritional suppers to after school and youth to after school and youth develop programs in schools located in low income areas. during the health care debate, edwards secured a that holds insurance companies accountable for un-justifiable rate increases. she has also introduced legislation to expand research and a moment, domestic manufacturing and infrastructure spending to great jobs and grow our economy. she was also the first member of the house to introduce an champion a constitutional amendment to overturn the supreme court's citizens united decision. we cannot be more honored to have congressman edwards here today to share her perspective on this critical issue. please welcome congresswoman donna edwards. [applause] >> thank you very much. good afternoon, everyone. i'm so delighted to be here at one of my favorite organizations.

i cannot tell you what it means to have cap at the table making sure those of us who are policymakers really have the right stuff in front of us to do that job. thank you very much. i cannot say enough about women donors network. i came to know them many years ago in my time in philanthropy. i have come to know the woman of wdn, including donna hall. we have been able to work together on a number of issues over the years. i appreciate your leadership. what a better time could we find to discuss leadership and leadership development and reflective democracy? in fact, they are the same thing. when i think about -- as i was listening to my own biography, my story is a story of what it

means to have reflective democracy. i was stunned as well when i won the election in 2000 eight and 2008 and people said to me, you are the first african-american woman to represent maryland in congress and i denied it. that cannot possibly be true. how could it be true that in a state that was the home and centerpiece for harriet tubman and sojourner truth and frederick douglass? how can it be possible that i'm the first african-american woman to represent maryland in congress? and yet, that is the question as we look across the united states that we have to ask ourselves because increasingly around the world, we are coming in on the low end when it comes to leadership that reflects our population. i want to talk about what that means for women.

i am on the political side, the recruitment chair. during this cycle, we recruited of our top-tier candidate, a majority of them were women. i don't think it's an accident when you have women around the table helping the conversation about identifying candidates, talking to people, that you will come out with an awful lot more women. i'm proud of that, but it's not enough. although it is true that in this congress, we have a majority of democrats in the house of representatives that is more representative than it has ever been, if you take a look together at the aggregate of african-americans in congress and women in the congress and lgbt members in the congress, we are more a minority majority congress on the democratic side than we ever have been.

but that is not the whole congress and it is not at large. the difference when you have representatives at any level of government that better reflect the population and the communities we serve, the better public policy will be. issue not be an accident or a surprise that my first act of congress was to add maryland to the afterschool suppers program. part of that is because of my experience as a mom. the experience of a single mom, a struggling mom, to put food on the table and make sure when my son went to school that he had enough to eat. it was thinking on that experience along with marrying that to the experience of so many in my congressional district.

they should not be a surprise that the priorities for me as the chair of the democratic women in the house and the cochair of the bipartisan women's caucus that i put at the front and center of equal pay for equal work. making sure we have one day of paid sick leave. focusing on things like child care and providing access to quality affordable childcare. i want to talk about that for one minute because we know that two thirds of america's workers who work for the minimum wage are women. an awful lot of those women are women of color. it makes a difference when you're at the policy table about whether that becomes a priority or not. that is reflective democracy. when you think about things like equal pay for equal work, i was with a group of senior women just yesterday. over 100 of them.

i started talking about equal pay for equal work. the overwhelming majority of them are not working anymore and they are retired. most of them are either living on a small pension if they were fortunate enough to receive one or they are living almost exclusively on social security. what does it mean for those women the fact that we have not made sure that we have equal pay for equal work and that is not front and center of our policy agenda? they entered their retirement years having lost hundreds of thousands of dollars in income, unable to contribute to their own retirement security because they did not make the same amount as the man next to them who had the same education and experience. we need leaders at the table

that reflect those experiences and are able to contribute to the policy discussion to make sure those policies become reality. i had an experience when i was raising my son. i was really struggling around the issues of childcare and paying for mortgage and those things. i remember when i ran for congress, there were some people who said to me, "you should not talk about those things. people don't want to hear about that. it will make you seem to soft and no one will want to vote for you." nothing could be further from the truth. my ability to speak about my experiences as a single mom and as a worker really contributed to the conversation about why it is that i should be elected. those are the conversations that can come to the table when we have democratic representation that reflects our communities. why do i think that childcare is important? i was one of those moms paying one dollar a minute for every minute i was late picking my son

