Announcement

**sharon sanders** · October 13, 2014, 10:49 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

From: "Media@cdc.gov (CDC)" <sohco@CDC.GOV>
To: MMWR-MEDIA@LISTSERV.CDC.GOV
Subject: CDC Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 AM CT)
Date: Oct 13, 2014 10:49 AM

NOTE: Change to satellite feed for today?s press briefing.

SATELLITE
FEED :
Date: 10/13/14
Time: 1200-1300 EDT (12:00 PM-1:00 PM): 720p
Satellite: (KU-Band digital) Galaxy 17: Trans: 23 Lower
Bandwidth: 18 MHz
DL Freq: 12151 Horizontal
FEC: 3/4
Symbol Rate: 13.235
Data Rate: 18.295

Media Advisory

FOR IMMEDIATE RELEASE
Sunday, October 12, 2014

Contact: CDC Media Relations
(404) 639-3286

CDC Update on Dallas Ebola Response

WHAT: CDC will host a press briefing Monday to update the Dallas Ebola Response

WHO: Tom Frieden, M.D., M.P.H,
Director, Centers for Disease Control and Prevention

David Lakey, M.D.,
Commissioner, Texas Department of State Health Services

WHEN: Monday, October 13, 2014, at 12:00 PM ET (11:00 AM CT)

WHERE: Centers for Disease Control and Prevention
Tom Harkin Global Communications Center (Building 19), Press Room
1600 Clifton Road NE
Atlanta, GA 30329

Reporters who wish to attend the media briefing in person should RSVP no later than 11:00 AM, Monday, October 13, 2014. Please contact CDC?s press office at 404-639-3286 or email us at media@cdc.gov to RSVP. Reporters who RSVP will be guaranteed access.

For directions to CDC, please visit http://www.cdc.gov/museum/visitor.htm

SATELLITE
FEED :
Date: 10/13/14
Time: 1200-1300 EDT (12:00 PM-1:00 PM): 720p
Satellite: (KU-Band digital) Galaxy 17: Trans: 20 Lower
Bandwidth: 18 MHz
DL Freq: 12151 Horizontal
FEC: 3/4
Symbol Rate: 13.235
Data Rate: 18.295

Contact: Synaptic Digital/Tom Harkin Global Communications Center (404) 639-3311

Satellite feed service is provided by CDC and free for media use

LIVE WEBCAST :
Windows Media Connection: >http://wm.onlinevideoservice.com/CDC1<

Flash Connection: >http://www.onlinevideoservice.com/clients/CDC/?mount=CDC3<

DIAL IN :

Media: 888-795-0855
Non-Media: 877-601-4718
INTERNATIONAL: 630-395-0360

Important Instructions
Please dial in 10 to 15 minutes before the start of the press conference. If you would like to ask a question during the call, press *1 on your touchtone phone. Press *2 to withdraw your question. You may queue up at any time. You will hear a tone to indicate your question is pending.

TRANSCRIPT :
A transcript of this press briefing will be available following the briefing at CDC?s web site: www.cdc.gov/media.

**sharon sanders** · October 13, 2014, 10:52 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

I am not live tweeting this event. I just did the Canadian media conference here. If someone would like to post notes, please do. They have been really good.

**annaraven** · October 13, 2014, 11:14 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

I like that he addresses that he is not blaming the HCW.

**Chicagogal** · October 13, 2014, 11:19 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

Frieden: Stopping Ebola is hard. Yesterday, we had the first case of transmitted Ebola. Our thoughts are with this HCW. We understand she is clinically stable, but please refer questions about her condition to the hospital.

We know how Ebola spreads. We know it's possible to take care of it safely. However, we have to re-think how we address Ebola infection control because even a single infection is unacceptable.

To review: there were 10 contacts known to have contact with the index patient and 38 others who may have had contact. None of these people have developed symptoms. This is consistent with what we know about Ebola - it becomes progressively more contagious as patients get sicker.

Second, we have spoken with the HCW and have identified only one contact. That individual is being monitored and has no symptoms.

Third, we need to identify and interview the HCWs who had contact with the index patient. That process is still underway. The thinking is: this person was infected in a way we don't understand, so everyone may be at risk.

