what happened to that patient and can you tell us who the patient is? >> we don't reveal information about individual patients. we certainly provide detailed consultation from cdc on every single patient who we find, every single patient who might have ebola so that we can provide that expert consultation and ensure that they get the the care that's available here. so just in wrapping up, i would like it to thank all of you for your interest. i'd like to remind us of the tragedy of ebola for the patient's family in dallas and for the thousands of families throughout west africa that have been dealing with this terrible disease for the past six months. i would like also to thank the department of homeland security and deputy secretary mayorkas and customs and on border protection and the commissioner there with whom we work very closely and have a very productive relationship and remind us that the bottom line here is that we're stepping up our efforts to protect americans p, that we will always look at what works. we'll continuously evaluate it and cons

what happened to that patient and can you tell us who that patient is? >> we don't reveal information about individual patients. we certainly provide detailed consultation from cdc on every single patient who we find, every single patient who might have ebola so that we can provide that expert consultation and ensure that they get the care that's available here. so just in wrapping up, i'd like to thank all of you for your interest. i'd like to remind us of the tragedy of ebola for the patient's family in dallas and for the thousands of families throughout west africa that have been dealing with this terrible disease for the past six months. i'd like also to thank the didn't of homeland security and deputy secretary mayorkas for their partnership in this and with others who we work very closely and have a productive relationship and remind us that the bottom line here is we're stepping up our efforts to protect americans, that we'll always look at what works, we'll continuously evaluate it, and consider what more we can do to keep americans safe, underst

the first patient diagnosed with ebola in the united states has died. the white house supports screening of passengers arriving into five airport in the u.s. >>> families of 43 students who disappeared in mexico calling for justice and worldwide protests. >> good afternoon, the first person diagnosed with the ebola virus in the united states has died. thomas duncan passed away in texas succumbing to what has been called an insidious disease. screening will begin at five airport. we wait for the latest of course on ebola concerns. first to ash har quaraishi where duncan was being treated. there was an indication of a slight improvement in duncan improvement, what happened. >> on monday he remained in stable yet critical condition. he was undergoing treatment with that investigational medication. his liver levels had improved. they declined over the weekend. but that could truck wait they said. his vital signs were getting better. the fever was down. they had a plumber of hope that things were taking a turn for the better. he passed away around 7:51 p.m.

i will just say that the second patient as well as the first had extensive contact with the patient whents of both vomiting and diarrhea. the assessment of the team is that in those first several days in the hospital, a variety of forms of personal protective equipment were used. there are several ways to use personal protective equipment safely. it's critical that that be done consistently and correctly. and that's one of the areas of active investigation.

the patient, of course, is in the hospital, one of the patients is in the hospital today. one of the other patients -- one of the other contacts so there are three contacts, one of whom is in the hospital today. yes. >> can you tell me -- [ inaudible ] -- come in contact with the -- travel and quarantine and opt out -- [ inaudible ]. >> so you're asking about the health workers here at this hospital. the health workers, of course, are using full protective gear. they were ready because we knew that this patient was being transported. he had a very orderly removal from his home and with emergency workers who were in full protective gear. he came here and had a very smooth transfer up to the isolation ward which he's been looked after by experienced, seasoned health workers who all have been training for this purpose over the last months, training, drilling and so on. these workers are working on this unit exclusively and as far as having anybody who has opted out of that i would tauj to dr. raju. >> no one opted out so -- [ inaudible ]. >> no, that's what's so important abo

the patient in question is a doctor who has worked with ebola patients in west africa. and when his sittoms emerged, he was taken to bell sue by special hi trained medical service, workers who transport all poet calls. the patient is now in's haitian. the health department has a tea team, a we're tracing awele of the patient's contacts and we're prepared to quarantine contacts as necessary. there have been reports about the patient's movements in these medical detections. we're putting together pieces of the timeline. we emphasize again ebola is very difficult to contract being on the same subway car or living near a person with ebola does not put somebody at risk. we're working with our officials to ensure the health of all new yorkers. people should rest assured the extraordinary medical professionals of this city and state are working to ensure that every protection is in place. a moment of commentary in spanish before i turn to governor cuomo. >> over the last weeks, the team has been extraordinary in their preparation and their coordination with us. welcome, govern

