are screening 94% of the people? spansion toay, with the four additional locations, that covers about 94%. >> 94% being covered, that means somewhere between 2000 between 2000-3000 people a year coming into this country without being screened from affected areas. a they would undergo different form of screening. we are still going to ask them questions about their itinerary. we are alert to any overt signs of illness and chlorinated with cdc and public health of they are sick. we are also going to give them a fact sheet about ebola, about the symptoms, and most important link, who to contact. >> will you be checking temperatures? >> we will not be taking temperatures. >> so there are 2000-3000 people a year entering the country without taking temperatures,

contextfilling out a she. >> they're going to arrive at hundreds of different airports throughout the united states. >> i want to talk about travel restrictions. non-us military commercial flights are currently going into the affected countries? >> i don't have the exact numbers. >> does anyone on the panel know? from the united states or from anywhere? >> from the united states into those areas. >> there are no direct flights into the united states. >> or into west africa? >> there are direct flights into west africa? >> how many? does anybody on the panel know how many? back to the united states? >> there are no direct flights coming back to the united states from those affected areas. what about from europe?

>> there are hundreds of flights coming from europe. >> and people from west africa throughhrough their -- there. and there is 94% screening. >> we would have to get back to numbers, butof huge quantities of supplies are needed. >> if you could get back to me with that number, i would appreciate it. are you aware if nigeria has a travel ban on countries affected by the outbreak? >> they do not. the areas brought up regularly to me when i go home, what should i tell my local hospitals and local doctors that they need to do to address ebola? >> make sure if anyone comes in with fever or other symptoms of

, they need to ask where they have been for the last 21 days and whether they in west africa. >> and the training the small local district hospital would receive, is that the same kind of metropolitan hospital would receive? >> there are override the of forms of training. hospitals are usually supported by the state. >> what do we need to do to make sure people understand that there could be similar conditions, similar circumstances, so we don't have a situation where people are panicked. >> the key issue as you point out is that we are going into flu season. by all means, get a flu shot. for health-care workers, anytime someone comes in with fever or other infection, take a travel

history. that's really important. >> you mentioned that we can't have a travel ban because you are afraid of the impact it would have, but you don't know how many personnel or flights are currently in use. >> my point earlier on was that of passengers are not allowed to come directly, there is a high likelihood they will find another way to get here, and we will not be able to track them as we currently can. talking supplies and personnel. how many? how much equipment? not able to track people coming directly, we will lose the ability to monitor them for fever, to collect information and share it with local authorities, and to isolate them if they are ill. you.ank we now recognize mr. wilshire for five minutes.

>> first, i want to understand this. u.s. andn came to the infected to health-care workers in dallas, correct? >> at this point, none of the 48 contacts he had prior to haveoping symptoms developed anything and they of all past the point -- >> we have had two incidents in the united states, but this is such a highly contagious disease, we are on full alert, correct? >> it is as severe disease. it is not nearly as contagious as other diseases, but any infection in a health-care worker is unacceptable. >> and there is an enormous amount of public concern about this, so we appreciate the effort you're making.

there has been some concern about what happened in dallas, the efforts made. and now you're telling us that there has been information provided to all of the hospitals in the country about what protocols to follow, correct? >> that's right. >> is it feasible that all of our hospitals are going to be in a position to provide state-of-the-art treatment or as a practical matter does it make sense for hospitals to contact you when they have a potential infection, for you to come, and then for there to be centers where an individual can be treated. >> every hospital needs to be able to think it may be ebola, call us -- we have had hundreds of calls, and then we will determine what treatment is best for that patient. -- this isalso heard absolutely a public health infrastructure issue where he gets out of hand, correct? >> public health measures can control ebola.

>> they have effective measures in nigeria where they have been able to contain it, but they have no public health infrastructure in the three countries where the epidemic is now gaining headway, correct? >> right. >> and in the u.s., we are fortunate to have a pretty good infrastructure, but we do have to have an answer, i think, to this question that is being asked about travel. a concern people have because it is seen as a "easy answer. co i want to understand what the answer." "easy it seems like a debate within the medical community, but it may be a psychological answer but not necessarily in effect of medical answer. all of us have been asking you to give your explanation as to why, from a medical standpoint,

you have concluded that a total travel ban is inappropriate and not effective. >> first off, many of the people coming to the u.s. from west africa are american citizens, american passport holders, so that is one issue to be aware of. way, i don't have much time, but if we're going to encourage people to go and do important work, including military personnel, we have to take them back and make sure we can treat them if they do get the illness, correct? >> people travel and people will be coming in for it >> you say there is basically a trade-off. if there is a full ban, there are ways around it and then you lose the benefit of being able to track folks who may be infected and that could lead to a greater incidence of outbreak. it is a trade-off. is that essentially what is going on? >> we are open to any possibility that will increase the safety of americans. >> are there midpoints that

makes sense to you in coordination with your colleagues, particularly mr. wagner? >> we would look at any proposal that would improve the safety of americans. >> this is not about funding so i am not going to ask you because i think we know what your answers would be, but i just want to share the concern expressed -- mr. chairman, we may want to have a hearing at some point about funding requirements to make sure the emperor's structure this country needs to be in place before thishing -- infrastructure country needs to be in place before something happens is robust that we have people who are strong and trained and ready to do the job. that is not today's hearing, but i think it is a question we should address the cause with 20% across-the-board funding and nih, i find not to be a reckless

decision. 12% at cbc i think is reckless. we have to revisit our priorities and making sure we have the emperor structure in public health to protect the -- infrastructure and public health to protect the american people. >> we do have a hearing scheduled on that. >> i now recognize mr. griffith. >> thank you, mr. chairman. i believe we should have reasonable travel restrictions. i am submitting a letter for the a prominentcites medical and travel security services country with more than 700 locations in 76 countries that reports that africans have

imposed air, land and travel bans by persons from countries where ebola is present. south african development community members only allow highly restricted entrance from ebola affected regions with monitoring for 21 days and public gatherings discouraged. i find that interesting because some of those countries have had a previous ebola outbreaks themselves. >> i will take your word for it. >> i will tell you that this is a concern to a lot of our constituents and mine as well. recently, a father from virginia prayers for his daughter because she lives in the complex with the first nurse

and was very concerned. while i think i know the answer, i would like to get your answer. he asks, if i get to 21 days and is nothter is in fact -- infected, can i exhale and breathe a sigh of relief? >> he can do that now. the first nurse only exposed one contact in that was in the very early stages of her illness. at most, one person from the community was exposed. >> i appreciate that. he said there were some concern coming out of dallas that the patient's dog may be infected. by the virus be transmitted dogs? i did some homework on mess because i thought it was an interesting question and i found a publication from march of 2005 the did a study on dogs in

and dogs in france as a control group. they showed that while dogs have antibodies for ebola, they are asymptomatic, but the study went further to say that there are a lot of questions about how ebola is transmitted. there is a question as to whether or not or how the ebola outbreak occurred. it wasn't in normal ways, human human, and the report indicates the dogs might be -- might be -- i don't want to scare folks -- might be suspect. isn't it true that we don't know a whole lot about the outbreak of ebola and when we are trying to a sure american people -- just like previously we didn't think it would come to this country and then if it did get

to this country we wouldn't have any problems controlling it and now we have all kinds of people being monitored. aren't there a lot of questions about how ebola is spread? >> although we are still learning a lot, we have a lot of information about ebola. we have a good sense of how it .s controlled we have looked at exposure to animals. we don't know of any documented ,ransmission from dogs to human but we will be looking to help assess that situation. seenthough we have not transmission, we have a lack of evidence as opposed to evidence that it cannot be transmitted. we have no restrictions on travel of human beings.