All these people will be actively monitored - this is how we break the transmission. Also, as I indicated yesterday, we're doing a detailed analysis to figure out what happened. We are particularly focused on the process of taking off the PPE. We've had a team on the ground, working with the state and hospital. When the additional patient was diagnosed, we "doubled down" and people have been working through the night to address anything that could make it safer and easier to care for people who have or may have Ebola. We are not going to wait for the final results - each time we identify a process, training, equipment, or protocol that can be improved, we are improving it right on site.

Yesterday, I spoke about a "breech in protocol." Some interpreted that as finding fault with the hospital or healthcare worker. That was not my intention and I'm sorry. People on the front line are protecting all of us. The enemy here is a virus, not a person, country, person, hospital. It's a virus. It's hard to fight, but I'm confident we'll stop it. However, we all need to take responsibility for improving the safety of those on the front line. I feel awful that she became infected while trying to help someone who was infected. We need to reduce the risk to help prevent this from happening with HCWs.

All hospitals need to be thinking "Ebola" with any patient who has fever and who has traveled to these areas. Second, is the issue of care once the diagnosis has been made. That care is complex, and we are now working with the hospital to make that care simpler and easier with hands-on training and monitoring. We'll do this any time there is a case of Ebola.

I want to end with what comes next. What will happen in coming days/weeks? First, we will do everything to make sure HCWs are protected and get the best possible care. We also need to consider the possibility that there will be additional cases. We are concerned and unfortunately will not be surprised if we see additional cases with other HCWs who provided care. Third, we'll continue to track contacts - initial 48, plus new contacts. Fourth, we'll work with hospitals throughout the country to "think Ebola" when fever and travel to affected countries are involved. Fifth, we'll double down on training and assistance throughout the hospital system. We'll reach out to health department at the state and county levels to increase awareness and the ability to respond rapidly.

We wish the situation were different than it is, and we're concerned about additional infections. But, right now, we're implementing steps to make sure her care is safe and effective, and that we can do so in the future wherever Ebola arises.

**Chicagogal** · October 13, 2014, 11:22 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

Lakey: it's been a tough couple of days. We know this could happen, but it's disappointing. Our hearts are with her family and we're working on her care right now.

Our top priority is the contact investigation. We've pulled in additional staff from many different levels of government. We're looking hard at infection control practices and making sure they're even more stringent. The HCW's apartment cleaning has been done. Additional cleaning will be done today.

One issue: the healthcare worker had a dog. We're working to find a location to care for the dog and monitor it.

The final work we're doing is contingency planning. A lot of work is taking place with HCWs, EMS, public health. We continue to be grateful for support from the CDC and other partners.

**Chicagogal** · October 13, 2014, 11:31 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

Q. You spoke about the possibility of further infections. Is that because there's a known breach in protocol that you know about?

A. If we knew of a specific incident, we could narrow it down. But we don't know, so we have to cast the net more widely. We have to monitor a larger proportion of workers and procedures. For example, our staff are watching as staff put on and take off garb and retraining them on how to do it safely. They're looking at the types of PPE to see what's easier to don to reduce risk. We're looking at what someone does when they come out of the isolation unit and possibly spraying them down with decontaminants. We're looking at gloving. We're looking at things that can be done within the isolation facility to prevent equipment from becoming contaminated.

Q. You just said you're making things simpler/providing training. Seems like there's a gap between what you think is happening (fully prepared) and what really is happening. Have you thought about bringing in Doctors without Borders? Also, what about a travel ban? Can you better explain why it's a bad idea?

A. We've worked very closely with MSF and have replicated their training course. We have doctors who are going to Africa going through a MSF-based training. Definitely we will be looking at how we can increase training materials to Dallas and throughout our healthcare system. The single most important thing is to take a history of travel. If they have a fever, ask where they have been in the last 21 days. If the three endemic countries, place them in isolation.

In terms of travel, we're screening on departure from these countries. 77 people in the last 2 months were not allowed to board. None were diagnosed with Ebola - many had malaria. Starting yesterday, we started screening incoming passengers. Since that was implemented, 91 individuals were identified. None had fever, 5 were referred for CDC evaluation, none were assessed to have Ebola. We'll continue to learn from this experience.

