'The Last Word with Lawrence O'Donnell' for Thursday, October 16th, 2014
Read the transcript to the Thursday show
Show: THE LAST WORD WITH LAWRENCE O`DONNELL
Date: October 16, 2014
Guest: Dr. Charles Chiu, Karin Huster, Dr. Kent Sepkowitz, Cecile
Richards, Tessa Thompson, Justin Simen, Bryan Walsh
LAWRENCE O`DONNELL, MSNBC HOST: Wow, Rachel. What a collection of heroes.
MADDOW: Amazing stuff. Thanks, man.
O`DONNELL: Thank you.
O`DONNELL: Tonight for the first time, we are seeing and hearing from the
Dallas, Texas, nurse who contracted Ebola while caring for her patient.
Nina Pham`s tearful video "thank you" from her Texas recovery room is next.
DR. TOM FRIEDEN, CDC DIRECTOR: Ebola is not new although it`s new to the
UNIDENTIFIED FEMALE: Demanding answers. The nation`s top health experts
are on Capitol Hill.
UNIDENTIFIED MALE: The head of the CDC will be testifying on Capital Hill.
UNIDENTIFIED FEMALE: CDC Director Tom Frieden will be testifying there.
FRIEDEN: There are more than 5,000 hospitals in this country. There are
more than 2,500 health departments.
UNIDENTIFIED FEMALE: Are hospitals across the country prepared to deal
with another case of Ebola.
UNIDENTIFIED FEMALE: The most contentious exchanges came over the issue of
UNIDENTIFIED MALE: This is the question American public is asking, why are
we still allowing folks to come over here?
UNIDENTIFIED MALE: Is the White House considering a travel ban?
FRIEDEN: I can`t speak for the White House.
UNIDENTIFIED MALE: Do you know if they`ve ruled out a travel ban?
FRIEDEN: I can`t speak --
UNIDENTIFIED MALE: Have you had conversations with them about it?
FRIEDEN: We`ve discussed the issue of travel.
UNIDENTIFIED MALE: There`s some suggestion that the patient`s dog may be
infected. Can the virus be transmitted by dogs? We`ve got no restrictions
on travel of human beings. How about the dogs? Don`t you think we ought
to at least restrict travel dogs?
UNIDENTIFIED MALE: When you`re talking about a travel ban, you`re talking
about a very aggressive government action.
UNIDENTIFIED MALE: Ebola doesn`t care about that.
UNIDENTIFIED MALE: Screening and self-reporting in airports have been a
UNIDENTIFIED MALE: We have new screening underway, of course, at O`Hare in
Chicago, here in Washington, at Newark Airport, as well as Atlanta
UNIDENTIFIED FEMALE: Travelers arriving from Guinea, Liberia and Sierra
Leone will have their temperatures taken.
UNIDENTIFIED MALE: The fight against Ebola in this country is
FRIEDEN: CDC works 24/7 to protect Americans. There are no short cuts.
Everyone has to do their part.
O`DONNELL: We have new video inside the hospital of a nurse who contracted
Ebola in Dallas while caring for Thomas Eric Duncan. Right now, Nina Pham
is on an airplane to Maryland. When she lands, she will be taken to the
National Institutes of Health for further treatment.
Before she left Texas Presbyterian Hospital in Dallas a few hours ago, her
doctor recorded this conversation in her room.
(VIDEO CLIP PLAYS)
O`DONNELL: A family of the other nurse with Ebola, Amber Vinson, released
a statement tonight saying she is stable, and that she followed all the
protocols while treating Thomas Eric Duncan and is trusting her doctors and
nurses at Emory Hospital in Atlanta.
Between 1976 when Ebola was discovered and 2013, there were 20 Ebola
outbreaks and all of those combined killed a total of 1,548 people. This
year, Ebola has killed more than 4,500 people. Almost 9,000 have been
diagnosed. Almost all of the cases of Ebola have been in three West
African nations, Liberia, Sierra Leone and Guinea. There have been two
cases in the United States, one in Germany, and one in Spain.
Today in Madrid, a man on an Air France flight who had traveled from West
Africa to Spain was rushed to the city`s best hospital suffering from a
fever and chills. He is being tested for Ebola.
The nation of Jamaica today imposed an immediate travel ban on people who
have traveled through the three Ebola infected countries.
And today, a U.S. House subcommittee considered the idea.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: My recommendations based on what occurred in this
hearing, I believe we need an immediate ban on commercial nonessential
travel from Guinea, Liberia, and Sierra Leone.
