Doctor in New York Tested Positive with Ebola; Interview with Representative Charlie Rangel; Interview with NYC Health Commissioner Joseph Esposito; New York on High Alert Over Ebola
ANNOUNCER: This is CNN breaking news.</s>DON LEMON, CNN ANCHOR: Hello, everyone. It's 11 p.m. in New York, and this is CNN TONIGHT. I'm Don Lemon. Our breaking news, New York and the nation on alert tonight over Ebola. Dr. Craig Spencer who returned from treating Ebola patients in West Africa on October 17th, he is infected. He is in isolation in Bellevue Hospital right now in New York City. He had close contact with at least three friends who are now all quarantined. Another, a taxi driver is not considered at risk at the moment. Want to get straight to CNN's Poppy Harlow who is at Bellevue Hospital where they just wrapped up a press conference a short time ago including the mayor of New York City and the governor. Both of them saying New Yorkers should not be worried. But I'm not sure how much that will translate to people who don't know that much about this disease. Who say there are still too many unknowns when it comes to this virus -- Poppy.</s>POPPY HARLOW, CNN CORRESPONDENT: It's a good point, Don, but can't reiterate enough that New Yorkers should operate, officials are saying, as normal because this disease, Ebola, is so hard to contract. It is not an airborne disease. You contract it by transmission of bodily fluids and it becomes increasingly contagious the more symptomatic the patient becomes. This doctor, the 33-year-old who returned from treating Ebola patients in Guinea, just developed that 103-degree fever this morning. Sometime between 10:00 and 11:00 a.m. he did not leave his apartment after that except for when the first responders came in their hazmat gear, et cetera, to properly transport him here to Bellevue Hospital. The hospital designated by New York City to deal with a situation just like this. But, you know, of course there's concern because we learned at the press conference that he indeed took a number of different subway trains in the city. He took a taxi to Brooklyn last night to go bowling. He went to a restaurant, he walked on the high line, which is an elevated park in New York City. So he was out and about. In addition to him being quarantined and treated here behind me at Bellevue Hospital, you have one other person being treated -- being quarantined here and monitored. It is believed to likely be his girlfriend and then also two friends that are also in isolation at their respective homes at this time but, again, the governor and the mayor saying it is highly unlikely that any other New Yorker would be contracting this and saying there is no better health system in the country, they say, than New York to take care of this. No better hospital to take care of this than where I'm standing, Bellevue.</s>LEMON: And Poppy, let's talk about that a little bit because during the press conference the governor of New York, Andrew Cuomo, said there are eight hospitals in New York state who are equipped for Ebola.</s>HARLOW: Right.</s>LEMON: Right? Who can do the most intense Ebola treatment. Two hundred hospitals in the state he says all of them are ready but they can't do the intensive treatment that they believe is needed for this.</s>HARLOW: Right.</s>LEMON: But Bellevue Hospital, one of those hospitals, and he said that was the right thing to do considering what just transpired today.</s>HARLOW: Well, yes, I mean, it is the one. I mean, we might have some photos to show you from two weeks ago, October 8th. They ran a big drill here in front of the media showing us their emergency department, quarantine centers there. There's the isolation unit right upstairs. They were preparing for exactly that. We heard the New York City health commissioner speak today and she said tonight that we've been preparing for this for months. So knowing that this could come to New York City, knowing what a densely populated city this is they have been certainly preparing for this. It was asked in the press conference, will the doctor remain to be treated here? Will he be transferred, say, to Emory University Hospital in Atlanta where we've seen some successful treatment or to Nebraska? They said that has not been determined at this time. One other question that we still have outstanding is what kind of treatment he's getting. We know the state that this patient is in, the 33-year-old doctor, according to the mayor earlier today said that he was in, quote, good shape. That's positive. But we don't know, for example, will he get any of those experimental treatments, Don, like ZMapp which we know is in very short, to no surprise, supply. So what kind of treatment is he going to get? I think they're really just assessing it. It's only been a matter of hours since that positive came back.