how do you fix this situation, a patient from liberia to two more patients. is this continuing to grow? >> the number you're talking about could be zero. and it's a very interesting number because it tells you how many people a single case will infect. at the moment, the answer is two. if a single case infects two people, and those two people infect two people, you have a case in the u.s. i still think anyone listening to this program should not be concerned about ebola in the u.s. what they should be concerned about now is nurses not showing up to work. and whether or not the hospital itself can protect the staff. we've seen this in toronto. so what i'd say at the moment the cdc do not even after nina pham, we have not got a sense of people -- i'm sure people staying up all night, but we haven't got a sense what they're doing to try and solve this problem. i think now if i was one of the 70 people exposed working on thomas eric duncan, i'd want daily glove tests. i'd want to be taken out of work. i'd be quarantined and i'd be observed extremely carefully for

the patient's fiance being quarantined. and we are, as always, looking at each individual contact in determining whenever kwaurn tee is necessary. we know as was said last night, the patient took the subway, went to a bowling ally and a new other food establishments, before being admitted to bellevue yesterday. so we have been able to retrace those steps, our teams have visited each of those establishments. i want to emphasize again, casual contact with not lead to acquiring this disease. the only threat is if one has come in contact directly with the bodily fluids of someone who has this disease. before i turn to my colleagues, i want to raise one important point, because people in a moment of vieries always ask what can they do? what should they know? and i think it's important that we help new yorkers understand the crucial information their need. we have made clear all of the things that ebola is not, all of the ways it does not transmit, but that still does not mean people can't do something to help in this crisis. fir

this is an individual patient that treats each individual patient as an individual patient.s what we're interested. not how she's doing compared to others. we will take care of this patient. >> is she interacting with her care givers, the doctors, nurses? is she sitting up? >> she certainly is sittin ting. she was examined by dr. davy. we saw her this morning. rick, would you like to just give whatever information you can give without violating any patient confidentiality? >> sure. as the doctor said she's resting comfortably, she's interactive with the staff. she's eating. she is able to interact freely and really think she's doing. >> talk more about the specifics on how you're caring for her. [ inaudible ] i'm not going to compare this hospital with other hospitals but i can tell you what we have in this hospital we have intensivists we have infectious disease experts, on a daily basis notwithstanding ebola take care of the sickest possible patient patients we have individuals there and nurses f s who are hi trained, highly prepared, and highly experienced. that makes a d

duncan to then continue normal patient care duties taking care of other patients even though they had not had the proper personal protective equipment while providing care for mr. duncan. that was later recommended by the cdc. patients who may have been exposed were one day kept in strict isolation units, the next day they were ordered to be transferred out of strict isolation and into areas where other patients, even those with low-grade fevers who could potentially be contagious. >> frankly, these allegations by the union, nurses union, are shocking. texas health presbyterian hospital is responding to the allegations, a spokesman says "we take compliance very seriously. we have numerous measures in place to provide a safe working environment, including mandatory annual training and a 24/7 hotline and other mechanisms that allow for anonymous reporting." that's not much of a statement, frankly. i have a panel of doctors with me. i'll get their take right after the break. [ female announcer ] take skincare to the next level with roc® multi correxion® 5 in 1. proven to hydrate dryness,

of the patients. i think a lot of hospitals will go to methods like that. >> doctor, when we're having our first national experience with maximal in our approach, for instance, any remaining fluids or anything that fluids may have touched should be considered infectious for a long term. even after a patient has moved on, died, we go to their apartment after they're being treated, anything, spew item sputem, spit, vomit, everything should be considered a hazardous material bus we don't know how long the virus will stay alive. >> we don't know to the hour but we know that viruses don't stay alive outside of the body. there is a lessoning risk as time goes by. i do think we should be on high alert from the start. and i gray we need to be on high alert for some time after a patient has either been recovered and been discharged from the hospital, or has died. surfaces should be decontaminated, of course, but i don't think that decontamination process needs to go on forever, and i think we know how to rid a

on every single patient we find and every single patient who might have ebola so that we can provide that expert consultation and ensure that they get the care that's available here. so just in wrapping up i'd like to thank all of you for your interest. i'd like to remind us of the tragedy of ebola for the patients family in dallas and for the thousands of families throughout west africa that have been dealing with this terrible disease for the past six months. i would also like to thank the department of homeland security for their partnership in this and for customs and border protection and the commissioner there with whom we work very closely and have a very productive relationship and remind us that the bottom line here is we are stepping up our efforts to protect americans that we will always look at what works and continuously evaluate and consider what we can do to keep americans safe understanding as long as ebola is spreading in west africa it will remain a risk at here and we will do everything we can to both stop the source and protect americans here. thank you very much.