On a travel ban: I understand there are calls to do this. I try to focus on the bottom line: reducing risk to Americans. The way we're going to do that is to do the steps I've outlined and stop it at the source in Africa. We are helping to turn the outbreak around. We are working with the DoD and many other governments. If we do things that unintentionally make it harder to get supplies in and to manage these activities, it's going to become much harder to stop the outbreak at the source. That will increase the risk to Americans. Above all, do no harm.

Q. Texas Pres is a relatively large hospital and still had an issue. Are you still confident smaller hospitals can handle this?

A. We're going to look carefully, but it's important for every hospital to be prepared. There may be Americans deployed to the area who come back. We need to be prepared.

Q. You mentioned doing everything possible to protect HCWs. Can you be certain with a patient with vomiting that respiratory protection is not needed?

A. Hospitals in this countries have all used PAPRs - a form of respiratory protection. I don't think we have concern about the route of transmission, but if there is any concern about aerosols (intubation, suctions), we recommend respiratory protection.

**Chicagogal** · October 13, 2014, 11:46 AM

Re: Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

Q. Have you identified any breach in protocol. Second, earlier this year you held a conference about Ebola where you were pressed again and again about negative air pressure. Again and again, the CDC said it was up to individual hospitals.

A. We have not identified a specific problem that lead to this infection. We've identified a series of things where we can make care safer and easier. We need to have practical solutions that are workable. Sometimes healthcare workers may think more is better - additional sets of gloves or coverings. That may paradoxically make things less safe.

Q. Screenings that begin Thursday: do they work? If people are non-symptomatic, we're relying on everyone being honest...

A. Airport screenings will identify fever. They include a detailed questionnaire about contacts. Until we stop the outbreak in West Africa, there is no way to get the risk to zero. We need to stop its spread here and minimize new cases.

Q. Is there any type of federal/state standard for HCWs to work in an isolation unit? Is there certification for this? Should we do this going forward?

A. Series of specialties - critical care nursing, infection control managers, where this is an integral part. Specific certifications do not exist. In the coming days, we'll be increasing education and training for this hospital and other hospitals.

[Lakey] We examine negative pressure rooms to make sure they're up to standard and review training, but there is no specific standard.

Q. Late last night, the Louisiana attorney general said he will not allow Ebola waste to be disposed of in L landfill. How will that impact care?

A. We know how to destroy Ebola virus - it's not particularly hardy environmentally.

[Lakey] We feel comfortable that the incineration and inactivation procedure poses no risk.

Q. You mentioned several other staff members you were interviewing. What are you talking to them about?

A. What kind of contacts, what kind of care they gave on each day so we can develop a map of potential exposures. it's a relatively large number, but only a portion will have contact. We're hopeful that by tomorrow we'll be able to provide that number.

Q. You say more training is needed. The TX hospital had a training session the week before Duncan was admitted. Is there any certification program being considered to know which hospitals are up to par?

A. The events in Dallas reiterate how difficult it is to care for Ebola patients. We're looking at every aspect.

Q. Could you please tell us the steps HCWs were taking to decontaminate?

A. We're looking at every aspect: when PPE is donned, what's used, what they do in the room, reducing the risk of contamination, and what they do when they come out and taking equipment off (equipment buddy for monitoring/supervision). It's an ongoing process.

Q. Should you be reconsidering end of life care, such as intubation?

A. We want to make sure we have safe and effective care. We want people to have confidence that they will get the best possible care.

[Lakey] Appreciate the support of the CDC and other partners. Bringing in the staff we need to do contact tracing. Working to make sure infection control is stringent. Doing everything else we can to coordinate response.

[Frieden] Care of Ebola is hard, but we know how to do it. Need to make it safer and easier. The one case we've had tell us there were risks. We're assessing what more we can do to improve care/reduce risk.

Q. [shouted question] Should the public be confident we know how to do this?

A. If "this" is stopping Ebola, we know how to do it. Right now, we need to make sure care is done safely and effectively everywhere. We've cared for patients for decades without infections. We know how to stop Ebola. For the general public, if you're a HCW, do what you can to help stop it. For individuals who were potentially exposed, monitor intensively. For everyone else, there is no risk for exposure unless you go to West Africa. That's why we're going to West Africa -- to stop that risk there and stop it at the source to protect Americans.

Announcement

Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

Media Advisory: CDC update on Ebola Response - Monday, October 13, 2014 at Noon ET (11:00 a.m. CT)

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