</s>LEMON: Poppy Harlow, thank you very much. Let's get some of those answers, I'm sure Dr. Sanjay Gupta can help us out here. He's our chief medical correspondent. Doctor, before we go through a timeline here, what -- let's talk about what Poppy said. What might his treatment be?</s>DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, we know that the patients, you know, certainly even in Dallas have received blood transfusion which is really a plasma transfusion. You'll remember, Don, Nurse Nina Pham received that. What that is, is basically taking a blood of someone who has had Ebola and then survived it and taking their plasma which has antibodies in it that can help fight Ebola and transfusing that into a newly infected person. So that is an option. There's also the option, as we talked about for some time now, the experimental medications that Poppy mentioned. You'll remember, Don, that Dr. Kent Brantly and Nancy Writebol received ZMapp, that is one of the experimental medications. There's no supply of that right now. But there are other experimental medications. So my guess is both of those things are going to be options and he may receive one or both of those as well. We don't know for sure. There's not been scientific data to say that they absolutely worked but certainly they have been used several times now both in the United States and in West Africa. So that -- those are going to be sort of the treatments that he'll receive. The main thing, though, is making sure he is fluid, he gets enough fluid. If he's having any bleeding problems he can be given blood and that, you know, he'd be taken care of in the hospital in that regard.</s>LEMON: OK. Dr. Gupta, let's go through some of the timeline here. What they said during the press conference. They said he was working in Guinea with Doctors Without Borders. He finished that on the 11th --</s>GUPTA: 12th.</s>LEMON: The 12th of October. And then he left the 14th via Europe and then he arrived at JFK on October 17th and said he was told to check his temperature twice a day. And then October 21st he began feeling tired but that was between 10 and 11 days after he returned, he started getting a fever but he also got on the subway, he spent time with his girlfriend and two other friends. He went to a bowling alley. He went to a restaurant. He walked on the high line. He got into an Uber taxi. And on and on and on here. The question is, should Dr. Spencer have self-quarantined when he got back to the United States 10 days ago?</s>GUPTA: You know, it's a very interesting question and a lot of people are going to hear you ask that right now, Don, and they're screaming at their television set saying, of course, he should have self- quarantined. It would have been the judicious, prudent, responsible thing to do. And, you know, I think that makes a lot of sense in many ways. I want to remind you and I know you know this, Don, but the science suggests this, that someone is not going to transmit this virus until they are sick so while he was doing those things, you know, on the subway, bowling, my understanding is at a restaurant, my understanding is, and you have to -- if we're taking him at his word obviously here is that he wasn't having any symptoms at that time. And certainly someone who is quite sick with Ebola probably is unlikely to be up bowling but, you know, just in this abundance of caution which is a term we've heard a lot over the last month or so, somebody who's had intensive contact in West Africa with patients with Ebola taking care of them as a health care worker. When he got back to the United States in addition to taking his temperature twice a day should he have basically just eliminated his contact with other people. You know, there may be some real value in that. The CDC has been unclear as far as I can tell and if there hasn't been strict guidance on saying these people should be quarantined and that's, Don, is going to be a question they need to answer.</s>LEMON: So, listen, what do we know about the four people that he came in contact with? As I understand, obviously he is in the hospital. Two of his friends are in quarantine and I think the other person he came in contact with I'm assuming is his girlfriend, also according to the health commissioner, the New York City is in the hospital as well tonight but not showing any signs of Ebola?</s>GUPTA: That's what my understanding was. I took the same thing away from that as you. She sounds like the person he had the most intensive contact with and that's why she is in the hospital and in quarantine, as well. Not showing any symptoms. You'll remember, Don, again with Mr. Duncan, he's somebody that we had gotten to know, you know, he was the person who got sick in Dallas, ultimately died, but was in his apartment or he was in an apartment for two days after showing symptoms with friends and family members and none of them got sick. So it is -- that's potentially good news for these other people who are now being observed, you know, Dr. Spencer's contacts.