as we talked about earlier this morning patients--when a patient comes in with a fever it's basic medicine school 101 that you ask the patient have you traveled recently. have you been in contact with anyone sick? either of those questions, if answered truthfully, would have picked this up. that is concerning. >> doctor, is it your sense as an expert in this field there is a much greater degree of concern at airports for instance, on either coast, new york, los angeles, washington, d.c. as opposed to placing like chicago or dallas, that don't think that these patients are going to be coming to their particular region? >> well, i do think that given how the epidemic continues to explode in the west africa region we'll probably have more cases like this one. essentially no one who is not sick gets on the plane, and in this countries they are screening the airports to make sure that you don't have a fever, you don't have symptoms. you may have someone who is not yet sick getting on the plane and traveling here. what will most likely happen is the scenario is if they get sick after arrival 37

in those panels, there was a big emphasis on patient experience, and patient engagement. about some of the challenges to that based on both the way that americans have historically gotten their health care, and challenges related to the fee for service payment system. on the other hand, patients are -- have been a bit skeptical about being engaged in payment reforms that are in the name of improving quality. but too often end up seeming more focused on reducing costs through reducing access. so this is the set of issues around challenges for acos are definitely focused on some of the challenges around effectively working with patients in new ways. in these new kinds of care models. just briefly, i've highlighted engaging beneficiaries as a key challenge facing accountable care today. related to this are issues with payment formulas, paying based on quality and cost. it's different than paying based on volume and intensity. as you heard earlier, the method's revolving and may not be as aligned as well as they could be with some of the key goals of better care for patients

we have seen the other patient move to emery. it seems the decision is being made to take greater control these cajun -- patients. also, workers who are working with them, we have that as well. >> dr. it would seem to meet it helps clarify communication channels for the cdc, since they are getting all the questions about this every day. the director is getting questioned as if he is in charge of the specific treatment. bringing it closer to the communication chain seems to have invented too this is -- i cannot stress enough that every level of government in the federal, state and local level, we are handling this on the fly. we are learning from this experience. i think it makes sense to consolidate all of this data that is coming in from the treatment of the ebola patience in the u.s. >> on the other hand, the pressure on the national institutes of health and the people there, when there is this expectation that even though in many ways this will be a first for them and a first-time experience, there is the expectation that ever

this patient was taken there tonight. why were bellevue and four other hospitals specially designated as a place where ebola patients would be handled in the event that one did turn up? >> the idea here is to make sure that there are facilities that are up to speed to care for a patient that gets sick with ebola. it's a very complicated process. dehydration and fluids is really critical. this is very difficult to manage. also infection control. all of that has to be done well. on the other hand, the possibility that here or anywhere else, the patient can walk into an emergency room of a smaller hospital, maybe less well-equipped, and there have been claims made to make sure that patients and staff our state between someone walks into the emergency room randomly until they get to a specialized hospital, whether in new york city or the national centers. >> in terms of the unpredictability of for where somebody might turn up, to the point you're making, governor cuomo kept stressing over and over again that every facility in

this patient is in the hospital, one of the other patients is in the hospital today. one of the other con targets. so there are three contacts, one of whom is in the hospital today. >> are there any other restrictions being placed on [ inaudible ]. >> so you're asking about the health care workers at this hospital. they're using full prospective gear. we were ready because we knew this patient was being transported. he had a very orderly removal from his home. and with emergency workers who were in full protective gear, he came here and had a very smooth transfer up to the isolation ward where he's been looked after by experienced, seasoned health workers who all have been training for this purpose over the last months, training, drilling and so on. these workers are working on this unit exclusively. and as far as having in inwho has opted out of that, i would actually turn to the doctor. i'm not sure anyone has. >> no one opted out. >> that's what's so important about the work that we've done preparing for this day hp there's a long standing isolation unit here. one