UNIDENTIFIED MALE: We need a plan to treat those who are sick, and to stop
the spread of this disease, this includes travel restrictions or bans from
that region beginning today.
UNIDENTIFIED MALE: Sealing people off in Africa is not going to keep them
from traveling. They`ll travel to Brussels, as one of the people did, and
then into the United States.
UNIDENTIFIED MALE: Why from a medical standpoint you have concluded that a
total travel ban is inappropriate and not effective.
(END VIDEO CLIP)
O`DONNELL: Tonight, President Obama said this about a travel ban.
(BEGIN VIDEO CLIP)
BARACK OBAMA, PRESIDENT OF THE UNITED STATES: If we institute a travel ban
instead of the protocols that we`ve put in place now, history shows that
there is a likelihood of increased avoidance. People do not readily
disclose their information. They may engage in something they called
"broken travel", essentially breaking up their trip so that they can hide
the fact that they`ve been to one of these countries where there is a
disease in place.
And, as a result, we may end up getting less information about who has the
disease. They`re less likely to get treated properly, screened properly,
quarantined properly. And, as a consequence, we could end up having more
cases rather than less.
If they come back to me and they say that there`s some additional things
that we need to do, I assure you, we will do it. And it is currently the
judgment of all those who have been involved that a flat-out travel ban is
not the best way to go.
(END VIDEO CLIP)
O`DONNELL: And today, the director of the Centers for Disease Control said
(BEGIN VIDEO CLIP)
FRIEDEN: Many of the people coming to the U.S. from West Africa are
(END VIDEO CLIP)
O`DONNELL: Dr. Charles Chiu is an infectious disease expert, who studies
the Ebola virus at the University of California and San Francisco, and
Bryan Walsh who is the "Time" magazine foreign editor and has been
supervising their Ebola coverage.
Dr. Chui, first of all, to the issue of the day, which is a question of
some form of travel ban. What is your position on that?
DR. CHARLES CHIU, UCSF, VIRAL DIAGNOSTICS CENTER: I mean, I believe that a
travel ban, the issue of the travel ban is a very complicated issue. There
isn`t a clear answer as to what may be right.
Certainly, instituting a travel ban may have the negative effect of kind of
impeding kind of the flow of greatly needed resources, personnel to West
Africa. And also, it is something to be said that having a travel ban
potentially may make it more difficult to track patients that are coming,
or individuals that are coming from West Africa with Ebola virus infection.
So, this must be balanced against the need to protect Americans, and
whether or not a travel ban will indeed protect Americans is still in
O`DONNELL: And, Bryan, as a variety of possible travel bans, you could
just shut off absolutely all traffic, but then possibly leave a window open
for American citizens to return to the United States. There`s a bunch of
variations that are possible here.
BRYAN WALSH, TIME FOREIGN EDITOR: Well, no matter what you`re doing here
and one thing that hasn`t really been mentioned is that if you do cut off
travel in almost in any way, not only will you sort of create the problems
the president was talking about, people going underground, still trying to
get to the United States or other parts of the world to escape Ebola, but
you will also slow down which is most important, which is the flow of
health workers, the flow of health materials.
What we really need to get into these infected countries to slow down this
outbreak. If we can`t do that, then we`ll just be fighting this
essentially forever. We need people, we need material, and if you slow
down travel, you`re going to make it that much more difficult.
O`DONNELL: Dr. Chiu, there`s still confusion out there when people listen
to all the evidence and listen to all the testimony today at the hearing,
people are still wondering, how could these nurses have gotten infected?
CHIU: And that`s a really good question. And actually, you know, as CDC,
and other agencies and the health care providers and the hospital
administrators had admitted, we still don`t know how they became infected.
However, some of the things that need to be taken to account, one is that
it was clear that there was probably that the hospital was inadequately
prepared. In fairness, they are really the ground zero for the initial
infection, the first case of Ebola being treated by a hospital that wasn`t
specifically prepared to manage or take care of Ebola patients.
The other thing that needs to be taken into account is there were some
differences in the way -- perhaps in the way the personal protection
equipment or protective gear were put on or taken off. This is something
that needs to be done in extremely meticulous fashion to avoid
inadvertently becoming infected from contaminated material.
And I think there`s a third aspect of it, which was actually remarked upon,
was that certain invasive procedures such as dialysis, such as respiratory
intubation, these are procedures that are typically done in Africa. And
may have inadvertently exposed them, health care workers, because of
aerosolization of highly infectious secretions.
So, I don`t think we know the answer, but I do think that the fact that two
health care workers became infected doesn`t change -- fundamentally change
what we know about the virus and how it`s transmitted.