</s>LEMON: OK.</s>GUPTA: The likelihood of them getting sick is very low but obviously they have to monitor them and make sure that they take their temperature.</s>LEMON: All right. Stand by, Sanjay. I want to get to Miguel Marquez who is in Harlem tonight in front of the apartment building of Dr. Spencer. And as I understand, the Health Department has been to Dr. Spencer's apartment that they are -- what are they telling residents, Miguel?</s>MIGUEL MARQUEZ, CNN CORRESPONDENT: Well, two things, they are finding the neighborhood with public health officials today handing out these cards, telling people exactly, both in English and in Spanish, telling them exactly the concerns about Ebola, how you get it and where you have to be concerned. The other thing they're doing and more importantly is want to find out not only in this building but around the neighborhood. Everybody we speak to along the neighborhood seems to remember this individual. Who came in contact with him over the last several days, who might they have to worry about. Who do they need to get in contact now that that test has come back positive? I can tell you that the folks in this neighborhood all afternoon have been pretty mellow, very kind of cool, but now that this test has come back positive, there was a switch that went off. There was an increased police presence after that. More people in the neighborhood coming by to see the building and people who live in the building now not running in fear or not seeing people packing up their belongings in that building but they are now beginning to wonder should I take more precautions, all the other things I can do. I need to be a little more vigilant and a little aware. Certainly the fact that he took the one -- the one train, the A train, the L train, and was in public parks is going to concern people as well and they are going to begin to wonder if they have seen this guy and on the train next to him in the last couple of days and should they be worried about the next time they get a sniffle -- Don.</s>LEMON: A train, one train, L train. Thank you very much. We appreciate that, Miguel Marquez, in Harlem in front of Dr. Spencer's apartment building. I want to bring in now New York Congressman Charlie Rangel. He's on the phone. Congressman Rangel, this is your -- this is your district. What are health officials telling you? Are they keeping you updated?</s>REP. CHARLIE RANGEL (D), NEW YORK: No question. I've been in touch with the city as well as the White House and the Centers for Disease Control, and that's not nearly as important as I am concerned about the feeling of fears that the people have in the district and I am so confident that the sophistication that my constituents have, it just so happens I've had six community meetings and all of the people knew that there was an Ebola victim living in our district that was in Bellevue Hospital. But we recognize that we had hoped that it didn't happen in West Africa. We certainly hope it didn't happen in Dallas. And we are concerned it didn't happen in our congressional district but we never felt more secure with the medical delivery system that we have and that close cooperation that we've had before this in terms of being prepared, so, of course, we're not relaxed, but there has been no concern about being panicked about an unfortunate thing that we're certain that if it happened to have happened anywhere, we wish it wasn't in our city, but for the good of the world, we are better prepared than anybody else to deal with it.</s>LEMON: Congressman, but, indeed, you're hearing, you're hearing this directly from your constituents, from the people of New York and Harlem in your district saying that they are -- they're not concerned about it? Are you assuming that --</s>RANGEL: I didn't say that.</s>LEMON: OK.</s>RANGEL: What I'm saying is that we are concerned. We wish it didn't happen in our -- we wish it didn't happen anywhere but we are confident that our health and absolute cooperation working with the state and that several conversations I've had today that if it had to happen anywhere in America, that no community will be better able to deal with it than a city of New York and Bellevue Hospital in my district. Not my district but in Manhattan, so what we're saying is that we -- we hope that we can really -- you know, we're learning every day what happened in Dallas, what happened everywhere.</s>LEMON: Right.</s>RANGEL: And certain things that we have to recognize helps us. The victim was a doctor. He's sharing with our experts how he felt, when he felt, what he is doing. And no one really has threatened us with walking by people that it's contagious.