the patients were getting sicker. and antibiotics weren't working. >> and we tried combinations of five, six antibiotics. we tried making oral antibiotics into intravenous antibiotics. we even got an investigational antibiotic from a pharmaceutical company. >> an experimental one, a test one. >> an experimental antibiotic, and that also did not work. >> narrator: desperate to contain the outbreak, the hospital took unprecedented steps. they created a separate icu for kpc patients. brought in robots to disinfect empty rooms. >> had monitors here reminding us to wash our hands, built a whole wall up in the other side. we moved every patient in the icu, completely cleaned it, moved patients back in, and no matter what we did, the bacteria was still... it was still spreading. >> we didn't know what was going on. >> narrator: with the hospital in crisis, genetic researchers in building 49 next door were scrambling to figure out how the kpc was spreading. >> we had now gotten to the point where they were identifying a patie

parents of our patient. that, ladies and gentlemen, he would like to open this to your questions. we will take questions live and over the telephone as well. who would like to start? >> do do we know an exact incidents when mr. mukpo came in contact with someone with with he bowl bola or is it too hard to tell? >> i asked him about that a lot. but he's not certain. he was around the clinic and filming inside the clinic so he had an opportunity to be exposed. he does remember one incidents where he was helping spray wash a vehicle with chlorine and thinks he might have been splashed but is not certain. >> how high are his spirits right now? >> he's enormously relieved to be here. of course it's still quite frightening, but he's hanging in and he sounds very strong. and i think he shares in the relief with the rest of his family that he's been able to come back for good medical treatment here. >> he looks strong. he walked off the plain gingerly waved to us as we saw him from a distance wheeled in to the room

this patient was taken there tonight. why were bellevue and four other hospitals specially designated as a place where ebola patients would be handled in the event that one did turn up? >> the idea here is to make sure that there are facilities that are up to speed to care for a patient that gets sick with ebola. it's a very complicated process. dehydration and fluids is really critical. this is very difficult to manage. also infection control. all of that has to be done well. on the other hand, the possibility that here or anywhere else, the patient can walk into an emergency room of a smaller hospital, maybe less well-equipped, and there have been claims made to make sure that patients and staff our safe between someone walks into the emergency room randomly until they get to a specialized hospital, whether in new york city or the national centers. >> in terms of the unpredictability of where somebody might turn up, to the point you're making, governor cuomo kept stressing over and over again that every facility in hosp

and only that patient.an tell you that in my own institution at the nih, which recently admitted a person who had a risk exposure that we had a designated team that did that and only that. >> all right. well, thank you so much doctors. we really appreciate your expertise on this topic moving to another big story today we want to get to isis. it's only eight miles from baghdad's airport. we will take you there live and discuss it next. >> right now isis militants are just miles away from baghdad international airport. there has been a heated e-mail exchange going on about whether iraq's capital could really fall to isis take off e-mail and put it on tv so putting -- our cnn senior national correspondent. joining me on the phone. he is with the cnn military analyst. you used a really interesting analogy saying if isis was eight miles from dulles airport, would we not be worried about washington? is it not feasible? >> the battle for baghdad as far as isis is concerned would be a serious proposition. this is a

i will just say that the second patient as well as the first had extensive contact with the patient when they were having substantial amounts of both vomiting and diarrhea. the assessment of the team is that in those first several days in the hospital, a variety of forms of personal protective equipment were used. there are several ways to use personal protective equipment safely. it's critical that that be done consistently and correctly. and that's one of the areas of active investigation. >> our next question is from fox news. your line is open. >> thank you for taking the call. i'm curious if you can go into some more detail, how this nurse was able to get on an aircraft and not being monitored or quarantined if she had been in contact with the patient, the index patient, thomas duncan, in texas? >> director frieden, do you want to speak to that? >> the patient traveled to ohio before it was known that the first health care worker was ill. at that point, that patient, as well as the rest of the health care team, were undergoing self-monitoring, as the first health care did, resulting

so you've got 4.5 million people and only 200 beds to treat ebola patients and so now 90% of patients have ebola are being turned away from the treatment center simply because there's no place to go and they go back and infect their homes. entire villages are being wiped out so we now have depths of a thousand or more every week in liberia so this is a very, very serious situation. we're not able to build treatment facilities fast enough to keep pace with the vice, which is is now in the exponential phase. so we go from 10 to 100 to a thousand to 10,000100,000. so unfortunately we're going to see a scale of death that we haven't seen in modern times with this ebola outbreak. >> let's hope, if we can, that that is not the case. i want to welcome our viewers again here in the united states and around the world. the breaking news is that thomas eric duncan, the man from liberia who traveled to the united states and was diagnosed with ebola here, he has passed away in a dallas hospital. i want to bring in elizabeth cohen now who has been monitoring the situation outside the hospital. eliz