how about the dogs? i called customs. they said experts are there. called the usda. they said that would be cdc. i understand all of your reasons -- while i don't agree with them completely, i understand about humanitarianism in all of that, but don't you think we should restrict travel on dogs? legs we will follow-up on what is recommended -- >> we will follow-up on what is recommended. >> i like to start by mentioning "will americaled meet the ebola challenge?" i would like to submit that for the record. this has been a very enlightening hearing. i would like to acknowledge that

the kentucky international guard, which is taste in my district, is in senegal providing help for the 101st. so into the ink them for their effort. displaying my ignorance, we know that you cannot do text ebola until it -- until itagious becomes symptomatic, at which point it is contagious. is there any way to detect going on? >> at this point, we don't have a test that would identify it before someone has symptoms. the test only turns positive when they are sick. the test is for the virus itself. that is another reason we are confident that it doesn't spread -- we can't even find tiny amounts of it in people's bodies until they get sick. is there any research been

done on a possible test for this? >> there's a lot of research being done to understand, diagnose, prevent and treat better. sensitive to have a media treat situations like this. certainly, the media can be a very important part of providing public information about a potential threat to public goety, but they can also .verboard i see comments in the media the threat oft ebola and the spread of ebola. while it has spread to two health-care workers, i know the public may perceive that differently. like, for instance,

in the washington post today, a picture of a woman at the dulles airport who looks mummified because of her concern about contracting ebola. one survey showed 98% of the american people are aware of the ebola situation and not even 50% know there is an election coming up in three weeks. media has certainly alerted people that something is going on. my question to you is has the helpful orage than harmful in having the public have an appropriate level of concern as to what the situation is. workersimes health care become infected and ill it is unacceptable and our thoughts with those health-care workers and hoping for their recovery. it is certainly understandable that there is media interest.

it is new to the united states. it is a scary disease. there was a movie made about it. it is important that we pay attention and the doctors, hospitals, community clinics in health care practices stop it at the source to make is completely safe. i thinkthe coverage, many would agree, may exaggerate the potential risks or confuse people about the risks. we know about ebola. cdc has an entire group of professionals who spend their entire careers working on ebola. they stop outbreaks all the time. outbreaktopped every except the current one in africa. there is zero doubt in my mind that are in a mutation there

in thet be an outbreak u.s.. it warrants attention but it's important to put it in perspective. >> i agree. additionaly authority that cdc would find helpful in conducting your responsibilities. specific authority that would make it easier to do your job? >> we are looking at a variety of things, procurement, for example, to see if there are changes that might allow us to respond more quickly and effectively. >> thank you. i yield back. fore recognize mr. johnson five minutes. >> thank you for being here. thank all of you on the panel

for being here today. politics orabout international diplomacy. this is about public health and protecting the safety of the american people, particularly our health care workers who are some of the high risk folks to be exposed. as of my main concerns though we don't know what we don't know. throughout testimony and questioning today, i have heard you say multiple times i don't know the details of this, i don't know the details of that. i think what the american people , is some assurance that somebody does know the details.

salome us your question. do we know yet how the two -- so let me ask you a question. do we know yet how the two health-care workers contracted the virus? was it a breakdown in the protocol? was it a breakdown in the training of the protocol? do we know of the protocol works? >> the investigation is ongoing. we have identified possible causes. >> so we don't know. we don't know. i get that. we don't know. you know, the people in ohio are , especially now that we know that one of those health-care workers traveled through ohio, even spend some time in akron with family members. kasich's governor immediate actions to try to address the situation. in my experience as a military

war planner, 26 and a half years in the military, and i know we have the military engaged in this process overseas, we don't wait until the bullets start flying to figure out whether our war plan is going to work. when did the cdc find out their was an outbreak of ebola in west africa? >> late march. >> one of the things we do in the military is conduct operational readiness inspections. scenarios inworld controlled environments, no notice, so that those who are going to be responsible for whatting a war plan know to do when the first shot is fired. no panic, no second-guessing, they know what to do. ebolae plan to address an

outbreak ever been tested by the cdc in a real-world environment? >> not only has the plan been tested, that outbreak control has been done multiple times in west africa. >> i am talking about in america. >> in america also. >> do you know of any hospitals in southeastern ohio that have participated in any kind of real world scenario of an ebola outbreak? >> i can speak to that -- cannot speak to that specific example. >> let me go further. daymentioned that 150 per roughly are coming in from west africa. let me give you a scenario. in tosay a person comes

the country from west africa, and let's say that everything in the screening process works right. they may be on day 14 of having in westosed to ebola africa. symptoms andwith go through the screening process and then go to wherever they may go. day 17 or 18 they start getting ill and start seeing a spike in their temperature. if they want into any emergency room in appalachia, ohio, and start throwing up and having planoms, does your identify that can tell that hospital emergency room what to do and then scenario?

don't know that person came from liberia or any other place. >> we have detailed checklists and down rhythms we have provided widely two health-care workers throughout -- algorithms we have provided widely two health-care workers throughout the country to determine if there is an outbreak of ebola and if they do, to call for help, and we will be there. mr. madison is next for five minutes. >> thank you, mr. chairman. a number of questions. i will try to move through them quickly. dr. friedman, it strikes me that controlling the outbreak in west africa is really one of the real of to keeping americans safe. the reports indicate we may be losing ground in liberia. what would enhance the

international community's ability to gain some ground in africa in terms of actions and resources? that itwe're finding is is moving quickly and there is a real risk it will spread to other parts of africa. therefore, the key ingredient to progress there is speed. the quicker we surge in a response, the quicker we blunt the number of cases and the risk ,o other parts of the world including the u.s., decreases. angress has provided agreement to use money from the department of defense. received $30e million for the first 11 weeks of this fiscal year, which we appreciate. has an unprecedented

number of people in the field right now in west africa and texas. how many people do you have doing airport screenings? >> i would have to get back to you with the exact numbers. we are overseeing screenings to make sure they are done correctly and to screen individuals here -- >> make sure you get that ifber, and also find out those resources are best used there or elsewhere with your limited number of people. is there progress in developing test to determine if somebody has ebola? >> a more rapid test would be helpful. we are currently testing one in africa that is simpler and quicker and would be more aspful even if it is not thorough.

