dr. macgregor-skinner. he is a infectious disease expert with theringering foundation. i want to know some of your other history. you recently returned from nigeria where you were actually treating patients on the ground with ebola. you also worked in helping prevent disease after the 2004 tsunami. you have an extensive background here in dealing with these outbreaks. i'd like to get your thoughts off the bat about some of the latest headlines we've heard out of the ebola outbreak. the dallas officials have -- people wn to 10 who might have been infected with ebola. the death toll worldwide is now over 3,300. are we handling this epidemic in the right way? >> that's a very good question. we have within the us health care system a wonderful trained .ealth care staff we have the staff in place. what we really have at the moment is a hub type approach to controlling ebola. the c.d.c. is in the center and then we have all the health care systems, whether it be the hospitals, the urgent health care, the travel c

dr. gavin macgregor-skinner, r. griffinizabeth foundation, thank you so much. >> on the next "washington journal," david wasserman, with the latest on the 2014 house races and public opinion and politics with brian and stefan hankin. we will take your calls and you can join the conversation on facebook. at 7ing the journal, live a.m. eastern on c-span. c-span's 2015 student cam competition is underway. the nationwide competition will award 150 prizes totaling $100,000. create a seven minute documentary on the topic -- three branches and you. they must be submitted by january 20, 2015. grab a camera and get started

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dr. robert macgregor-skinner remains with us. so dr.you talk to us about the breach of protocol, and explain to us exactly what that means to you about what happened? >> well, something obviously inadvertent happened, because the nurse to date has not reported an overt breach, and her colleagues working with her have not reported that a breach took place. however, this is early days in the investigation, and if subsequent information comes out, we will find it. as many of us have said, the most hazardous moment is actually when you are going on break, when you are off of your shift, and after working in the intensive environment like this with all of the protective equipment, you are eager to take it off. and you need to be with a buddy, because that moment of disrobing is the most hazardous. it is more hazardous there than taking care of the patient. >> dr. hidalgia, can you tell us how is it that the nurse involved saying that i don't recall any time where it might have been a breach, those around her are reporting that they don't rec

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dr. skinner. thank you for the valuable you are providing. there is a lot of discussion bout the movement of ebola people, the virus with special virus inwith the ebola the united states. i wonder if you could provide instances there are where diseases of the united states have moved to that part. guest: first it is great that nursing dent for the association told the truth and we have a challenge in the healthcare system to say when not working and we have failures to tell the truth. we have -- that they have a situation where we can fix by training. because i get nt lots of phone calls from they told us ng that we are ready but we are not ready but we don't want to tell but we need t that health. hat you said about diseases going from the u.s. to other areas we saw -- i will talk when we had merica the pandemic influenza it came globally.co and spread we know all the transportation we have with the planes and everything else it is possible but because of our animal and ystem in human health we controlled many f the highly infectious disease

dr. gavin mcgregor skinner, who has designed disaster preparedness programs for the u.s. government and the united nations. doctor, you heard the powerful words from the president but it seems most americans don't care. a new poll says 80% of americans support quarantines for people coming back in west africa. the attitude is better safe than sorry. why do you think they're wrong? >> i think it's important to make the american people aware what i did when i came back from west africa after treating ebola patients, that is to follow the cdc guidelines which calls for movement. that is not quarantine. that is controlled movement. don't take public transport, but it doesn't tell me to stay home locked in a room. it tells me if i don't have symptoms i don't have ebola and i'm no risk to anyone. >> as i mentioned, governors of six states have enacted mandatory quarantine for 9 who is coming from an ebola hot zone, is that an honor code? >> it is not just an honor code, it is a p to p code, we are taking our temperature twice a day, i also when i came back reported to the local

dr. gavin mcgreg gomcgregor skinner.i will point out you were with us on our set just a couple of nights ago and at that time you talked about some of your very serious concerns about the mismanagement of information, wrong protocols being given. you've been down at the cdc. you've been giving advice down there. do you see things changing? >> at the moment, they haven't and i want to point out why. we don't have a national communication plan for ebola and we need one. if you go to google, yo you putn ebola, and you're taken to the cdc, website, it's full of pdf documents. also the ppe guidance there is not based on a risk assessment we do constantly in west africa and for u.s. hospitals. based on the symptoms, the likelihood of the outcome of the disease, based on the hazards and based on what we need to protect. and we need to protect u.s. health care workers and that risk assessment for ebola is complete coverage of the body no part of the body exposed. >> you have said to me that really the front line health care work