O`DONNELL: One of the members of Congress at that hearing is herself a
nurse, Representative Renee Ellmers. Let`s listen to what she had to say.
(BEGIN VIDEO CLIP)
REP. RENEE ELLMERS (R), NORTH CAROLINA: You already said you don`t believe
this is airborne and yet there again, I know how nurses are, I was one for
21 years before coming to Congress. You`re protecting yourself, you`re
protecting your patient, you`re protecting your family. They followed
precautions, I am sure.
FRIEDEN: We are confident that this is not airborne transmission. These
nurses were working very hard. They were working with a patient who was
very ill, who was having lots of vomiting, lots of diarrhea. There was a
lot of infectious material.
And the investigation is ongoing, but we immediately implemented a series
of measures to increase the level of safety.
(END VIDEO CLIP)
O`DONNELL: Bryan, there we are going backwards in the dialogue. Talking
about, is it air born. Something that people who have come on this program
said with absolute assurance in the last several weeks, absolutely not
airborne. There`s no chance it`s airborne.
But it seems to me the infection of the nurses is what is making people
reconsider everything because they -- even with these small possible
vulnerabilities in their protective gear, they still were highly protected.
And people have been sitting here saying, Ebola is hard to catch.
WALSH: It is hard to catch. I mean, it`s clearly something went wrong.
It`s very concerning to have the head of the Centers of Disease Control
saying we really don`t know how this happened. Clearly, there was a
mistake, there was a gap somewhere along the way.
And it seems wrong, which I keep hearing, is that some people almost
blaming these nurses for making a mistake or being responsible for this in
some way. That`s not really fair at all. You know, it takes a lot of
practice to do this. You can`t really just be trained in this level of
infection and control in a week, in a day.
You know, what Doctors Without Borders does is really a very, very finely
tuned machine. And that`s something they`ve done for years. And it`s not
really reasonable to expect --
O`DONNELL: How long do they take training a nurse for working with Doctors
WALSH: I mean, it will take weeks. I mean, you actually have to be
trained at the Brussels headquarters before you go out to the field. And
also, you have a buddy system that isn`t always the case here in the U.S.
The reality is simply that the CDC had said, any hospital can do this.
That`s not really the case, as we`re finding out, because it`s not really
about infection control, but what do you do with the waste? A million
other things that didn`t really come up until now, we`re actually dealing
with a number of patients we`re seeing, it`s not nearly as easy as we would
O`DONNELL: Dr. Chiu, do you feel ready in San Francisco? Do you think San
Francisco hospitals are now on this alert that everyone has been getting
through the media, do you think they`re more ready now to deal with this if
a patient were to show up there?
CHIU: Well, I think that every hospital across the country has now become
acutely aware of this and indeed of the threat that Ebola can present. And
I think that every hospital has to become prepared, has to be prepared that
potentially patients with infected with Ebola can end up in emergency room
or urgent care clinics at any hospital in the country.
And our hospitals as well and other hospitals are implementing measures and
taking into account kind of the recently CDC recommendations, or
modifications on how to address patients with Ebola virus infection.
O`DONNELL: Dr. Charles Chiu and Bryan Walsh, thank you both for joining me
Coming up, Cecile Richards and her reaction to the Senate campaign debate
last night about personhood. It is the must-see debate moment of the week.
And Bill O`Reilly and Jon Stewart have a little debate about white
privilege on the eve of a weekend movie opening of the film titled "Dear
And I know you think Congress is bad, but wait until you hear how bad
Congress thinks Congress is.
O`DONNELL: Last night in Denver, a moderator showed how to ask a question
when a politician is in deep denial. It is the must-see campaign debate
highlight of the week, and it`s next.
O`DONNELL: When Colorado State Representative Republican Cory Gardner
supported a statewide personhood amendment that would give a fetus the same
rights as a person. After Gardner was elected to the House of
Representatives, he co-sponsored the Life at Conception Act in 2013.
Shortly after Cory Gardner entered the Colorado Senate race against
incumbent Senator Mark Udall last March, he told "The Denver Post" that he
had a change of heart and could no longer support personhood at the state
However, since that announcement, Gardner has said he will continue to
support the federal Life at Conception Act, a bill he continues to claim is
not a personhood bill, just life at conception.