but just -- as phil said, we have a patient -- we have one patient. so when we talk about lines of defense, you don't want to go the most extreme one immediately. what i would do right now is ensure that the u.s. line of defense is strong enough, so we should have more interrogation and surveillance on the receiving end. and there was a complete breakdown on the public health side. if people are feeling fear, it is not because of the airplanes because a guy walks in from central casting for ebola and every symptom suggested this is what he had and they didn't catch it. so we need to pick up at the border and our public health community. i won't put the restrictions off the table. we have one case. it is just one case. so we need to put that in perspective. >> but erin, what is the risk here? these are three small countries. it is no skin off our nose prohibiting travel. they may not like it, i understand. but it is not permanent. and the job of the american government is to protect the american people, period. >> phil, here is the question -- >> well

we have to be ready to screen these patients, to isolate these patients and to care for these patients. so we really -- since that news hit last week, we've ramped up our plans big time. >> dr. samadi just brought up a really big, important point about screening at the airport. fever may not be the best way. so what are our options at this point? if we're going to continue to let flights route through different countries to come here, what are our options to finding it before it would spread? >> dr. samadi brought up a couple good points. first and foremost, we have to continually assess how we're screening people coming to this country and are they at risk for spreading ebola there? i agree. is it temperature? is it a more thorough questionnaire? is it a more thorough medical screening? i also agree wholeheartedly that god forbid we get a patient in northeast ohio, in any part of this country, i agree that first and foremost, the best place to care for those patients is one of those four centers across this country. >> i know that there are those four centers and that the cdc had firs

patients who are older. the other hypothesis that we have is that she was wearing personal protective equipment during the care of her patient in dallas. and therefore, it is quite likely that the amount of virus that she was exposed to was substantially less than what we see in patients who get infected in less-developed countries. and we also know that the higher the viral load that you get infected with, the more severe your disease is likely to be. >> we're going to take a couple of questions from a call-in line now. can we get those questions now? >> thank you for your time. i would just like to commend the response from emory. overall, what did the methods that you would like to get over to the public about some of the fear that really gripped us? >> so the question for those of you who may not have heard it is, what message would we like to get out to the public in terms of the anxiety and fear which is very present in the united states? and i think the message we would like to get across is that, aga

patient has ebola. i was specifically talking about the doctors without borders, a team of people who are trained. they do this kind of work all the time. >> right. >> they take care of these patients specifically. >> they are getting affected, too. >> they are this year. for decades they did not. does that indicate somehow the virus has changed is your question. i don't think there's any evidence that the transmission has changed, that it's become airborne or anything. just have a lot more patients. you have more patients than we've ever had before. we keep hearing about the lack of basic resources now in those areas. again, not a problem i would think here big hospitals in the united states, so their track record in the past has been excellent with dealing with a few patients. here we are just dealing with one initially and two health care workers got sick. if i could just point out one more thing to you, the whole notion of what constitutes protection, demonstration a couple of days ago showing that

these are nurses who are now patient patients people say why don't we move them to specialized isolation units, there's four of them around the nation. what are the pros and cons of that, sanjay. they would get the great care they need there but i guess by transporting them you're putting people in that chain of contact in harm's way as well. >> well, there's divided opinions on this. let me say a couple things. i think you need to distinguish between what is treatment of a patient and what is prevention of secondary infection, so making sure that patient sick with ebola doesn't infect other people. they're both very important and there's some crossover there. from the treatment standpoint, i think there is no specific treatment first of all for ebola. it's a lot of management of fluids, perhaps a blood transfusion like we know nurse pham received in dallas. i think treatment seems like it could be done in many different places, even access to experimental medications. in terms of preventing secondary infections, michaela, you make a good point. you could say as soon as someone is diagno

care for an ebola patient.management. it is about supervision, and so we heard dr. frieden talk about there needs to ban investigation, but part of the investigation should not be the government, but a neutral party to go in there and turn the investigation into the lessons learned and look at the supervision and the management of the hospital and the staff. >> and what you mean by that is that the nurse was nursing and someone should have been overseeing that in the room with her or outside of the door, is that where you think that the problem was? >> exactly. and for a highly infectious disease like ebola, we teach a system called the buddy system, a a nd that is if you and i wer treating the ebola system, i watch you and you watch me. and i don't do anything unsupervised, because we do it throughout the world, and where was the buddy, and so if that nurse made a mistake, and again, the breach of protocol, and the protocols are a piece of paper and so it comes down to how many training did she get, and she is