up from childcare on a fixed income when i cannot afford that extra dollar a minute. in washington, it's more like $18 a day if you are stuck in traffic. i had to get what i already knew as a mom to be substandard childcare for my son and he ended up with meningitis and i almost lost them. talking about these issues is exactly what the idea of reflective democracy is all about. frankly, we can have the kind of democracy that all of us aspire to and want if all of our voices are at the table. 18.5% is not enough in the congress of the united states to reflect a population of a majority of women who need to be serving in elected office. it's just not enough. it's not enough that we've gone through what, 238 years of

our country and not had a woman at the highest level as president of the united states and as commander-in-chief. it's maybe been 238 years too long for that. maybe 238 years too long that we only have a very small percentage in the congress of the united states. we have to do better. when i think about my african-american sisters in the congress, we are a small cohort. we sure bring an awful lot of different conversations, even at our table with african-american male colleagues. it's not enough for us to say that we can elect people of color into the congress. it's time for us to elect women into congress. finally, i would like to close by sharing with you this story.

the story of a little girl who is in her preteen years with glasses and braces and no one wants to take out those pictures of any of us in middle school. i had one of those pictures. i began to look at leaders like barbara jordan and i thought, my gosh, i want to be like them. i looked at my mom who had worked so hard all her life, taking care of six children and trying to grow them into responsible human beings and i marvel at that because i had enough of a challenge trying to grow one child into a responsible human being. i think about my grandmother who struggled when she was farming with my grandfather and really struggled to put food on the table and when the farm was not working, she would go and clean houses and she never had more than a high school education,

but she was one of the most brilliant, smart women you would ever meet. we have these legacies in our country and it's about time that our political leadership actually reflected the kind of legacies we have in every single family and every single household. thank you very much for having me here today. i'm hoping to sit in on a bit of the panel discussion. thank you to the women donors network for the research that you've done that can really inform the direction we take. going into -- we are about to finish one election season. going into another election season, wherever it is that we find ourselves, it's time that we stopped just asking women to run. it's time that we really support and get behind them when they do.

more than that, to stand behind them when they lead. thank you very much. [applause] >> good afternoon, everybody. as the other donna said, i am the other donna. my name is donna hall and i have the privilege of serving as the president and ceo for women donors network. it's wonderful to have you here today because for us to have donna here with us, it's a celebration that takes me back to the time when i first met her. we were going to chile and michelle was elected the first time, the first elected president in south america. there was a group of 15 of us who traveled there. she made it a campaign promise that half of her cabinet would be women. when we went to see her inaugurated and she asked her

cabinet to stand up, it was a remarkable thing for all of us from the united states to see 10-20 leaders stand up who are women. is wonderful to have you here today. this is a follow-up to one of those questions. how do we really get women and people of color into office? as i mentioned before, i'm the president and ceo of the women donors network. we are a national network of 200 members. we strive to make structural strategic changes through catalytic and collaborative funding and through working in partnership. that's what brings us here today. who leads us? this is our topic today. america was founded on the ideal that all people are crated equal and have a stake in how our nation is governed. we may not always succeed, ours

is a history of pursuing this vision. it's not enough that women and citizens of all races have the right to vote. every american must have equal access to lead as well. today, we are here to confirm with hard data, the extent of a very serious problem. the problem that our elected officials do not truly represent the populations they serve. our research reveals what we all knew, white americans and particularly white men maintain a powerful hold on the political representation at all levels in our country. we have long been concerned that women and people of color do not have a real voice at the tables of power. we have learned this over and over again as we apply a lens to all works we engage in. a lens that overlaps race, gender and class as it applies to the problems of our time.

this concern is not limited to election office holders. it also extends to the halls of business, the arts and many of the large and powerful nonprofits and foundations. we all agree that there is a growing awareness of this reality and a lot more discourse today than there used to be about these persistent patterns in our society. for us, we have decided to start with a narrow focus on elected officeholders as a strategy to reflect the democracy. today, we're here to describe that we now have an open source database that has compiled demographic data, including race and gender for the first time on over 4200 officials in the united states, from the federal, to the state, to the county and down to large cities. what you will hear and see shortly tells a very stark story. one that will surprise you more than you think.