dr. mcgreg goror skinner, aren't you afraid these folks won't want to volunteer anymore? >> again it's the p top network. when i come back i don't go to the red skins game here in d.c., i stay away from the metro, i do go to work and stay away from my children. if i had body aches and fever i would get on the phone and i would call for help. i would call the emergency medical services and say look i've recently come back from west africa, i've had contact with ebola patients, i don't feel well, i don't want to move. they would come and pick me up. everyone who arrives at our airports, in that between days if you get sick stay where you are, call us and we'll come pick you up. every health care worker knows that, it's been in the cdc guidelines for months and months, hasn't been well communicated. >> dr. gavin mcarthur skinner, he's worked with the cdc as well and with infectious disease outbreaks, works at penn state university. appreciate your being here. we're reminded that all politics is in fact local and that politicians will always zero in and latch on to the hot is

dr. skinner, on this specific question? >> wolf, this is a public health emergency.to evaluate our capabilities and develop operational plans. at the moment, it's not airborne. we can start developing plans in case it does become airborne. but we don't have a national communications strategy or a training program. we have a cdc handing out recommendation documents but we have no video, we aren't using lessons learned from dallas and nebraska and emery. so again, we can't do the implementation, and we have no coordination. >> please stand by. joining me now is the mayor of dallas. mayor, thank you very much for joining us. a lot of people are wondering, amber vinson, this 29-year-old nurse got on this night and flew out of dallas, went to cleveland, came back even though she had an elevated fever. what happened here? >> well, i don't know. i'm asking a lot of questions today. there's no way she should have been on that flight. she was being monitored here in dallas, and if she was monitored correctly, she would have gotten into the hospital, i think, earlier than goin

dr. gavin mcgregor skinner. he's an expert on ebola and recently returned from nigeria where he was treating patients. thank you for being here. did you take some of the same precautions you're hearing lenny talk about? >> i agree with lenny 100%. everything i said is exactly what we do on the ground. the other thing we do in our training with our doctors and nurses is not to raise your arms above your shoulders and touch your face. it's a human behavior challenge. it's difficult to do but something we put into our training. >> what sorts of advice would you give to journalists who are maybe preparing to go to these countries in africa to cover this? >> that's a great question. when i worked at cdc as a disease detective and i went to do outbreak investigations, journalists ach caoften came ou me to see the conditions in the field. i would say right now with the public health people, the cdc people, the dod people and all the other doctors and nurses we have from the u.s. on the ground let's form a team through

dr. gavin skinner from the department of public health science at penn state hershey.hey will be screening passengers. is that enough? >> it gives us another level of protection. about 150 people from guinea, leone arrivesierra every day. we will take your temperature and ask questions. where have you traveled from, how are you feeling, who do of contact with, where are you going? and a third critical function, advice of what to do if they develop a fever. >> is that adequate? should more information be given? >> what they need to do, if they have left the airport and develop a fever, what do they do next? we want them to stay home. what is coming in winter? flu season, and we do not want patience with fever and body aches and fatigues sitting next to people like a woman who is pregnant or a child, and possibly risking spreading ebola. >> you were in nigeria, where the outbreak was successfully contained. you were part of the effort. how did they do it? >> the nigerian government had a plan, a community plan. they brought everyone in from the community and did not stig

dr. skinner.t on public health preparedness and has been to the ebola hot zone earlier this year. what do you make of this one strict standard for u.s. military personnel leaving that ebola hot zone in west africa opposed to civilians who will have much freer reign if you will. >> as someone who has worked for years with highly infectious diseases like ebola, everyone on my team, we follow the cdc guidelines, they state we undergo controlled movement. that means no commercial transport. no public transport. and we report to the public health authority. no symptoms, no ebola. we communicate about this all the time. we have to be careful about the needs for communicating on what ebola is and the threats -- >> the military personnel in italy who just got out of liberia, they have no symptoms. >> how they are defining quarantine? i'm not sure. it hasn't been explained to me. >> they are throwing away utensi utensils, plastic knives and forks they are so worried about it. >> a lack of communication and