was she delivering direct patient care? did she touch the patient? nurses do a lot of different things. perhaps, for example, she was transporting soiled garments, that's another possibility. there are lots of them. and you know, the cdc says that health care workers who were doing all sorts of things, whether you're directing patient care or transporting soiled garments, you need to take these protective steps, but hospitals, in general, ebola aside, often, there's been concerns that they have trouble with getting everyone to take these protective measures, that he is there a been this emphasis on doctors and nurses who are with the patient doing the protective measures but maybe there hasn't been enough -- >> pause there and listen to the head of the cdc, thomas freiden speaking now. >> public worker in texas has tested preliminarily positive for inaffectiif he cafection wi confirmer to testing is under way at cdc and will be completed later today. we don't know what occurred in the care of the indexed patient, the original parent in dallas, but at

in the initial 48 patients or contact who had possible contacts with the patient we have already identified. the second point i want to make is what we do to stop ebola is to break the link of transmission, to break the chains of transmission. to make sure every person with ebola is promptly diagnose and probably isolated and we identify their contacts and actively monitor their contact every day for 21 days and if they develop symptoms or fever, that we do the same process again. that is how we have stopped every ebola out rake in history except the one currently in west africa. that is how we stopped it in nigeria, that is how we will stop in dallas. breaking the links in the chain of transmission is the key to preventing further spread. i would like to turn it over now to dr. leahy. >> thank you. on the commissioner of health in the state of texas. i appreciate all the help the cdc has given us, not only overnight but over the last several weeks as we have been working through this unprecedented event. our staff had been working throughout the night trying to gather more information and

just by one patient.ve the processes in place to dispose of safe ly all that waste. >> i'm glad you mentioned that. there's a video i just got. someone sent me, bob, say i just noticed that the nypd was taking off gloves and putting them in public trash can. and i sent a note to producers saying true, i'm sitting here looking at the camera, i don't always see the video because i'm concentrating on sometimes what's on the teleprompter or thinking about what the next question is going to be. so here you go. is there any concern with that? >> i guess we don't know what they've been handling or doing. i mean, who knows. they may have just had -- i can't think of a single reason why they would be putting the gloves in the trash cans. but we don't know the full story. but for sure, it doesn't look good what they're doing there. >> there's a couple of things to consider. in the hospital, people wear gloves for a lot of different things. if you come in contact with any kind of blood or bodily fluids, you would no

they aren't teaching -- texas patient. tomorrow, this is going to happen, and this is what we did consider itneed to now. we're not sharing experiences. >> you're saying there's a lack of communication with the hospitals dealing with this disease? >> there is a need for better communication. there is a need for teamwork. and we aren't working as a team. state, i teach public health prepareness, and the answers, all the time, to all my students -- i teach graduate students. they're in their 40's, 50's. they've had many years of experience. telling them you don't work as individuals. here in the u.s., we have a wonderful democracy, where we promote individual thought, creativity, innovation. but when it comes down to disasterrings and emergencies and -- disasters and emergencies and highly infectious diseased, get all the team together. and we haven't got the whole team together. >> seems like part of the issue education. i think there's a lot of confusion, perhaps misperception exactly how ebola is spread. can you break it

i have not seen the patient yet. i will when she gets here, but at this point from the report we're getting from our colleagues in dallas is that the condition is stable, and she seems to be doing reasonably well. i have to verify that myself when the team goes over. >> if other people come to dallas somewhere else, transfered to nih. there's a limited capacity of beds doing this high level care in containment. our total right now is two beds. she'll occupy one of them. >> thank you. doctor, when we spoke on the phone the other day, you were opposed to travel restrictions because in your words, cutting commercial ties hurt fledging democracies. is this the opinion of cdc, your opinion, or someone advise you within the administration or the other agencies? where did this opinion come from that that's of high importance? >> my sole concern is to protect americans. we can do that by continuing to take the steps we're taking here as well as -- >> did someone advise you on that? someone outside of yourself? somebody else