to me that when it comes to infection control and prevention and hospital standards, i think he very wisely from hospital to hospital in this country. what regulatory or legislative actions could strengthen these systems? how can we reduce this variability among hospitals in ?ur country >> infection control in our country generally is a challenge cdc worksing that hard to improve. hospitals are regulated by the states in which they operate and the issue of what could be done isimprove infection control complex. cdc has a large program of ofpital prevention infection. we share new efforts in new ways to do things better. that center of excellence model is an important one. suggesting that while

you can provide guidance, implementation is more of a state function than a federal function. do you think we should be looking at that issue? we have a federalist system. the cdc provides information and input that roughly 5000 hospitals in the country were not regulatory. >> one other line of question. there is no good news about ebola, but at least it is not , it does not transmit as an airborne identity. it is clearly that we do not want to underestimate the trent -- the ability to transmit it. the focus is on ebola and rightly so, but there are other airborne transmittal pathogens that ought to be of great

concern. birds being one of them. is this experience we have had with ebola, how do we learn from it to make sure we are prepared for other, human to human that mayible pandemics have a higher rate of transmission van ebola? >> two major lessons. prevented at the source. either go to find it, stop it, and prevented, it would be over already. country, tor continue preparedness and public to find and stop public health threats. >> recognized for five minutes. >> thank you. today, we have referred to , referred to nurse one

and nurse two. these are two young women who dedicated their lives to helping other people, sick people. nurse oneo them as and nurse to does not sit well with me. it is reminiscent of dr. seuss, thing one and thing two. these are not things. i would like to think -- first nurse and the second nurse -- these are young women with families. one particular has a fiancé. i think it would serve us well are humanr these beings, young women, who have dedicated their lives to help people. i would like to open with that. dr., he said in your testimony earlier, only by direct contact can you contract ebola. you contest that statement?

and it is not airborne? you agree? >> it spread person-to-person not by the airborne. >> if you need personal contact fluids, why is it scrubbed four times? aren't they wasting money? contact,n have bodily why -- >> it is a scary disease. >> so it is just for public perception. they do not need to be doing that. >> we have detailed guidelines. you need to be sick and generally, the first symptom of illness is a fever.

>> do you need a fever to be contagious? >> later in the disease when people are deathly ill, they may not have a fever but they would be able to walk at that point. >> you need to show symptoms within 21 days of exposure. are contagiousu at that point? time, anywhereon from 0-21 days. question early within the first 21 days or so. >> you said there were 121 people from west africa to the united states. you are opposed to -- constituents are in favor of you orng -- i predict the president will put on traveling restrictions. and ik they are coming think sooner rather than later. 150 a day and you rationalize,

we do not need to worry about that because they can get cross orders and go by land. number might be reduced to five or 10 a day? >> i cannot comment on what numbers. >> if someone had to make an effort rather than going on airport and jumping out a plan, if they really had to, don't you think the number would dramatically dropped? >> i know people come back. right now, we are able to screen them and collect information. >> what if they do not come back question mark a lot of people miss country, they do not come back. what happens then? if you have five coming in today, i were my constituents rather have five a day coming in. this thing was checking for temp -- temperatures, like it will help, is like scrubbing what does not need to be scrubbed. i would like to commend reading this copy, ebola is coming to

america. the u.s. had a chance to stop the virus in its tracks but it missed. before mr.ame out duncan came to this country and diagnosed with ebola. there is good reading there. i also recommend, if you want to google a hospital from hell, hospital fromla, hell, if you get a chance to read that, i think everyone would be in favor of the travel restrictions and today, the health administration just today said customs and border control immigration and nations are at risk of coming into contact with ebola. are we prepared for that? protected?ents this came out today.

>> we china my how to wear the protective gear and what circumstances. travel with a whole host of potential diseases, we are aware and we trained to recognize signs of over illness. we have protocols without professionals to get those care and into that protect our employees. >> they phone the same category as nurses. save us ande to protective of the country. god bless you. i yield back. >> the german is retired. >> thank you so much. i have a number of questions. i would like to start in regard exposed, myurses understanding is the first nurse, was exposed in the emergency room. is that correct? repeat theu

question? in thefirst nurse was emergency room? is that correct? >> it is not correct. she came in contact with mr. duncan when mr. duncan was up.sferred >> that was some time up from september 28 through the 30th. is that correct? >> that is correct. sent, wasond nurse she also an icu nurse? so they were exposed after the --nt that is not correct. the nurses from the time may have first contact with mr. duncan were in personal

protective equipment according to cdc guidelines. nina cared for mr. duncan. stop you right there. they are already using universal but were using more isolation. just answer yes or no. >> yes. i is ok. this, and i will just back up, on october 2 -- excuse me, october 6, i sent a letter calling for travel restrictions. there is no question i believe they need to be put in place. after having this subcommittee hearing now, i believe even more strongly that we need them. i want to back up to a couple of questions. are there multiple strains of ebola?

>> five different subspecies. this outbreak is one particular subspecies. all of these have been closely related third >> we know it has to one particular strain. the quote was, unless it mutates, there will not be an outbreak here in the united states, is that correct? be a largell not outbreak here buying a mutation. >> lemon nurses were using how has thisar, happened? it tells me something is changing herein are we currently looking into the situation now? what we have seen is very little change in the virus. we do not think it is spreading by any different way. you have artie said a couple of times it is not airborne.

you are protecting yourself and your protecting your patient and you are protecting your family. based on precautions, i am sure. we are now having this conversation and i am concerned about that. is notre confident this an airborne transmission. nurses working very hard and working with a patient who is very ill and was having a lot of vomiting and diarrhea. a lot of infectious material. the investigation is ongoing, but we immediately implemented a series of measures. >> i will move on. faste discussion of for ebola, where are they at with that? >> a diagnostic test? there are three authorized for use. taken some proactive steps by contacting commercial manufacturers who we know have

potential technology to bear here. we reached out to a handful who might be interested in working with us. >> you're in the process of working toward a fast-track process. >> yes. we expedite every such path. >> leslie, i am speaking on behalf of my constituents in every in my cut -- in the country. i just do not believe it is acceptable, the quote you have given us, as the reason for why she -- we should not implement travel. i believe we can. dofar as our border patrol, you believe there is a way we can implement tracking of individuals, if we do not allow it >> yes. we have a way to determine that through review of passport. it is easier when they come to direct places. >> rue, thank you.

thank you for indulging. i am over time here. >> thank you, mr. chairman. i appreciate your holding this hearing. i've talked to a number of health care professionals and listening to the panel as well. i want to join with chairman upton in urging the president to immediately issue a travel ban until such time as they can firmly and scientifically prove that americans are safe from having more ebola patients coming into the united states. i know, dr., you expressed disagreement with that. have you all had any conversations within the white about a travel ban and whether or not the president has the authority? many of us have said the president does have the authority to do it today. >> from the point of view of

cdc, we are willing to consider anything -- >> have you considered an have you ruled it out, or have you not considered it at all? have you had conversations with the white house about a travel ban? it is a yes or no question. conversations with the white house about a travel than? >> we have had discussions on the issue of travel >> have you ruled it out? if you are in those conversations, maybe they had their own conversation about you, but if you were involved in conversations with the white house about a travel ban, did they rule it out and are they still considering it? --we will consider anything >> are you going to answer the question about your conversation with the white house? is the white house considering a travel ban? >> i can't speak for the white house. >> have you had conversations with them about it?

-- >> wecussed discussed the issue of travel. >> i would urge you, if you do not think it travel ban is the right way to go, a lot of people disagree with you, at a minimum, you ought to look at -- you can travel in the united states from liberia. have you all considered that were discussed it or ruled it out? authority is our to acquire the isolation of individuals. >> but you said you do not think there should be a travel ban. att about at least looking extending visas to non-us citizens? >> the cdc does not issue visas. can make a recommendation to the white house that you think would be in the best interest of the american people to have that kind of suspension issued. are you not aware of that?