In last night`s Colorado Senate debate, moderator Kyle Clark pressed him on
(BEGIN VIDEO CLIP)
KYLE CLARK, KUSA DENVER/MODERATOR: You continue to deny the federal Life
at Conception Act which you sponsor is a personhood bill to end abortion
and we are not going to debate that here tonight because it`s a fact. Your
co-sponsors say so, your opponents say so, and independent fact checkers
So, let`s instead talk about what this entire episode may say about your
judgment more broadly. It would seem that a charitable interpretation
would be that you have a difficult time admitting when you`re wrong and a
less charitable interpretation is that you`re not telling us the truth.
Which is it?
REP. CORY GARDNER (R), COLORADO: I think again, I do not support the
personhood amendment. The bill you`re referring to is simply a statement
that I support life. But let me just repeat the words of Senator Udall.
CLARK: Why does no one else think that? That`s what we` getting at.
GARDNER: Again, I have answered this question multiple times.
CLARK: I`m aware of that.
GARDNER: If you look at what "The Denver Post" said, "The Denver Post" has
called Senator Udall`s campaign on these issues because he`s a social
issues lawyer, obnoxious, focused on one single issue. The fact is the
people of Colorado deserve better. They deserve more than a single issue
that Senator Udall is attempting to give them.
CLARK: And believe you me, we`re going to talk about that. But what I`m
asking you about here is what appears to be the willing suspension of the
facts. People who agree with you on the issue of life think you`re wrong
about how you`re describing the bill. Everybody seems to have a cohesive
idea of what this is with the exception of you. And I`m just wondering,
what should voters glean from that?
GARDNER: There are people who agree with my opinion on life. There are
people who don`t. I support life. I voted for exceptions, but the fact is
that the bill that you`re talking about is simply a statement that I
Now, again, I`ve answered this question multiple times. But I`ll repeat
the words of Senator Udall who said when he changed his position on the
issue of gay marriage that a good faith change of position should be
considered a virtue not a vice. Now, that`s not my words, those are the
words from Senator Udall.
CLARK: And you remain on the bill, the idea of personhood is conferring
the rights of normal human beings on the unborn. I mean, that`s what the
GARDNER: Again, I believe I support life, and that`s a statement that I
(END VIDEO CLIP)
O`DONNELL: Joining me now is Cecile Richards, president of Planned
Parenthood Action Fund.
Cecile, we all support life as we kept saying, he supports life. But we do
not all support the notion that life begins at conception, which is what
that argument was all about.
CECILE RICHARDS, PLANNED PARENTHOOD ACTION FUND: Absolutely. I think,
look, this is a very disturbing debate in that, not only that Cory Gardner
does support and is co-sponsoring this national Life of Conception Act, but
now he would try to deny that fact. I think, obviously, the moderator got
This is a bill, as has been described, that is so extreme, it would
completely outlaw legal abortion in this country. It would threaten some
forms of birth control and even in vitro fertilization. It`s an idea so
extreme it`s been defeated handily by the voters in Colorado twice. And
even in the state of Mississippi, the voters voted it down.
So, I feel like Cory Gardner is not being straightforward with the Colorado
voters about where he stands on this, which is a very extreme point of
O`DONNELL: Let`s listen to how the Republican candidate Joni Ernst handled
this question in Iowa.
(BEGIN VIDEO CLIP)
INTERVIEWER: You supported a personhood amendment to the Iowa
Constitution. I`m interested in how far you would be willing to go in
terms of federal personhood legislation.
JONI ERNST (R), IOWA SENATE CANDIDATE: I do belief in protecting life, and
I believe most Iowans do believe in protecting life. And so, I will
continue to stand by that. However, if you look at any sort of amendment
at the federal level, amendments are -- they come together through
consensus. Honestly, we don`t have a consensus.
(END VIDEO CLIP)
O`DONNELL: So, Cecile, there she is saying, yes, I`m all for it, but I
don`t think it will pass right now.
RICHARDS: Well, the fact of the matter is, Lawrence, these are issues that
are going to be voted on undoubtedly in the next Congress. And when you
look at the record, looking back even at Cory Gardner, in one of the first
votes he took in the House of Representatives was to end women`s ability to
get cancer screening and birth control at Planned Parenthood. So, it`s not
just personhood. He has a record.
Joni Ernst, she`s going to have the opportunity to vote on these issues.
And for anyone who thinks this is simply a theoretical issue, look what`s
happened in the state of Texas. These kinds of bills, these kinds of
measures that eliminate women`s access to family planning, to preventive
care and to safe and legal abortion, this is happening across the country.
So, it really does matter who`s elected to the United States Senate.