dr. gavin skinner is an expert, who helped train the nigerian public. i'm struck with a couple of things that are happening. one thing it seems to be so much more frightening. we understood that eventually some cases would come from africa. but in this case, so quickly a health care worker becomes the object of transmission within days. is this cause for greater alarm than we have seen before? >> no, it calls for vigilance and training. we trained hospital workers following a very regimented standard of approaches and again the cdc has this. but what we're seeing now is when we say that all hospitals in the u.s. need to be prepared we don't have the resources to do that. so let's regionalize, and focus down and make that training more intensive and provide the resources they need. >> the information given by the cdc, you pointed a point in the website where there seems to be a disconnect. they're showing a picture of people wearing complete garb, permanent head coverings yet they show another illustration that doesn't show any of these things. why is th

dr. emanuel and gavin mcgregor skinner. gentlemen, thank you very much for joining us. dr. rought with us some information. i want you to show it to our viewers. this is from the cdc, instructions put forward on how health care workers should protect themselves from ebola. you have some problems with this. >> yes, wolf. the cdc, ebola website for health care workers, that's all health care and hospital staff within the u.s., has a guide how to put on the pp and take it off. it doesn't match what we're seeing on tv from emery, dallas, or even what people are wearing in west africa. >> what does that mean? >> you saw the people, even in boston today, people had a head covering on, wearing special shoes, boots on their feet. what we're seeing from the cdc website, they just got a gown on and the head is exposed. >> do you think that's a problem, dr. emanuel? >> we know it's bodily contact with fluids and fluids with spray around. as you mentioned in your last segment, fluids can spray around. so having full protection is important. we also need to be aware that it's very possib

dr. gavin mcgregor skinner, an infectious disease expert.k to you both about what we just hearted from this press conference from the head of the cdc. right before the break, elizabeth, you were saying there are still big questions we don't have answers to about what breaches in protocol could have caused this new person to have been infected with ebola and now that person is isolated at the hospital in dallas. >> right. it seemed clear from what dr. freiden was saying is that there was some kind of a breach of some kind and that it needs to be determined what that breach was. one thing that he mentioned and i don't have his ex-wording but said something to the effect, mo sr. not better. if the guidelines say under certain conditions, for example, double glove, you don't want to triple glove or quadruple glove. more is not necessarily better. presumably, one of the reasons is you have to take all of this off and once it's become infected, that's an issue if you have more. i think that there are various things they are going to be looking the

dr. macgregor-skinner and juliette kayyem. the emergency management who seemed confident but reaching a lot of people with who he came in contact with. he could have come in contact with thousands of people. >> he could have, but, again, he's conscious and talking to authorities and he's really giving a lot of information of where he has traveled to and where he's been and light of parallels between new york city and what we experienced in lagos in nigeria. it's a megacity of 21 million people and when patrick sawyer arrived, that patient, again, we expanded this huge net of contact tracing in the nigerian government visited over 26,000 homes and families and talked to so many people and, again, there wasle 894 people from the 20 cases to do that contact tracing. what new york is doing is correct, it's right, it's the principles we use every day to fight ebola and find and detect early to ensure no one else gets this terrible disease. >> to dr. garza. let's talk about the flights that dr. spencer took. how much do we know abou

dr. gregor skinner and elizabeth cohen thank you so much for being here. >> thank you. >>> joining me to talk about the legal aspects of all of this is cnn senior legal analyst, jeffrey toobin. great to see you. there are so many different facets of it that interest me. let's talk for a moment about the hospital where apparently the patient presented, and instead of admitting him, they sent him home and it was two days that there was then a delay. what kind of exposure might they face? what kind of exposure might he the patient face given what we know so far? >> well, you know, the first piece of advice i would give is ignore anything that imbeciles like donald trump say about this situation. the second thing is, you know, this is not a crisis at the moment. and there is no necessity for the hospital to be punished, for this man to be punished. obviously, procedures have to evolve. this is a complicated new threat in the united states. certainly the hospital could face some sort of loss or challenge or fine regarding its accreditation. i can't imagine that the state of texas really needs