>> we would certainly consider anything that will reduce risk to americans. >> do you have a high level of confidence that our u.s. troops over there right now, through activity are already in those countries. up to 3000 of those trips will be sent over from president obama. do you have a high level of confidence those trips are protected so they will not contract ebola? >> we work very closely with dod on the protocols. say there is zero risk there in those countries, but they are not participating in high risk activities. protocols inishes that case? >> they are following cdc protocols, but they follow their own. theet me ask you about protocols. i have heard reports that some people of some of the other organizations that have been there for a while, you have got a group, a showman by the name

of shawn kaufman, who is involved with some of the doctors over there that got infected. they have been working for decades in some cases. he said he warned your agency that the guidelines you had on the below were relaxed and his response was "they kind of blew me off. oh off." blew me >> do not know that occurred. >> i hope you go find out. is a real concern. i've talked to a number of medical professionals in my district. not are concerned they have had consistent protocols. there have been at least four in the last few weeks were the protocols keep changing. first nurse that was

infected, you personally said the protocols have been breached. have you back away from that? you said the protocols were breached. were they breached? yes or no? >> our review of the records suggest -- if you did not know for a fact -- do you still stand by the statement that protocols were breached? definite exposure -- >> i yield back. >> the ranking member and the chairman have a final two-minute wrapup. >> he started to say looks like was exposed in the first couple of days before the diagnosis came in. >> that is our leading hypothesis. >> thank you.

have you now see in my chart from the new york times about protective gear? ofyou know which types protective gear health-care workers were wearing in the last few days? guard, folks would have been wearing the first fiction or. >> thank you. it is your testimony, you do not really know how either one of these nurses were. is that correct? >> that is correct. >> i want to say one last thing. discussionsa lot of today about a lot of issues. i will make a statement and i will ask you to comment. it seems to me, beside from trying to stop the ebola from africa, the things we can do here, number one, better

ourning to people in emergency rooms, better responders, not just send them out e-mails and bulletins. we can have more robust protective gear at the early stages someone looks like he might have a risk for ebola. number three, it might be useful to have cdc on the ground earlier. down to the come dallas hospital until after the diagnosis. two days, people were moving in and out of mr. duncan's room and we do not know exactly what happened. can you comment on that? >> i do not agree completely on the framing. we are looking carefully at the equipment issue. we consult immediately every time. 300 --ave been more than only mr. duncan was confirmed to have ebola. we will do everything we can to

support the front lines. >> i would ask for both this chart, and the flights to be included in the effort. i would also ask all of our witnesses if they would continue updatedthis committee as changes in developments are made. i ask unanimous consent to put these statements in the record. >> i previously asked for unanimous consent but i do not think we ever agreed to it. >> it is so ordered. i now recognize for another two minutes. yourg listened to all of testimony, couple things stand out for me. i appreciate the statement of honesty. that we made mistakes. i did not hear that for many of you and that troubles me. what has happened here

is your protocol depends on everyone being honest 100% of the time. i am not a medical expert. i study behavior as a psychologist. people are not honest 100% of the time. it relies on tools that take temperatures. a 121 chance they may register something. and a person -- that is not helpful. recognize human behavior, the protocols may not be salt -- may not be followed. itt you put -- watch you put on and watch it taken off and do things. the example of how this failed was there was an assumption, you travel. granted the assumption that you use all the right protective gear, but we looked at this and you are not aware of what she wore. to this extent, these are my recommendations. i believe we need an immediate

ban on commercial and nonessential travel until we have an accurate screening process to treat the disease. a mandatory court order for any american who has traveled to or return from the ebola hot zone countries. because of an assumption and without this assumption of what they were was dawned and remove properly. number three, through training for health care hospital workers for personal equipment used in the treatment of ebola patients, and --ber four, identify those trained. inber five, identify gaps the statutory language to take more aggressive and immediate -- four but -- public

health in ebola. or any other action congress needs to do to facilitate your needs. number six, accelerate on development and clinical trials investigations on drugs and diagnostic tests. number seven, acquisition of vehicles capable of examining military personnel who may have contracted ebola in africa to return to the united states beyond the current capacity. number eight, additional contact and testing for public health agencies. number nine, to provide for congress and the resources needed to assist health interventions in africa so we can stop people of their. the members coming back today for the hearing and i especially appreciate the testimony of the panel. -- to be entered

into the record. >> yes. the office of and specter general, and the photographs i demonstrated earlier today? >> so ordered. they will be demonstrated in the record. >> mr. chairman, i want to -- to acknowledge -- >> we will follow up and notify participants and when that will be. agreedhat witnesses plea to respond properly paired with that, the hearing is adjourned. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2014]

>> will she be getting any of the experimental treatments? >> we will make that decision when she arrived. get her into the

unit and do the appropriate diagnostic, we will ask her first if we can make a statement .

>> towards the end there, you heard and it sounds like orders were asking him about nina pham, the nurse, the first nurse that at texas health presbyterian hospital. she is being transferred to the facility in bethesda, maryland. testifying before the subcommittee here of house energy and commerce. we're opening up our phones to see your response. are we doing enough?

-- we are also looking at your comments on facebook and on twitter. facebookof quick comments. this one is first up -- also one from esperanza, who says, -- that issue was certainly one of the many topics discussed during the three-hour hearing. i want to let you know two things about the hearing today. you will be able to see it shortly. we will show the entire hearing

bit here onst a c-span. the second is, it will also air tonight at 9:00 eastern on c-span. up this evening, as is our campaign coverage. bruce from iowa is sitting on the panel today. we'll tell you about that in a bit here and a couple of calls in a moment. a lot of twitter comments first, to those. this 1 -- a couple more on today's hearing. a couple of questions. what is the current rate at airports? how many are refused boarding due to ebola symptoms? from catherine, she says the gop makes cuts to nih research. how can the vaccines be developed with no money? one more, someone needs to give -- wasting time trying to

politicize the ebola hearing peerless go to phones. in oakdale, california, on our others line. is the u.s. doing enough? points of the discussion. the first one is, it seems congress on the topic of a travel ban is not to stop aid, but instead, they are distressing all those that do want to return from giving aid, to put them in a 21 time of quarantine. common sense. the second one, for being not infectiousted in disease, it i think it would be common sense the risk of infection is much further than just direct contact with infected or secondary contact with an incubation time. >> we appreciate your comments. we're are hearing from represented upton, the chairman he -- the chairman of the

committee and we will take those women back to your calls in a minute. >> our border is closed. until we resolve this issue in west africa, we will not allow folks with visas from that region to be coming to the united states, until we can get the problem fixed. thank you. gave a list of several recommendations and i want to lead us to the end of those, including a travel ban on tosons not citizens coming the united states, currently, until we have the problem solved. totally also make sure we have tried -- travel restrictions. made clear from the errors that people can make mistakes and people will not necessarily be trustworthy about the comment they make. doing is all to be

of these steps. what we're asking for may amount to an inconvenience for some. illness andive is death for some. has all ofouse and its wholesome make this decision right now. we want the cdc with us on this and we move forward with other >> i thinks there also, it sends mixed messages, saying they believe right now, they can trust folks to be honest and aware. i think it is important that they know congress is partners with the administration and we are pushing strong for this and we want to protect the american people and that is our first step.