it suggests that in order to have a real democracy, we must work purposefully to remove structural barriers. we got this work started, but we can't do it alone. we invite you to partner with us as we move this work forward. and next two weeks, we will be releasing more data and an interactive tool that will allow anyone to see how their state stacks up when it comes to representation of women and people of color. we will issue a toolkit for taking action. in 2015, we will focus on working with partners to develop projects that contest different solutions for tackling structural barriers that will result in a more reflective democracy. before interviews brenda, i want to take a couple of seconds to a college people here today who have really helped us with this work in getting us to this stage where we are.

i want to thank wendy for hosting us today. cindy, who i see in the back. they worked with us throughout 2013, helping us to distill our focus and provide the overall structure for this reflective democracy. we could not have done the data projects you are hearing about had it not been for the great folks at the noi and rutgers university center for american women in politics. our opinion research firms and our communications. they have been partnered with us to do a lot of work in a short period of time. toally, i would like acknowledge jennifer, who is the senior director and is really managing this large initiative.

let's get to the meat of our conversation. i would like to bring up brenda, our campaign director. she joined us in january. she has a rich history of campaign work and working in electoral politics. she was the perfect person to take over and i'm delighted to call you up. thank you. [applause] >> thank you, donna. i'm really lucky, or maybe really unlucky to be the person who gets to present the results of an effort which was conceived of and carried out by a large team of people, many of whom are here today and some of whom have in up all night getting our website and other assets going.

i really appreciate your work and i want to second donna's thanks to all of you. today, i would like to do three things. first, on going to talk about what our research revealed. second, offer some preliminary thoughts about what it suggests. third, talk about where we go from here. let's look at a short video we put together. if i can operate this. [video clip] >> have you ever wondered, what does america actually look like? let's zoom out from the people we see in the media and the people we talked to everyday and look at the big picture. 314 million of us live in the united states. 51% of us are women and 49% of us are men. 63% are white, 37% are people of color. our country is changing fast.

but of the people who represent us, from city council to congress, keeping up with that change? do we live in a reflective democracy? we did some research, and here is what we found. we study 42,000 elected officials who represent us from the county level all the way up to congress. if they reflected american populations, our elected officials should look like this. it actually looks like this. 71% of elected officials are men. 90% are white. 65% are white men. that means men have twice as much power as women. white americans have three times as much power as people of color and white men have eight times as much power as women of color. when 31% of the population controls 65% of elected offices, that mosta surprise

americans feel our democracy is broken? to learn more about the data we have collected, visit us online and share data with your friends and tell us how you think we could become a more reflective democracy. [applause] >> just to recap, we looked at the people who hold elected office from the counties of the national level, and we matched race and gender using both self-reported information and voter file records. we found that 90% of those officeholders are white. only 63% of the population is white. 71% of them are men, compared to 49% of the population. so again, this is what it would look like if it were truly reflective. this is what it actually looks like.

white men who are 31% of the population holds 65% of these elected offices. effectively constituting a vetoproof minority in our political system. we have all heard plenty about the demographics of congress. we wanted to take a deeper look, diving into the demographics of local level elected office. when we started the research, some of us, including me, held out hope that we would discover a more diverse and gender balanced pool at that level. for the most part, that hope did not become reality. women are slightly more well represented in the state legislators and county

offices, holding 25% and 30% of those, respectively. but they hold only 21% of statewide offices and 19% of congressional ses. for people of color, the level of representation at the local level can only be described as dismal. people of color hold only 7% of statewide offices and 9% of county offices. their representation in state legislatures is slightly better, but still less than half of their share of the population. i have spent a fair amount of time cooking about race, gender, and power. i am rarely accused of being an optimistic person. in spite of all of that, i was shocked by the numbers. what they show us is an imbalance of power so stark that if we saw it in another country, we would undoubtedly conclude that something was very wrong with that political system. that judgment should apply no less to ourselves.