dr. gavin mcgregor skinner brought this to our attention last week.helping get his health care workers ready. there seem to be so many ironies, about ebola, nigeria so densely populated. this was a place that was supposed to go bad and yet it had not. how did that happen? >> joie, when we heard ebola had reached lagos, a a mega city, all my comrades and i were nervous. risk assessments, risk assessments, they defined the how. their communications plan, they communicated.openly and honestly with all nigerians, using a website, a 1-800 ebola web site, but they used smx text messaging, text blasting, where they sent messages to everyone's cell phones to wash their hands often and report to an emergency station if they felt they had ebola. >> what i hear is mostly these new guidelines a may not be all that new but also they're really just focused on creating greater consistency. >> you're absolutely right. let's go back to history. we've been dealing with ebola and other highly infectious diseases since 1976. so we've dealt with ebola now for 38 years. we

dr. gavin mcgregor skinner, infectious disease expert, joined me on reliable sources last week and get his about the media coverage of this. let start, ed, by telling us what did we learn this morning at the first local press conference that took place? >> the significant headlines of what we know so far is this is a health care worker who was not considered to be one of the high-risk people that was being monitored. this was someone in the lower risk category, but this was someone who came into contact with thomas eric duncan, not during his initial visit that first emergency room visit where he was turned away and returned three days later. so, it was after he had come back to the hospital. and we are told, and this is the disturbing part of all of this, is that this health care worker had been using protective gear, the gowns, the masks, the facial mask, the gloves and everything, and despite all of that, has still become infected. also this morning here, brian, a great deal of attention focused around the apartment complex where she lives just a few miles away from here at the hospital

dr. gavin mcgregor-skinner discusses the u.s. response to ebola. then political reporter james hellmann looks at the 2014 elections and key governors races around the country. and bloomberg news examines how the u.s. trucking industry is addressing highway safety issues. plus your phone calls, facebook comments, and tweets. all on washington journal, live saturday at 7:00 a.m. eastern on c-span. >>> this weekend on the c-span networks, tonight at 10:00 eastern on c-span, a conversation with retired u.s. supreme court justice john paul stevens. on saturday night at 9:00 eastern the founder and former chair of microsoft, bill gates on the ebola virus outbreak in west africa. and sunday evening at 8:00 on q&a the director of the myth sewnian's national museum of african art and tonight at 8:00 on c-span2 authors john yoo and bruce fein talk about war and 9 constitution. saturday night at 10:00 author heather cox richardson on the history of the republican party and live sunday at noon on book tv's in-depth legal affairs editor in charge at reuters and

dr. alexander garza with us and gavin mcgregor skinner. juliet kayyem and dr. debbie, talk to us about this virus. you said the temperature depends on -- the fever depends upon your immune system. >> some have a low fever. some don't have fevers right away and some have high. so your body, your immune system is what creates the fever. there's a period you don't know if the patient is contagious or not. it depends. it could be there before it reaches high levels -- >> i want to talk to juliet kayyem. coordinating with hhs, also ron klain, a new ebola czar and also you heard the head of the cdc speaking at the press conference, the question all of this training they have been having here. they feel that they are prepared for it. new york city prepared it is prepared. they're activating its emergency operations system in brooklyn. all of these the right moves? >> absolutely. i think, you know, over the last couple of months, some of the sort of communications errors that have come out of the government are that they overpromised and underdelivered and saying it wo

dr. gavin macgregor-skinner on the response to ebola virus. an update on key mid-term election. transportation reporter on what the government and trucking industry are doing to improve highway safety. washington journal begins live at 7:00 a.m. eastern on c-span. >> this weekend on the c-span networks on saturday night at 9:00 eastern the founder and former chair of microsoft gill gates on the ebola virus outbreak in west africa and sunday evening at 8:00 on q and a director of national museum of african art. saturday night at 10:00, heather cobs richardson on the history of the republican parent live sunday at noon on book tv's in depth, legal affairs editor and in charge of reuters. and saturday at 5:00 p.m. eastern on american history tv on c-span 3, former fbi agents on catching the una bomber suspect and on sunday afternoon on american artifacts the 100th anniversary of the panama canal. find our situation schedule at c-span organize. call us at 202-626-3400, e-mail us at comments@c-span.org. join the c-span conversation, like us on facebook, follow us on twitter. >>> next