need for aravel ban is clear under the cdc's reasoning. they basically said we need to make sure they have you entity for supplies for personnel. the cdc does not know the number of supplies coming in. how can they basin entire bansion to avoid a travel when they do not even know the number behind the reason for the travel ban. the reasons today were basically the same thing you're saying, that we should make sure all children with chickenpox stay in school so we know they are. it makes no sense. we must make sure we are protecting the american people by making sure travel to the infected area is restricted. >> i join with the chairman and others by calling on president do this.immediately there are unanswered questions. this is something that should be done at a minimum, the president

ought to at least stop non-us citizens from countries to come here. i was disappointed the head of cdc would not discuss whether or not he had conversations with the white house about being rolled out of the travel ban. that is something that ought to be asked. there are a lot of other questions that need to be found out. if you look at some of the other complaints from evil like doctors without borders, some of the organizations that have been in west african countries that have been infected for decades, they have been critical of cdc procedures. had of them suggested they been blown off by the cdc. the head of the cdc ought to dig .nto that find out who they are >> [inaudible] all, we have asked

for the president to institute a travel ban their the doctor would not say whether or not it has been ruled out. we're placing this on the white house and we're asking the president to issue a travel ban and they can do that. what the president says. we want to give that opportunity of the things we have done is shown by coming here today we will take the issue seriously and we will be here to do whatever that needs to be done. the president can institute a travel ban and we have called on him to do that. we also at least answer those questions. yes or no, it is a straightforward question. oni would just like to say behalf of moms and nurses and health care workers across the country, i believe we are working together in a collaborative way. we want to work with the white house and the president on this issue. if there is a better time for our present -- our president,

now is the time. the traveln place restriction and get to the bottom of the issue before any other american. america theo remind chances of contracting the ebola virus is very small as long as you're not exposed to someone else. to be in place -- >> [inaudible] >> u.s. citizens have a right to read returning to this country. let's look at a proposal from the white house. what has been admitted to us is for the whole. anything else? a cute.

-- thank you. >> one of the recommendations commanded today's hearing was a travel ban from the countries most affected by ebola. they're calling on the president and administration to do that. the representative dennis ross of florida has introduced a bill that would do that. his bill would ban the arrival of any commercial aircraft in which the ebola disease has reached epidemic proportions as determined by the director of the cdc. a reaction on the senate side, the democratic senate side, a democrat from florida, member of the test occasion committee, it his recommendation, i am convinced -- --

>> sharon on our republican line. thank you for waiting. >> thank you for taking my call. there are a couple of things are nurses, i worked in the health field for years and nurses make mistakes. have had nurses giving me an iv or medicine, and they would forget to wipe the iv site with alcohol. nurses are not perfect, ok? but i mean, we have got our children we have to be concerned about. everyone wants their children to go to school. but when they are sick, when is enough is enough? to tell them to stay home, or they get threatened with the truth. thing, having people before they get on a flight is one thing, to have them verified

by a doctor, that they are well theyh to travel and that cannot have the symptoms or does not look like they have the symptoms that could potentially turn in ebola, and make them paperwork, by a physician. it is an idea, it is a start. but we have got to do something to protect the americans. i mean, we have a lot of people coming into our borders and going out. no.ave to finally say president obama, if you are listening, please close our borders for the protection of the american people. >> let's go to britney in north carolina. hello. what are your thoughts? is the u.s. doing enough in response to these cases of ebola

and the outbreak in west africa? >> asked lily not. i know this will sound bad. -- absolutely not. i know this will sound bad, but we have to take care of ourselves first before others. if we have an outbreak here in america, we cannot help those in africa. put the quarantine in place, but do not let anyone else in. it is common sense. the person before me has got a great point. we are told constantly to put your kids in school. a fear of putting kids in school right now. if he has a fever, we are told to keep him home. don't send them, but then you get people at the door, you get phone calls, the social workers in, why is your kids not in school? he is got a fever and you cannot send him. >> i want to share with you some

of the comments of a representative, a democrat who put these out for his members, information worth sharing. ebola is not now. if he has a fever, we are told to keep him home. don't send them, but then you through one. the spread -- -- >> i am sick and tired of any administration telling us this is not spread by this. we have 9/11 once again. down,not a building going but this is insulting to the american people. this woman is a nurse, and yes, nurses make mistakes, but she should have known enough that she takes care of this and she was taking care of very close andters, to go on a plane believed she had a 99 point five fever. why? because she said so? she took it upon herself to go on a plane, which is insulting to the american people. we cannot know the full story of

what is going on here. i do not know what will happen, but we need to do something. we -- we have a very serious problem. better start protecting the american people first. we will not be able to protect others. we will not be able to protect other nations. >> that second nurse was flown yesterday to every university, the first nurse to contract that , nina, is being taken today from texas health presbyterian, the hospital in dallas, nih, in bethesda, maryland. hot springs, georgia, where is this? >> arkansas. >> ok. go ahead with your comment. >> i am a retired technical nurse. this year they are talking about, it is a big joke.

they absorb any kind of a liquid. you try to take that off, you will get exposed. this is the biggest joke i've ever heard. >> hang with us. you have got. -- experience with this. you're the ranking member, she was asking the texas hospital official about that. the gear ask you how has improved over the last couple of days. one was the original cdc guidelines. cdc's original guidelines for health care workers. they advanced to this. extra levelsmended of protection in cases where workers could come in contact with the patient is vitally foot. then this third one here, after a second nurse in dallas was diagnosed with ebola, the north shore system in new york, they updated their level three suit by adding an impermeable on top.

do any of these work? which one is the way to go. >> the one on the far right. that is a hazmat suit. that is the one you need to protect yourself. here is the joke about hazmat. i had hazmat training. they just come in one day, here's how you do it, and goodbye, you have been trained. that will not get done. epidemic.be a major he is supposed to know all about this stuff and he says this thing will mutate and it will be airborne. if it is airborne, it is going everywhere in the country. >> officials from cdc and today buses testimony did a lot to attack that down in terms of becoming airborne. let's go next to arizona. teri is on the line. hello?

>> hello. i am amazed texas has done it and dropped the ball again as the borders letting alegals in, and letting loose guy that has ebola. it is amazing to me. i wish texas would have gone with the president and maybe gotten people in texas some insurance. we're going to the hospital. >> he says, where is the texas hospital administration that says, let the market is tied. on the travel ban issue, this one is from jeff who says, the travel ban on african countries is racism. --

this is very in cedar block, virginia. welcome. hello? you are on the air. are you with us there? you are coming in and out. go ahead. you are on the air. for taking my call. i have talked to a lot of professionals in the area here and they totally disagree, that the hospitals in our local areas are not to speed to handle ebola.

>> thank you for your comments. we are taking your comments as well. here's a post from arlene, who writes the doctors without borders has been dealing with patients in countries with ebola without the medical check -- medical staff contracting the disease as well. maybe the cdc should have doctors without borders teach u.s. hospitals with personal protective equipment is necessary and how to safely put on and remove it without contaminating themselves and others. more of your calls to glen rock, pennsylvania. hello. go ahead with your comments. personally, i believe it is airborne but not the way people think it is. there is a thing called bio aerosol. it will catch on to whatever stuff is in the air here that floats around for a while.

for short distances, it is airborne. that way. good chance >> ok. kate, hello there? mrs. peggy. ranford. north i have a couple of things to mention. i am a recently retired residents -- registered nurse with years of experience. >> ever had to do with anything like this where he had to put on a hazmat suit? >> not a hazmat suit per se. was always some skin exposed. but i was a nurse in the early 80's taking care of a lot of hiv-positive and aids patients, before they were called patients with that disease care that brings a realm of experience to as well as my education.

the things i want to mention, first, i think air travel untilction is a good idea you can get a handle on exactly the way said go about limiting on this disease. person-to-person contact is one .hing arent to reiterate there airborne precautions contact precautions, and a kind of precaution called droplet. sneeze, if you cough, if you laugh, you are projecting humidified air out of simply because the system has to humidified air that breeds in to get into the body.