</s>LEMON: Yes. OK, I think, Congressman, I think you're right. Everyone gets it. I was just wondering if you had heard directly from your constituents. But I appreciate you joining us, sir, tonight. We'll get back to you, Congressman Rangel, if there are any more developments. Thank you very much. I want to turn now to the doctors, Dr.Devi Nampiaparampil, I will call her Dr. Devi. Dr. Alexander Garza, and Gavin McGregor-Skinner, Juliette Kayyem and also Dr. Alexander Van Tulleken. Of course Juliette Kayyem, I elevated her but she's also very knowledgeable on this. Let's turn to the doctors in front of me. New York City Office of Emergency Management expected to activate its emergency operations center in Brooklyn. That's according to a law enforcement agency official. She also says the immediate focus is to track down anyone who may have come in contact with Dr. Spencer. Investigators are taking this seriously because they are concerned it appears that he didn't self-quarantine. The official said according to the same official the doctor took an Uber cab which we know they confirmed and Uber confirmed to us as well. Bowling alley again that is confirmed. In Williamsburg, Brooklyn, and also he took the train and went to a restaurant. Also walked in the High Line. So Congressman Rangel is saying, Dr. Van Tulleken, that he is very confident. Should he be as confident as he is? Should the people of New York be as confident as the congressman is?</s>DR. ALEXANDER VAN TULLEKEN, CNN MEDICAL ANALYST: Well, he is in a very interesting position. Because I think -- I'm not sure he should be that confident, actually. I mean, he's one of the people in charge, he's one of the authorities. And I don't think the authorities should be feeling confident. I think they should be feeling very worried and they should be -- at the abundance of caution is the least of it. I mean, they should be tracking down absolutely everyone. Taking every measure they can to make people feel safe.</s>LEMON: Very worried why?</s>VAN TULLEKEN: Because we've got a case of Ebola and because he's been out in the city potentially symptomatic. But it's really important to say they should be worried, they should be out all night working really hard on it. The rest of us should get a good night's sleep, not worry about it, and I'll be on the</s>LEMON: Well, here's -- you know, everyone says we don't -- you know, we don't want people to panic but don't you want people to -- shouldn't it be an overabundance of caution rather than saying no, it's not a big deal, whatever you can -- this won't happen. We're -- you know. Isn't there overconfidence in the beginning of this?</s>VAN TULLEKEN: Exactly. And that's what I'm saying. I mean, I think the congressman is saying we feel really confident. That isn't the mood you want. I think what we want is for him to feel very nervous, for him to be working extremely hard to make sure everyone is traced down all those authorities. I think the rest of us -- I don't think anyone in New York should change their behavior tomorrow.</s>LEMON: You're not worried because you and I talked about riding the train.</s>VAN TULLEKEN: Right.</s>LEMON: You're not worried about that.</s>VAN TULLEKEN: I mean I live five blocks away from him. I will be going out to the bars tonight exactly where he was.</s>LEMON: Five blocks away from him.</s>VAN TULLEKEN: You let me know.</s>LEMON: About 15 blocks away from me. All in the same neighborhood. But do you -- what about the confidence level here? You said you don't believe that it's -- my question to you as we were listening to the press conference is if they're going to go and they're going to sanitize this bowling alley, if the airplane that he was transported on, if that's being taken out of service to be cleaned, why not the subway system? Why not other -- why not the restaurant?</s>DR. DEVI NAMPIAPARAMPIL, ASSISTANT PROFESSOR, NYU SCHOOL OF MEDICINE: Well, I agree with you. Yes. I agree with you. I mean, that's the whole problem that we've seen all along, right? We're telling people that it's safe that you have to be exposed to bodily fluids which is true but then at the same time we send a different message when we say OK, let's sanitize all these other areas that he went to before he was sick, so I think that's the confusion. If it wasn't the subway, if it was something much easier to sanitize or evaluate I think people would just say do it and then that would be the end of it. But with the subway you have a much more practical problem. How many people come in to the subway, how many people were on this car, and tourists, you know, how are you going to track them if they came in and then they left and they're not watching the news. It's very difficult to actually do that so in terms of, you know, whether people should worry or not, I don't think they should worry in the sense that, you know, he wasn't symptomatic at that time, and the likelihood of bodily fluids being there is very low but at the same time these missteps send kind of mixed message do kind of confuse people.