dr. gavin skinner says how uninformed louisiana's governor is on the danger of incinerated ebola waste andt's adding to hysteria. >> if he's concerned you do a simple test on the waste and show there's no virus in there. we know that's a waste of money and resources because that virus is dead. has zero risk to the environment, to people, to anyone being infectious. >> reporter: despite the lack of risk, the waste management company has sent out a statement saying it will not ship the ebola ashes to a louisiana landfill. apparently to avoid a legal fight with the state's attorney general. there is, though, a real problem in the u.s. dealing with ebola waste and it's happening where it would be generated. hospitals need to be equipped with these. it is a supersized pressure steam device called an autoclave. think of it as a huge, high temperature pressure cooker for hospital garbage capable of killing any germ or virus. >> it's a specialized waste and it requires on-site incineration or placed in an autoclave which means it's sterilized here on site before we ship it off to the final disposi

dr. gavin mack gregor skinner looks at the u.s.'s response to ebola. and how the u.s. trucking industry is addressing highway safety issues. plus your comments, facebook comments and tweets, all on washington journal live at 7:00 a.m. eastern on cspan. >>> with live coverage of the u.s. house on cspan and the senate on cspan 2, here on cspan 3, with compliment that coverage by showing you the most relevant constitutional hearings and public -- cspan 3 is the home to american history tv, with programs that tell our nation's story, including the six part series, the civil war's 160th anniversary. american artifacts, touring mew steams and historic sites to discover what artifacts reveal about america's past. history bookshelf, with america's best known history writers, and looking at the policies and legacies of our nation's commanders in chief. and top college professors devilling into america's past. and our new series educational films from the 1930s through the '70s. cspan 3 created by the cable tv industry achkd funded by your local cable tv provider. >>> this year

dr. gavin mcgregor skinner discusses the u.s. response to we bowl of. ebola. focusing on incumbents with tough reelection bids. the u.s.nment and trucking industry are addressing the issue of highway safety. we will take your calls he can join the conversation on facebook and twitter. washington journal, live at 7 a.m. eastern on c-span. >> this weekend, on saturday night at 9:00, the founder and former chair of microsoft bill gates on the ebola virus outbreak in west africa. evening, the director of the smithsonian's national museum of african art. that is set at a night at 10:00. history of the republican party and live sunday at noon on book tv's ind-depth, the supreme court biographer. saturday at 5 p.m. eastern on american history tv on c-span 3, former fbi agents on catching the uniabomber suspect. it would hundred anniversary of the panama canal on sunday. let us know what you think about the programs you are watching. or you canmail us send us a tweet on twitter. like us conversation, on facebook, follow us on twitter. >> the 2015 student cam competiti

dr. sanjay gupta. gavin mcgregor-skinner from penn state university.me here in "the situation room," erin tolbert, an emergency room nurse practitioner. sanjay, i'm curious, one of the nurses who is there in the hospital, nina pham, her condition went from good when she was in dallas to now being fair. she's at nih in bethesda, maryland. what does that tell you? >> i don't know that i would read too much of that. when a patient is transfer, the condition is slightly downgraded because the hospital wants to create these assessments themselves and it requires them evaluating themselves, maybe looking at lab values and different things. having said there, she did get off the plane and we saw her late last night, she walked to the ambulance. that's obviously a good sign. but also she is starting to enter now what would be considered the more concerning phase of the disease. so she has ebola. there are different phases of the disease. we know she is going to be getting into one of the more serious phases and will be monitored and cared for very, very closel

dr. yaz min, a former cdc disease detective who writes for the "dallas morning news," gavin mcgregor-skinner public health preparedness and our correspondent, elizabeth cohen. that little 5-year-old boy tested negative and the statement released by the new york city department of health said the test is negative. but out of an abundance of caution, further ebola tests are required to ensure the patient is clear. the patient will be tested for common respiratory viruses. the patient will be in isolation until all test results have returned. is it possible, even though this initial test was negative, he still might be positive down the road? is that what they're suggesting in this statement? >> it's possible but highly unlikely. i have spoken to some pediatricians. they said with this clinical history, it sounds like so many other illnesses that 5-year-olds get. he's vomiting, it could be any other conditions. it's unlikely to ebola. and now it's even more unlikely given this one negative test. >> as you know, gavin, dr. craig spencer, the physician with doctors without boarders back, he's got