what is going on here? what is the cause of the problem? there are three main places we could look for the answer to the question. first is in the nature of local -- political office itself. proponents of the view that this is the cause of the problem argue that there is something about running for and holding political office that is so exceptional that it really cannot be held to the same standards as other occupations or fields. after all, this argument goes, being a politician is not really like having another job. it is an unusual thing to do and tends to attract people with an unusual set of skills and interests. so we cannot really expect politicians to look like america. we are leaving this program to bring you a live briefing from the center for disease control in atlanta. we will have two speakers and

take questions. for those of you asking questions in the room, please give your name and affiliation. our first speaker today is the cdc director. >> good morning, everyone. thank you for joining us. we are deeply concerned by the news that a health-care worker in texas has tested preliminarily positive for infection with ebola virus. confirmatory testing is underway at cdc and will be completed later today. occurred inw what the care of the indexed patient, the original patient in dallas, but at some point it was a breach in protocol and that breach in protocol resulted in

this infection. the health-care worker developed symptoms on friday. they were assessed last night and this morning -- sliced -- last night, i should say -- today's sunday. and were assessed friday tested yesterday and the laboratory response network laboratory in austin tested their results preliminarily positive. that result came in late last exactly 12 hours ago. i will outline the steps that we before, since,g and in the future to address this. the individual was self-monitoring and immediately on developing symptoms as appropriate, she contacted health-care system and when she came in she was promptly isolated.

the level of her symptoms and indications from the test itself suggests the level of virus that she had was low. there are four things we are doing at this point. we do to make sure everything possible to care safely and effectively for this individual. second, assessing her possible contacts from the moment she cdcloped symptoms, and the team lead for the dallas investigation has interviewed her, and it appears at this time there is only one contact who may have had contact with her while she may have been infectious. that individual is under active monitoring. we are evaluating other potential health-care worker

exposures. was exposed,idual which they were, it is possible that other individuals were exposed. we know this individual did provide care to the index patient on multiple occasions and that care included extensive contact. we will undertake a complete investigation of how this may have occurred. that is so important so we can understand it at her and intervene to prevent this from happening in the future. into a little more detail on what we are doing to promote safe and effective care and then on the investigation. in terms of safe and effective care, we had already begun several days ago to ramp up the education and training of health care workers at this facility.

the care of ebola can be done safely, but it's hard to do it safely. it requires meticulous and scriptless attention to infection control, and even a action can result in contamination. we are recommending to the facility at the number of workers who care for anyone with suspected ebola be kept to an absolute minimum. third, we recommend that the procedures that are undertaken to support the care of that individual be limited solely to essential procedures. fourth, we are looking at personal protective equipment, understanding there is a balance and putting more on this not always safer. fifth, we are recommending that

there be a full-time individual who is responsible only for the oversight, supervision, and monitoring of the infection withol while any patient suspected or confirmed ebola is being cared for. sent additional staff to texas to assist with this response, and we will continue to work closely with them. in the investigation itself, we look at three different phases. what happens before someone goes where someone with suspected or confirmed ebola is being cared for, what happens in that space, and what happens when they leave. where we will be looking particularly closely is the performance of kidney dialysis and respiratory intubation. both of those procedures may spread contaminated materials and are considered high risk procedures.

they were undertaken on the indexed patient as a desperate measure to try and save his life. and taking off respiratory protective equipment, we identified this as a major potential area for risk. when you have gone into and potentially soiled or otherinated gloves, mask, things, to remove those without any risk of any contaminated and thattouching you being on your clothes or face or skin and leading to an infection is critically important and not easy to do right. these are areas the investigation will look at, but we don't know what it will find. we will be doing that over the coming days. before i turn it over to the doctor, i have the commissioner texas held services.

unfortunately, it is possible in the coming days that we will see additional cases of ebola. this is because the health-care workers who cared for this individual may have had a breach of the same nature of the individual who appears now to have a pro-limoneira positive test. -- preliminary positive test. none of whom so far had developed symptoms are fever or in any other health care workers who may have been exposed to this indexed patient while he was being cared for. we are still determining how many health-care workers that will be. that is an intensive investigation. it takes many hours of tracing steps. we will always cast the net wider. to peopleo risk outside of that circle of the health-care workers who cared