, notnk it is very easy realizing the subtle difference. >> thank you for sharing your is -- your experiences. this to me -- back to calls, california, it is jack on the republican line. go ahead. >> thank you for having me. i want to talk a little bit about cdc budget cuts. they even made nasty commercials about how republicans cut the cdc budget. >> you're seeing that in some of

your campaign races out there? >> yes. they are like national commercials about how republicans have cut cdc budget. the reality is, congress approved more than the president even requested initially. that should be checked out by all of these people. i do not know why the republicans cannot find it in themselves to defend themselves in forums like this. it is frustrating to me. also, the travel ban is absolutely critical. the doctor at one point said we need to isolate and treat this as a source, which would be in africa, and then in the second breath, he says he opposes a travel ban the is it would not be affected here we have got 100 deep ebola day coming into this country than -- that may not have the symptoms, they will not

be traced by the cdc. they will go out into the communities. flu like they get the symptoms, when they go to the hospital, they will not be treated as if they have got ebola. >> today's hearing wraps up with the chairman calling for the administration to impose a temporary travel ban from west where theuntries, outbreak of ebola has been most imaging, to be sure. in the meanwhile, a republican of florida has introduced legislation that would do actually that. the committee called on the administration to do that, rossa seek a vote on that. the earliest congress can do that is november 12. let's get a couple more of your phone calls to arizona. mike is on the democrats line. with whatto start out

the congresswoman brought up about securing borders. this is what this is all coming down to. the president is not about to put a flight restriction in. he danced round the question, danced around the question. all of those in arizona have been asking for ever to secure the southern border. this is the tip of what is going on here in he will not make a decision and put a travel ban and stop anybody from going into any country and coming up illegally or anything like that. the only wayebola, it will come in through air travel, it will come up through the southern border. i have worked down there and some of the stuff i've seen through there, they have more rights than the people actually living here legally. it is so sad the people who run this country would rather sell a -- sell out their own people to to shut thed than border down. >> we heard from officials in the administration, the defense department and the state

department today, the head of the faa had comments that recovered and we will show you that later in the program. the president this afternoon is meeting with members of his cabinet for the second and row as they continue to monitor the ebola situation in the u.s. one more call is in texas. heather is on independent line. taking my call. i just wanted to say i agree with everything the committee has lined out. i hope the president will come to his senses and agreed to those. i have a concern, i was looking at the cdc website today and looking at the weight is transmitted. is on their website that, though the initial time ends in men can carry the disease for up to seven weeks in their semen. that has a lot of implications couples,ies, unmarried

and no one mentioned that. that makes me wonder, are we getting the whole story? i do not trust the cdc. the other question is, where is the department of health and human services? where is the surgeon general? do we have one? where are the other health officials? wire we just looking to the cds the? >> not yet approved by the u.s. senate. a couple of final comments on twitter. this one is from texas. his spokesman says -- chris van hollen, a democrat in the house, says he spoke with director cones of the nih and told me it is specifically equipped to handle ebola -- lastly, from dennis ross --

we look for your comments. one more comment on facebook -- >> i want to let you know the hearing is coming up momentarily. you knowant to let about our campaign 2014 coverage. coming up, the iowa senate debate. bruce braley will be debating tonight. his republican opponent, joni ernst. we'll have that live for you at 8 p.m. eastern here on c-span. goingt, though, we're to -- oh. and i want to remind you too of

governor's debate coming up tomorrow night. scott walkerker -- against the democrat, mary burke, tomorrow night, here on c-span. up next, though, we're going to bring you all of today's the house energy and commerce of sight subcommittee on the response to ebola. three hours. >> today the world is fighting epidemic inola history. cdc and our public health system fire. the middle of a job 1 is to put that out completely. until well not stop do. we must be clear-eyed and protect in purpose to public health and to ensure not one additional case is contracted here in the united states. we in congress stand ready to serve as a strong and solid crisis,in solving this because there is no greater responsibility for the u.s. government than to protect and defend the safety of the american people.

the stakes in this battle be any higher. the number of ebola cases in western africa is doubling about every three weeks. the math still favors the virus, surge in the recent global response. with no vaccine or cure, we are facing a disease for which there for error. we cannot afford to look back at this point in history and say we have done more. errors in judgment have been made, to be sure, and it is our to learn fromonse those errors, correct them rapidly and move forward onectively as one team, fight. let us candidly review where we stand. latest ebola outbreak in west africa was confirmed months ago, authorities thought the 1976be similar to outbreaks and quickly contain -- contained. that turned out to be wrong. by underestimating the danger and overstating the ability of our health care system to handle the cases of ebola, mistakes made.een

the trust and credibility of the and government are waning as the american public loses confidence each day ofh demonstrated failures the current strategy. but that trust must be restored. only be restored action.est and thorough we have been told, quote, virtually any hospital in the do isolationcan can do isolates for ebola, unquote. events in dallas prove otherwise. false assumptions create real sometimes deadly mistakes. we must understand what went a firmo we can get handle on this crisis. why was the cdc slow to deploy a response team at texas hospital?sbyterian what training of health care -- have health care workers received? and there are things about ebola we don't know. live on does the virus

surfaces? how do health care workers protective gear get infected? the cdc and n.i.h. tell us that patients are only contagious when having a fever. however, the largest study found that nearly 13% of confirmed cases in west africa did not fever.sociated now, i respect the cdc as the gold standard for public health. need for strong congressional oversight and -- remains remains paramount. i want to understand why they course in 2010 on proposals that would have strengthened the federal quarantine authority. to work through these and fix these problems. i restate my ongoing concern still refuse to consider any travel restrictions for the more than 1,000 travelers entering the united states each week from ebola hot zones. a month ago, the president told someone with ebola reaching our shores was unlikely and that we have taken the necessary precautions to increase screening at airports so that

someone with a virus does not get on a plane in the united states. screening and self-reporting in the airports have been a failure.ted yet the administration continues contradictory position, which frankly doesn't me. sense to it troubles me even more when public health policies are based concern over cutting commercial ties with fledgling democracies rather public health in the united states. this should not be presented as choice.r none we can and will create the means to transport whatever supplies goods are needed in africa to win this deadly battle. we do not have to leave the door all travel to and from hot zones while ebola is an and dangerous stowaway on these flights. i'm confident we can develop a meetnable strategy to these needs. the current airline passenger screening, through temperature taking and self-reporting, is

troubling. both cdc and n.i.h. tell us are only cons contagious when having a fever. beknow this now not to totally accurate. nearly impossible to perform contact tracing of all people on multiple thernational flights across globe. so let me be clear to all the federal agencies responding to the outbreak. resources or authorization is needed to stop ebola in its tracks, tell us in congress. believe thisi committee joins me in pledging that we will be everything in our power to work with you to the american people safe from the ebola outbreak in west africa. recognized the ranking member of the committee. five minutes. mr. chairman. on monday, the director general of the world health organization the ebola outbreak, quote, the most severe acute in modernrgency seen times. she warned that the epidemic, quote, threatens the very survival of societies and governments in west africa.