, the ebola patient in dallas. begin at the beginning with it was her apartment in which he was staying? >> she's a caretaker. thomas duncan was visiting her. she's had a relationship with him. they're not legally married. it's not clear what the current status is. he was visiting her and her family. started to feel sick. she took his temperature. it was 101. she brought him to the hospital. she says as they were checking in at the emergency room, he was asked for a social security number. she said he doesn't have one because he just came here from liberia. the person said that's no problem. they saw a healthcare worker. louise says she also told that person he had just come from liberia. louise didn't mention ebola. she wasn't thinking about ebola at all. thomas duncan didn't mention it at all either and none of the healthcare workers, nurses or anyone else asked thomas duncan about ebola. >> no bells were going off? >> no red flags were raised other than the fact she mentioned liberia twice to the hospital. he wa

are with the patient right now. indeed the hospital workers are caring for that patient right now. we're doing our work with the with the cdc. a lot of important hard work is taking place right here in texas and dallas to ensure that the people of dallas are safe. the good news is we have not had more cases. we are still very cautious to make sure we can continue to care for individuals, monitor the situation it needs to be done. our focus is to monitor every -- our and to identify priority is to keep tracking those individuals. ofwant to make sure we arm closely monitoring then. making sure food issues are identified or if electricity was turned off during the storm, that those issues are resolved. neighbors have had a concerns and we have tried to have health educators address those issues in the community. our focus is to make sure you are informed and understand how the public health system works. it works to prevent and contain these risks. of people are listening right now. i want to reemphasize ebola is not s

they are a highly trusted resource for patients. for many years now, the gallup poll has septemb-- broad range counseling and interventions and one of the opportunities we can address is that issue i mentioned earlier, patients not taking their medications as prescribed, if you go back to the statement i made earlier, that about half of all americans suffer from chronic disease, and most chronic diseases are dreeted with some type of drug therapy, and this is where the statistics start getting alarming, because one out of three patients who start a maintenance prescription will dpe side to discontinue medication before their first refill is even due. more than one-half of patients take their doses prescribed by their physicians and three out of four people will stop taking medication within the first year of beginning therapy for a newly diagnosed disease. i mentioned earlier, as mitch as 2,300 -- obviously, solving this medication adherence epidemic, it presents a huge opportunity to improve health and at the same time lower costs.

one of the patients is in the hospital today. >> one of the other -- >> one of the other patients -- one of the other contacts, so there are three contacts, one of whom is in the hospital today. yes. >> can you tell me -- the restrictions being placed on workers that come in contact what -- suspected -- [ inaudible ] travel and quarantine and opt out -- [ inaudible ]. >> so you're asking about the health workers here at this hospital. the health workers, of course, are using full protective gear. they were ready because we knew that this patient was being transported. he had a very orderly removal from his home and with emergency workers who were in full protective gear. he came here and had a very smooth transfer up to the isolation ward, where he's been looked after by experienced, seasoned health workers who all have been training for this purpose over the last months, training, drilling and so on. these workers are working on this unit exclusively and as far as having anybody who has opted out of that, i would actually turn to dr. raju. i'm not aware of any that have. >> no one o

in the home this is a service that is actually used more heal will i by women patients we've served 56 percent that are women we have a 60 bed unit and serve about 60 patients that were female that came there and probably the largest section is our skilled nursing session we have 3 hundred and 33 patient and women make up 45 percent and the top two diagnoses were stroke and dementia and with rehab about 80 women came there our physical program and the top diagnoses is stroke but post physical trauma we have a i think a very kind of a one of a kind hiv aids unit in 1989 a 60 bed unit last year 22 women and a pretty active substance abuse treatment and 33 percent of our rfrlz were from women i wanted to quickly share one story because the roll of honda is not in the numbers when i first came to the honda in the 1990s i was a physician on the hiv aids unit shortly after i got there i ended up taking care of a mother and daith date who had hiv the mother was in her 60s and had a pretty hard life living in an sro it burned down a couple of months later her daughter arrived they hadn't se

>> well, clearly the contact with the patient and with the initial patient was -- had a lot of flaws, a lot of flaws. and as you pointed out sending him home was terribly flawed. but i want to point out that even the -- the scenario that i saw with dr. gupta has its own flaws. we ran a program for 15 years taking care of patients in sierra leone with lots of fever which spreads exactly like ebola. and under the most ridimentary circumstances. and we never had but one over the years of transmission. >> what do you attribute it to? >> well, i attribute it to very careful procedures by the staff. and experience is one of the things here. anderson, we may be over -- having more technology than we need. we had a gown, a cloth gown, a cloth mask. and a pair of surgical gloves. that is what people wore to take care of patients. when they came out, first of all their washed their hands with the surgical gloves. that is the first thing they did, in bleach. and then they took off their gown. now, if somebody had as much stuff as i saw in the gown of dr. gupta, then we would spray it with bleach