for the patient and the initial orpatients who had definite possible contact with the indexed patient who we have already identified. the second point i want to make is that what we do to stop ebola is to break the links of transmission, break the chains of transmission. we do that by making sure that every person with ebola is probably diagnosed, promptly isolated, that we identify their contacts, and we actively monitor their contacts every day developays and if they symptoms are fever, we do the same process again. that is how we have stopped every ebola outbreak in history except the one currently in west africa. that is how we stopped at in l agos -- it in lagos, nigeria. that is how we will stop in dallas. breaking the links on the chain

of transmission is the key to preventing further spread. now i would like to turn it over to dr. leahy. >> this is david leahy, the commissioner of health for the state of texas. i appreciate all the support not only overnight, but over the last several weeks as we have been working through this unprecedented event. our staff have been working throughout the night, trying to gather more information. as we get more information, we will provide that information. as the doctor noted, we have one health-care worker that had extensive contact with the initial patient who did what was with early symptoms came in to be checked. we facilitated getting the blood test done. that test came back at 9:30 last and was positive. the controls were appropriate.

the amount of virus in her blood was less than what was there when they first indexed case came back. our hearts really do go out to family.ividual and the a health-care worker who is willing to compassionately care for mr. duncan. our thoughts and prayers are with them. we have been preparing for events such as this, putting in contingency plans and refining those plants. a lot of work is taking place right now. the 48 original contacts continue to be monitored and they continue to do well. we have this one health-care worker that now needs our care. we willrieden noted, continue to monitor health-care workers, stepping that up to make sure any health-care worker that has any fever or any other

symptoms will be quickly , continue to work to make sure the infection control practices being informed at the performed at the hospital are at the highest standards and informing what happened that allowed this individual to be infected trade -- infected. we have brought in more public health officials, epidemiologists, to make sure we have the individuals we need to fully evaluate the situation. i appreciate the work from the .dc and their work from texas thank you. we will not take questions. we will start in the room and go to the phone. worker haslth-care had multiple contacts with the

original patient. hasour interviews with her, there been a chance that occurred with this breach in , anything whys you're focusing on that part in your investigation. >> we have spoken with the health-care worker and that individual has not been able to identify a specific breach. the way we do investigations like this is we look at every single direction, the nature of that interaction, any other information we can gather. i was not mentioning taking on butff ppe or procedures, these are the two areas where we see the greatest risk. the involvement is going to change the way health-care workers interact with these potential patients, wearing more

gear -- what will change now? >> it is concerning, and it tells us there is a need to enhance training and protocols to make sure the protocols are followed. the protocols work. we have decades of experience caring for patients with ebola. we know even a single breach can result in infection. figuring out how all the things we can do to minimize that risk such as those i went through, reducing health care, reducing a re,cedure can't -- procedu having a site monitor there, these are all things we will look at closely. we will go to the phone for questions. >> thank you. if you like to ask a question, please press star one. question comes from [indiscernible] you are saying how one slip

can be so dangerous. there any consideration of moving to a system where you would move patients to the specialized units where they are trained instead of treating them in hospitals where they really don't have that training. >> we are going to look at all operations to minimize risk. we can't let any hospital let their guard down. an american returning or somebody else coming into this country you had exposure and maybe did not have an awareness of that exposure may become ill. to rapidlyospitals consider, isolate, and diagnose people who may have ebola. anyone who has been in guinea, liberia or serially own in the leone inays -- sierra

the past 21 who has a fever could -- should immediately be isolated and tested for ebola. that is something we will absolutely be looking at. >> on the phone, next question. [indiscernible] next question. the line is open. wondering if you could say anything more about the kind of extensive contacts, what was the role of this person who has become infected, and if you could clarify the monitoring process.

some of the other contacts getting in person visits? what is a process for taking temperature and reporting in? >> i will turn it over to commissioner leahy. i really do want to thank the texas and dallas health authorities who have been working around the clock since the diagnosis of the first everyt and have monitored one of those 48 patients and and theyir temperature have now intensively started to address this latest development. the 48 individuals that have been known to have contact or potential contact, those individuals have daily had an on-site visit. they have had a subsequent fever check later in the day. the health-care workers where there was no breach incontact were doing self-monitoring. case we arethis