assessment is no exaggeration. 1.4predicts that up to million west africans could be affected -- infected with ebola. more will die from treatable illnesses due to the collapse of these countries' public health infrastructure. this is a humanitarian crisis and we have a moral imperative help in west africa. but ending the west africa nationalis also a u.s. security imperative, because doing so is the best way to keep the united states. i was alarmed, like all of us were, when thomas duncan flew to the u.s. while harboring ebola and even more disturbed to learn the texascharge from presbyterian er with a fever after reporting that he had liberia.from even worse, we learned this week that two nurses treating mr. duncan, nina pham and amber vinson, have contracted ebola. know, mr. chairman, we all join in sending these women and

prayers.ilies our these new cases raise serious questions. the washington post wrote texasday that presbyterian, quote, had to learn on the fly how to control the deadly virus. hospital was, quote, not fully prepared for ebola. why thiso find out hospital was unprepared, and if others are too. and we need to make sure that the cdc is filling these readiness gaps. about thebe concerned appearance of ebola in the u.s. transmission to two health care workers. but we should not panic. stop ebola to outbreaks, by isolating patients monitoring and contacts. the u.s. health care system can cases fromlated becoming broader outbreaks. that's why i'm glad dr. frieden here with us, and dr. varga will be with us by video, be ane it would understatement to say that the response to the first u.s.-based

patient with ebola had been mismanaged, causing risk to scores of additional people. i know both of these gentlemen will be transparent and helping me to understand how we can improve our response when yet another person, and it will inevitably happen, shows up at the emergency room with these kind symptoms. i appreciate the steps taken by airportcustoms to begin screenings. these steps are appropriate. and as some call for cutting off all travel, as the chairman said, this won't be reasonable to be able to stop anybody with ebola from coming into the united states. and we don't want to take steps would endanger americans by interfering with efforts to halt outbreak in africa. there's no such thing as fortress america when it comes diseases.ous and the best way to stop ebola is going to be to stop this in africa. experts from doctors without

us that all quarantine on travel would have the, quote, catastrophic impacts africa. also, earlier this week, the director of n.i.h., dr. francis said, had we adequately funded his agency for over a decade, we would already have an ebola vaccine. reminder thata key public health agencies have stringent -- stagnant funding for several years, hampering our ability to respond crisis. mr. chairman, six weeks ago, when i first sent you a letter to ask for this hearing, the problem in west africa was beginning to come into focus. dire.e situation is let's work together to make sure that we stop it as quickly as we can. that, i yield the balance of my time to the gentleman from mr. braley. >> thank you. maker duty today is to sure the administration is doing everything possible to prevent

the spread of ebola within the united states. number 1 priority in combating this disease must be andprotection of americans we have to figure out the best way to do that. my heart goes out to all those suffering from this horrible epidemic. hard'm very proud of the work done by american troops, doctors, nurses and other volunteers to combat this disease. congress must come together, put aside partisan differences and outbreak.this today i hope to hear what steps the administration is taking to prevent the spread of ebola and respond to the outbreak. i'm greatly concerned, as congresswoman has expressed, that the administration did not act fast enough in responding in texas. we need to look at all the options available to keep our families safe and move quickly and respondably to make any -- responsibly to make any necessary changes. expired.me has we have a lot to do here, so

we'll just keep going. okay. thank you. now recognize chairman of the full committee, mr. upton, for five minutes. first begin by thanking our witnesses and all the members, republicans and for being here today. you know, it's unusual to during a hearing in d.c. this period, but on this issue, there is no time to wait. see thekewise glad to president get off the campaign trail yesterday to finally focus on the crisis. scared.re we need all hands on deck. a strategy, and we need to protect the american people. foremost. it's not a drill. people's lives are at stake and the response so far has been unacceptable. as chairman of this committee, i want to assure the witnesses stand ready to support you in any way to keep americans safe. but we're going to hold your the fire on getting the job done. and getting it done right. globale u.s. and the health community have so far failed to put if place an

enoughve strategy fast to combat the current outbreak. the cdc admitted more could have done in texas. two health care workers have become infected with ebola, even other medical personnel suggest that protocols are being developed on the fly. none of us can understand how a nurse who treated an whoa-infected patient and had herself developed a fever was permitted to board a commercial airline and fly the country. no wonder that the public's confidence is shaken. ago, before ebola reached our shores, we wrote seekingy burwell details for the preparedness and response plan here at home and abroad. clear, whatever plan was in place was insufficient. but i believe we can and must do now.r we need a plan to treat those who are sick, to train health safely provide care, and to stop the spread of home andase here at shores in africa.

this includes travel restrictions or bans from that today. beginning surely we can find other ways to aid workers and supplies into these countries. from the terrorist watch lists quarantines, there are tools used to manage air travel to assure public safety. not here? we can no longer be reacting to each day's crisis. be aggressive and finally get ahead of this terrible outbreak. the american people also want to ant our -- about our troops and medical personnel headed to to treat the sick. how are they going to be protected? that health care workers here in america have the necessary. it's not just the responsibility of the u.s. the global health committee finally getarge to ahead of the threat, to train all of those involved in and erad this disease kat re-- eradicaterad

the threat. our responsibility to ensure that the government is doing whatever it can to keep safe.blic partneredi have together. and while much attention has how this can help with diseases like cancer and same reforms can help us with deadly infections like ebola. we are partners in this effort to save lives. i yield the balance of my time to dr. burgess. you, mr. chairman. i think everyone here agrees, we must fix this. response to the ebola virus disease outbreak is not a political issue. a public health crisis and a very dire one at that. the frighteningening truth is we cannot guarantee the safety of our health care workers on the front lines. some timen known for that health care workers have a risk in western africa. of the -- they have a 56%

of those health care workers who catch this disease. contracted ebola in the united states. and indeed, we have to learn from the current situation in use any information we can gather to better help prepare hospitals and protect workers on the front line. we are here today because we questions.s to these this past august, the inspector general of the department of homeland security issued a personal protective equipment and anti-viral countermeasures. that the department of homeland security did not adequately conduct a needs purchasingprior to pandemic preparedness supplies, and then did not effectively stockpile of personal protective equipment in anti-viral medical countermeasures. this illustrates how unprepared we are. we have to get this right. to yield the balance of my time to tennessee.rn from >> thank you, dr. burgess.

welcome to all of our witnesses. is mentioned -- has mentioned we are here to work with you to protect americans, includes the caregivers. by that, i mean the men and frontlines,g on the the screaming eagles of the fort campbell. >> time expired. introducew like to the witnesses -- first i go to you. i apologize. >> thank you, mr. chairman. i'm pleased to have this openingity to make an statement before we hear from the witnesses. i think we have to put all of perspective and not panic. andybody said not panic then made statements like we're going to do something about it. what do we need to do? all, we've got a problem in africa. and this is a serious outbreak that could spiral beyond our control. the world health organization estimated that soon there could be up to 10,000 new

cases each week in west africa. thethe cdc has warned that outbreak could infect as many as 1.4 million people by the end of january. so this is a humanitarian crisis in africa. and we have a responsibility to help, because if we don't help there, that outbreak is going to continue to spiral out to other places. africa isople off in not going to keep them from traveling. they'll travel to brussels as the people did, and then into the united states. fromn stop the epidemic spreading in africa or the theed states if we isolate and contact -- and monitor the contacts of that patient. we can stop that, it there, and we can stop it