again, we know from a lot of data coming out of africa that younger patients do much better than patients who are older. the other hypothesis we had is again that she was wearing personal protective equipment during the care of her patient in dallas and therefore it is quite likely that the amount of virus that she was exposed to was substantially less than what we see in patients who get infected in less developed countries. we also know that the higher the viral load thaw get infected with, the more severe your disease is likely to be. >> we will take a couple of questions from a call in line right now. can we get those questions now? >> thank you for your time. i would like to -- >> we have been listening to the press conference at emory university hospital that just released amber vinson declare her no longer a risk and she can return to friends and family safely. she thanked the medical professionals at want hospital and at the texas hospital where she contracted the ebola virus. they talked about the lessons learned from the treatment. i want to go into that with art kaplan who is a

he wouldn't leave his patient.f sergeant mensink got into the ambulance, looked at the grenade embedded into the guy's guy and saw to his medic training that it was so deeply wedged in the man's thigh his femoral artery was exposed. so they're going to need a doctor. time to do surgery on the guy with a live ge nad stuck in his leg. they got a doctor from uab to volunteer to get into the ambulance with the guy who might explode at any minute. the doctor made an incision into the man's thigh right next to the live grenade stuck in there and then, quote, calmly and confidently, the staff sergeant reached into the incision in the man's thigh and removed the grenade by hand, careful not to twist it or turn it. and the guy is fine. i mean, obviously the guy is not fine, he plays with grenades. but after shooting the grenade into his thigh up against his femoral artery and finding the bravest paramedics on earth who refused to leave him and stayed with him in the ambulance for eight hours while they thought he might expo

are people who are providing care to ebola patients or the contacts of the three ebola patients. for our screening criteria we are always going to try to have additional margins of safety. we look at that and we would rather check more people and assess -- we are going to always have that extra margin of safety. >> thank you, and i yield back. castor forize ms. five minutes. >>

are people who either are providing care for ebola patients or the contacts of the three ebola patients and i outlined those in this sheet. for our screening criteria, we're always going to try to have an additional margin of safety. we look at that. we rather check more people and assess and so we'll always have that extra margin of screening for our safety. >> thank you. i yield back. >> thank you all for tackling this important public health issue of the ebola virus. i want to thank the experts of the centers for disease control and the nih and medical professionals across the country especially those at emory university healthcare who have been pro-active in containing and treating the virus. i agree with president obama and all of you, we have to be as aggressive as possible in preventing any transmission of the disease within the united states and boosting containment in west africa. i also think we need to pause here. this is a wake-up call for america that we cannot allow nih funding to stagnate any longer. earlier this year in the budget committee i offered an amendment to the

>>> we don't know what occurred in the care of the index patient, the original patient in dallas. but at some point there was a breach in protocol and that breach in protocol resulted in this infection. >> key words there. breaking news today, another first for the u.s. in the ebola outbreak today. the first time the dangerous disease was transmitted in america. she's a nurse who treated thomas duncan, the man who died of ebola last week in dallas. now an investigation into mistakes made in the latest case. does it mean more cases like this are yet to come? good afternoon to you. i'm richard lui. any minute now final test results expected from the cdc. preliminary data showing a dallas nurse is positive for ebola. she's in isolation at the hospital where she helped treat thomas duncan. one other person is being monitored as having potential contact with her. they are monitoring every single health care worker in duncan's care circle including those in full gear who followed procedures. >> the care of ebola can be done safely but it is hard. it requires skroop lus attention to infe

that is really getting at that patient-centered care that patients need and want. i think going back to what we talked about earlier with sort of helping patients understand the benefits of an aco -- and i know this is a little more complicated in the medicare space -- but i think there is a lot of documentation you can send to patients, welcome packet, frequently asked questions document. the acos we think are doing the best job are the ones who assign case managers to have actual conversations with the patients about what the aco is and what the benefits are for them and what care will look like for them in this aco. that is taking it that step further than just sending home a piece of paper. we all have too much paper in our lives. i think we need to have more conversations in health care. i think, also, it's all of the things that we know patients care about. it is materials written from a health literacy perspective. it is starting discharge planning at admission. it is really connecting patients with the services in their community that they are going to need