</s>LEMON: And as you guys have been saying, it's not binary. Right? Because when you think about --</s>NAMPIAPARAMPIL: Right.</s>LEMON: You know, last night, you know, I worked late. We went out, a couple of people had a drink, or whatever and then all of a sudden you wake up the next day and you have a fever. So it's not binary. But I mean, is -- I mean, this is like, all of a sudden I'm not symptomatic until I get that fever? That's not true, is it?</s>VAN TULLEKEN: No. No. I mean, what you're looking at is a gradual increase --</s>LEMON: Right.</s>VAN TULLEKEN: -- with the amount of virus in his -- in his bodily fluids. And at the time that he's -- you know, the time that we're concerned about, it will be very low. And we know this because other people have traveled on airplanes, Thomas Eric Duncan's relatives in the house with him and they didn't catch it.</s>LEMON: The health care workers.</s>VAN TULLEKEN: The health care workers were exposed to bodily fluids with -- you know, millions of millions of bioparticles in tiny amounts. And at that point it's very infectious.</s>LEMON: Let's talk about the readiness of New York City now. Here's the governor at the press conference a short time ago.</s>GOV. ANDREW CUOMO (D), NEW YORK: We have had a full coordinated effort that has been working literally night and day, coordinating city, state and federal resources, coordinating and drilling from airports to transportations to subway stations to ambulances, to hospitals, so we are as ready as one could be for this circumstance. We had 5,000 health care workers in the Javits Center who would be drilled on just this situation.</s>LEMON: OK. So they say, Juliette Kayyem, they have been preparing for this for months. Let's see what -- this is Ron Klain, who is the Ebola czar, has been in contact with the governor. Sylvia Burrell for the -- from HHS has been in contact. Also the head of the CDC Thomas Frieden also spoke at that press conference, also been in touched. The CDC is sending a go team here. What about the preparedness of New York City?</s>JULIETTE KAYYEM, CNN NATIONAL SECURITY ANALYST: Well, you know, look, there's no city like New York City. I was at the Department of Homeland Security sort of stands by itself in terms of its preparedness partially as a result of, of course, 9/11 but also the resources it has. And they have been drilling and you know we talked about some of the mistakes made in the past. One was clearly statements made by government officials that we were safe from Ebola. Now I'm not a doctor, as I -- as you said, you could predict someone was going to come here and not just one or two or three but we're a big country with a lot of travelers and a lot of people going back and forth.</s>LEMON: Juliette --</s>KAYYEM: And so --</s>LEMON: But here's the thing.</s>KAYYEM: Go ahead.</s>LEMON: So -- and I think Anderson and I talked about it, you know, right after the press conference. You know this is the most populous city and you guys can weigh in, as well. This is the most populous city in the country. People get around mostly through mass transit here. We're on -- the governor even said it. We're on top of each other here so obviously it's not airborne.</s>KAYYEM: Right.</s>LEMON: But still there are a lot of unknowns when it comes to this --</s>KAYYEM: But --</s>LEMON: Gut go ahead, Juliette.</s>KAYYEM: That's -- but no, so this is the challenge of Homeland Security, right? That it is as much about the homeland as it is about security. We could have a reaction. There's no question about it. We could satisfy the hysteria and say we're going to close down the A- train. You cannot live in a modern society like ours and close down an entire metro subway system in New York City because of one patient. So what you do is you focus on the patient, where was he for long periods of time, who was he with. And this is the constant balancing but any notion that we're going to bring down the system or close it because of a threat that we can now predict and that we are now training people to protect us from is just -- it's not sustainable in our modern global society and that's going to be a constant balance. And I think that's what Governor Cuomo was getting to.