here. to know,ica, we need are we moving fast enough? responders have adequate resources? are we effectively coordinating our response with other and international organizations? but here, people are scared. make them even more frightened. put this in perspective. cases of three recent ebola in this country. thomas duncan, who entered the harboring ebola and who flew through brussels to get here. and amber vinson, the nurses who became ill while caring for mr. duncan. we should be concerned about cases, and we need to act urgently. but we need not panic. is learn whato do we need to do, what mistakes we them.ade, and not repeat we want to find out what happened at texas health hospital, how cdc, officialslocal health can improve procedures moving

forward. we should also use this as wake-up call to ensure the adequacy of our own public preparedness safety net. before ao be prepared crisis hits, not scrambling to respond after the crisis. in the past decade, the ability public research and health programs has declined here in the united states. since 2006, cdc's budget adjusted for inflation has by 12%. funding for the public health emergency preparedness cooperative agreement, which supports state and local health department preparedness activities, has been cut from $1 billion in its first year of funding in 2002, to $612 million in 2014. all of these were also subject to the sequestration. and those who allowed that

sequestration to happen by the government have to answer to the american people as well. we need to commit adequate public health infrastructure. we need to hold public health standardscountable to of preparedness. based on what we know, it appears that texas presbyterian would have not met those fairness ithough in suspect that many, many hospitals all over the country struggled tove respond. this is a problem we have to solve. run outrman, before i of time, i want to acknowledge the health care workers and ebolaeers, those treating victims in the u.s., and those who have traveled to west africa during this outbreak. it's a dangerous work that they're doing. they're putting themselves in to save lives. they deserve our thanks and our praise. of ourwant to thank all witnesses. you have my confidence, and i appreciate your joining us today, to provide answers about

how to stop the current ebola outbreak in africa and how to improve our public health systems to avoid the next crisis. i am ending my career at the end of this year, but i've been so many hearings where, when there's a crisis, we have congressmen sit and point fingers. well, let's point fingers at all of those responsible. have our share of responsibility by not funding the infrastructure. and in africa, they have no infrastructure. we have to help them develop it to deal with this crisis, but we shouldn't leave ourselves vulnerable by these irrational budget cuts. you.ank i would now like to introduce the witnesses on panel for today's hearing. dr. tom frieden is the director the centers for disease control and prevention. is with the national institutes of health. of robinson is the director biomedical advance research

within the office of the assistant secretary for preparedness and response at the united states department of health. dr. boreo is the assistant commissioner for counterterrorism policy. mr. john wagner is the acting assistant commissioner of the office of field operations the u.s. customs and border protection. us today from video conference will be dr. daniel the chief clinical officer at the texas health resources. he'll be joining us in a moment. witnesses.ear in the you are all aware that the committee is holding an investigative hearing and when doing so has had the practice of taking testimony under oath. have any you objections taking testimony under oath? say no.esses and dr. varga? >> no. >> thank you. you that then advises under the rules of the house, and the rules of the committee,

you are entitled to be advised counsel. do any of you desire to be advised by counsel during your testimony today? dr. varga? >> no. >> everyone answers no. you allcase, would please rise and raise your right hand? i will swear you in. do you swear the testimony you are about to give is the truth, the whole truth and nothing but the truth? thank you, doctor. you are now under oath and subject to the penalties set 18, title 18,on of the united states code. you each to give a five-minute opening summary of your written statement. are recognizedu for five minutes. >> thank you very much, chairman, ranking members. thery much appreciate opportunity to come before you to discuss the ebola epidemic response to it, to protect americans.

my name is dr. tom frieden. i'm trained as a physician. i'm trained in internal medicine, in infectious diseases. i completed the cdc epidemic intelligence service training i have worked in the control of diseases, communicable diseases and others, since 1990. directpreads only by contact with a patient who is has with the disease or died from it, or with their body fluids. new, although it is new to the u.s. control ebola, inn in this period, even lagos, nigeria, we have been able to contain the outbreak. tried and true measures of finding the patients promptly, isolating them effectively, identifying their ensuring that if any contact becomes ill, they are

rapidly identified, isolated and their contacts are identified. but there are no shortcuts in the control of ebola. and it is not easy to control it. the united states, we have to stop it at the source. there is a lot of fear of ebola. and i will tell you, as the director of cdc, one of the isngs i fear about ebola that it could spread more widely in africa. happen, it could become a threat to our health wetem and the health care give for a long time to come. priority, our focus, is 24/7 to protect americans. that's our mission. we protect americans from threats. in the case of ebola, we do that multiple levels.

in addition to our efforts to control the disease at the source, we have helped each of the affected countries establish exit screening, so that every person leavings that their temperature taken. two-month period of august and september, we identified 74 people with fever. entered the airport or boarded the plane. themr as we know, none of were diagnosed with ebola, but that was one level of safety. recently, we have added another level of screening people on arrival to the u.s. that identifies anyone with workedere, and we have very closely with the department security and customs and border protection to implement that program. i would be happy to provide of it later.ls we've also increased awareness among physicians throughout the u.s. to think ebola in anyone

fever and/or other symptoms of infection, and who been to west africa in the previous 21 days. we've established laboratory the countryoughout so that not only laboratory tests have to come to the specialized laboratory at cdc. andof those laboratories, often texas, identified the first case here. also have fielded calls from concerned doctors and public throughout thes country. 300 calls andthan only one patient, mr. duncan, had ebola. but that's one too many. and we're open to ideas for what we can do to keep americans as possible, as long as the outbreak is continuing. we also have established response teams from to that will go within hours any hospital that has an ebola

them provide effective care safely. understandablef concern about the cases in dallas. slide, if we can show it, of the contact tracing activities there. we provided copies for the members. the two core activities in dallas are to ensure that effective infection control and to trace contacts. timeline of a exactly what has happened and the identification of contacts. followed each of the contacts. when any become ill or if any we immediately isolate them so that we can break the chain of transmission. how you stop ebola. i can go through the details wish.ou we also are working to ensure that there's effective infection control there. through the details of that.

cdc works 24/7 to protect americans. there are no shortcuts. has to do their part. there are more than 5,000 hospitals in this country, more 2,500 health departments a t the local level. support.re to we're there to respond to threats so that we can help americans. and we're always open to new ideas. we're always open to data, line is usingttom the most accurate data and information to inform our to protect health. thank you. >> thank you, dr. frieden. now recognize... you, chairman, ranking members. you've just heard about the public health aspects of ebola virus disease from dr. frieden. i appreciate the opportunity to this morning for a few minutes on the role of the allergy institute of and infectious disease in

research addressing ebola virus disease. is that our activities actually started with the tragic of 9/11/2001 which were closely by the anthrax attacks against the congress of the united states and the press. in that environment that a multifaceted approach towards was actually mounted by the federal government, one of which was the develop endeavor to countermeasures. we soon become very aware that ofurally occurring outbreaks disease are just as much of a terror to the american and world a deliberate bioterror. you see on the slide a number of category a pathogens, but look the last bullet. the viral hemorrhagic fevers, and others.ola the viral hemorrhagic fevers are particularly difficult, because a high degree of

lethalness. therapy is mainly supportive without specific interventions we do not have a vaccine. and so, what is the role of the national institutes of health? if we could advance the slide. of the national institutes of health, in the you can endeavor, as see on the slide, we do basic and clinical research. andimportantly, we apply supply resources for research in academia to advance product development. the end game of what we do are diagnostics. could we get the last slide back? there, right there. a multiinstitutiona