looking at, the ongoing monitoring of all the health-care workers and looking at having an epidemiologist see them, more active surveillance for these individuals. the health-care workers rather in no -- but no breach personal protective equipment have been doing self-monitoring up until today. >> this woman was not in a group of 48 contacts, she was an additional person? how many more people might this expand that to? >> this individual was not part of the 48. we are looking at defining what that new number is, working on that pretty hard right now. >> in order to identify that number, we cast the net wide. we identify anyone who might have had contact and then we do detailed interviews and record reviews with each and every one of them to identify those who

definitely did have contact, those who definitely didn't, and those we cannot rule out. next question on the phone. >> [indiscernible] pleasefrieden, could you clarify what you are talking about [no audio] that try to limit things to essential procedures? what does that mean? anddo you limit procedures not compromise the [no audio] limiting -- as we do ever were, ebola patients are cared for, we try to keep to a minimum the number of health-care workers to enter the area. that reduces risk. ensure thattry to the procedures undertaken are kept to the minimum. for the example, a blood draw to

monitor electrolytes is very important but if somebody is not having diarrhea and vomiting, maybe it only needs to be done once a day rather than multiple times a day. i'm not saying that was done differently previously. that is an example of how we might limit things to essential procedures. next question. i was wondering if you could comment more on the preparedness at regular hospitals outside of this, these bio containment units who have treated the other people who have come to the u.s. incident -- this what do you think it says about the preparedness, generally, of hospitals around the country? are you concerned about hospital preparedness?

you mentioned now and infection should berson monitoring in hospitals. is that a guideline for all hospitals or are you talking specifically about this texas hospital? >> let me answer the second question first. in ebola treatment units in africa, one of the things we have identified as a potential contributor to infections that have occurred there is a lack of an on-site manager at all times who doesn't have any specific responsibilities other than overseeing and supervising everything being done to ensure that infection control is being done correctly. i was saying that we will ensure that is done going forward in texas. question,f your first

very important to distinguish for infection control the from thelayout procedures and policies and training and staff work. in terms of the first, the demands are not expensive. there are some special demands forlace, like and anteroom people to take off and put on protective equipment. it is not a disease that spreads through the air, so it doesn't require some of the most intensive infection control physical procedures. on the personal training, supervision, follow-up, monitoring, it is very clear that the necessity of 100% of theight time does require a very intensive training, follow-up, monitoring process. next question? >> [indiscernible] >> good morning.

thank you for taking the call and doing this this morning. dr. frieden and dr. leahy, if you could respond to this question -- how frustrating is after saying we are going to stop ebola in its tracks to know that a breach of protocol among a professional is what caused this new transmission? two, is it shaking your faith in hospitals around the country to adequately prepare their staff? an internet over to dr. leahy. it is deeply concerning that , and our thoughts are with the health-care worker who was providing care. that does not change the bottom line here, we know how to break

the chains of transmission. we need to ramp up the infection control for any patient suspected or confirmed of having ebola. we have been what doing with contact tracing and monitoring. if you go back to what happened symptoms identified immediately on their onset. she was isolated promptly. at this point it looks like there is one additional contact potentially from that illness period. that individual does not have fever. we are looking for a closely at that, but it doesn't change the bottom line. the bottom line is we know how ebola spreads. we know how to stop it from spreading, but it does react to size how meticulous we have to be on every single aspect of the control measures from rapid diagnosis to effective isolation to effective care with infection control to scrupulous contact investigation. dr. leahy? >> thank you.

i firmly believe we are going to stop this here. we have to be very careful. closely look at the practice, infection control practices as they are occurring in the hospital to be meticulous and make sure there are no breaches. is it frustrating or disappointing? of course. family,ts go out to the the health-care worker that is infected. she is going to have a rough continue to need to make sure she gets the care she needs. we have been doing contingency planning for situations like this where it -- this. learnedhe things i have in disaster response, you have to have a little humility in how

you approach things. be very cautious with how you approach things. do i doubt that we are going to stop this, the spread here in this one hospital? no. i firmly believe we will stop it. thank you. >> next question. dr. frieden, i was just wondering, does the updated guidance on when screening will start at additional airports that were announced last week. screeningay we begin at jfk international airport in new york city. that screening went smoothly. there are a lot of lessons being learned through that to make sure that screening goes smoothly from other passengers. we are anticipating starting screening at the other four airports this week and we anticipate that starting on thursday. next question.