</s>LEMON: And Dr. Gavin, you know, I think people are -- rightfully or wrongfully, people are concerned about the unknown. This is -- you know, we deal with a lot of diseases that we get -- we deal with the flu and chicken pox and all of it. And we deal with all those things. But this is something that is unknown and newly introduced to America and I think people are concerned about that and it does raise a question, as I spoke with Dr. Gupta about this, about self- quarantining workers who have worked closely with Ebola patients once they return not only to America but to other places where there is no outbreak.</s>GAVIN MCGREGOR-SKINNER, ELIZABETH R. GRIFFIN FOUNDATION: No, again, and I just want to back to that, Don. CDC does have guidance. They term is Conditional Release and Controlled Movement. And those with us -- within the profession that deal with Ebola patients we know what that guidance is. The problem that Sanjay identified it's so hard to find these paper-based documents on the CD Web site. And actually find the one paragraph that refers to the guidance so it's not easily found and it's not common knowledge. But if you're with them in the profession you know that guidance is there. But I do have confidence in the New York system. And I think what we haven't talked about tonight, Don, is the disparity between the -- all the hospitals within the country. When the CDC director Dr. Tom Frieden said all the hospitals in the U.S. have to be prepared what he didn't tell us was how much that's going to cost. And as we found in New York, those hospitals that have money are able to have a 12-month exercise program, they're able to drill, drill and drill, that gives you the confidence and the practice and the rehearsal and the training to be prepared for highly infectious diseases like Ebola. We saw this after the Boston marathon bombing. The hospitals in Boston were prepared for disasters and emergencies like this because they practice and train and drill, drill, drill. Hospitals like Dallas don't -- we know weren't going through that same process and I get phone calls every day from hospitals around the country saying, come and help us be prepared and what do we need to do. We need to get up there and go through those what-if scenarios and drill, drill, drill, and that's what's lacking across the U.S. health care system to show that all the hospitals have a consistent approach and are ready for Ebola.</s>LEMON: Dr. Garza, are you in agreement with this?</s>DR. ALEXANDER GARZA, FORMER ASSISTANT SECRETARY OF HEALTH AFFAIRS, DHS: Yes, by and large, yes, although I would caveat it with it's very difficult to train every health care provider out there to be able to take care of very complex and infectious patients, and so I think New York City and New York state made a very bold and correct step by designating those eight hospitals within their state as Ebola treatment facilities. And I wouldn't be surprised to see other states falling in line. You saw an announcement from Rick Perry a couple of days ago. The governor of Texas demonstrating, you know, these are the two hospitals that will be treating Ebola patients in the state of Texas and so it is important that all health care workers are trained and provided equipment to do I think the initial sort of resuscitation. But I also think it's important that certain facilities be designated as those go-to places because these are very complex and very infectious patients.</s>LEMON: All right. Thank you very much. Everybody, stand by. We have got a lot to get to tonight about Ebola. A doctor returning from Guinea who had treated patients -- Ebola patients in Guinea now testing positive for Ebola and also spending time before he tested positive out in public here in New York City. Listen, I need to update you on something here because earlier this evening here on CNN we reported on Dr. Spencer, him visiting a bowling alley. That was one of the places that he visited last night. The bowling alley we showed and the name on the graphic was incorrect. They were incorrect and the actual bowling alley Dr. Spencer visited in Brooklyn was The Gutter. We heard the health commissioner in New York mentioned the name during the press conference this evening. The alley, that alley is temporarily closed and will be visited by health officials tomorrow. CNN does regret that error. Again, we want to make sure we get everything correct here when it comes to this particular story and again, as all of the officials have been saying here, we should not panic, but we should also be cautious and overabundance of caution, if you will. That's how health workers are treating it, that's how the government is treating it, and that's how you should treat it as well as a citizen. Lots to come here on CNN. We'll talk about Ebola and also to talk about breaking news here in New York City. Police officers attacked by a man wielding a hatchet. Sources say there may be, there may be ties to radical Islam and to jihad. We'll be right back.