O`DONNELL: They really seem to be playing a kind of hide the ball game
here, Cecile, because obviously they get huge energy out of the right wing
of their party and support out of the right wing of their party by saying
what they want to hear about life beginning at conception. And then when
you get them into a general election, where a lot more reasonable voters in
the middle are going to have to make a decision, they try to pretend that
this is really just a talking point, it`s not really a legislative
RICHARDS: No, absolutely. I think that`s what we`ve been saying,
Lawrence. And, look, I you know, I`m here on the behalf of the Planned
Parenthood Action Fund. We are 100 percent nonpartisan. We support anyone
who supports women`s access to health care.
And that`s why, though, this is so disturbing is to see candidates who
aren`t proudly running on their record. They are actually trying to
confuse voters and mislead them about what their true positions are.
O`DONNELL: Cecile Richards, thank you very much for joining us tonight.
RICHARDS: Thanks, Lawrence.
O`DONNELL: Coming up, last night, Bill O`Reilly and Jon Stewart had a big
argument about white privilege. But the important part, the part that not
very many people noticed is the part that they actually agreed on.
And in the "Rewrite" tonight, why Pakistan`s first winner of the Nobel
Peace Prize cannot live peacefully in Pakistan.
(BEGIN VIDEO CLIP)
JON STEWART, COMEDY CENTRAL: So, here`s my point. So, we`ve come to
agreement. You admit that white privilege exists, and while it`s not an
excuse, it is a reality.
BILL O`REILLY, FOX NEWS: It doesn`t exist to any extent where individuals
are kept back because of their color or promoted because of their color.
Look, you and I are lucky guys. We made it, we worked hard. It`s not
because we`re white!
STEWART: Wait --
O`REILLY: You think I`m sitting here because I`m white? What are you, a
moron? I`m sitting here because I`m obnoxious, not because I`m white.
(END VIDEO CLIP)
O`DONNELL: In the "Spotlight" tonight, "Dear White People". That`s the
name of a new film that comes out tomorrow and takes on topics like white
privilege and affirmative action.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: Dear white people, the minimum requirement of black
friends need to not seem racist has just been raised to two. Sorry, but
your weed man, Tyrone, does not count.
Dear white people, please stop touching my hair. Does this look like a
petting zoo to you?
It`s just that dating a black person to piss off your parents is a form of
UNIDENTIFIED MALE: You`re so racist.
UNIDENTIFIED FEMALE: Black people can`t be racist. Racism describes a
system of disadvantaged based on race.
UNIDENTIFIED MALE: You got no idea what they see when they see you.
UNIDENTIFIED MALE: You`ve got a thing for Taylor Swift. I know because my
Mac picks up your Mac`s library.
UNIDENTIFIED FEMALE: I must be careful.
You don`t understand. Girls like me --
UNIDENTIFIED MALE: Have to pick a side. I`m sick of your tragic mulatto
UNIDENTIFIED FEMALE: Don`t say mulatto.
UNIDENTIFIED MALE: Mulatto, mulatto, mulatto.
UNIDENTIFIED MALE: Did somebody say mulatto?
UNIDENTIFIED MALE: How would you feel if someone started a dear black
UNIDENTIFIED FEMALE: No need, mass media from FOX News makes it clear what
white people think of us.
UNIDENTIFIED FEMALE: Your hair is so cute. Is it weaved?
UNIDENTIFIED FEMALE: Weaved. It`s weave. Known, present tense.
UNIDENTIFIED MALE: Racism isn`t over in America. The only people who
think about it are Mexicans probably.
(END VIDEO CLIP)
LAWRENCE O`DONNELL, MSNBC ANCHOR: Joining me now actress Tessa Thompson
and the writer/director of "Dear White People" Justin Simen.
Justin, for even a moment, were you for a moment tempted to entitle it dear
JUSTIN SIMEN, WRITER/DIRECTOR, DEAR WHITE PEOPLE: You know, it had crossed
my mind, especially after seeing that clip, you know? I think, I would
love for him to see it actually. I think he might need it.
O`DONNELL: Yes, it sounded like it.
Tessa, Jon Stewart took Bill O`Reilly through some things last night. It
come to a point where O`Reilly actually said, I think this is very
important got lost in there in the big rush of words. He said for some
reason yes, OK, so poor black kids have a tougher time.
TESSA THOMPSON, ACTRESS, DEAR WHITE PEOPLE: He did.
O`DONNELL: That is the entire point. There`s a lot of other words you can
throw around there and they got caught and lost in a lot of other
semantics. But the fact of the matter is Bill O`Reilly agreed with
Stewart`s basic principle.
THOMPSON: I think about three times he agreed with his principle. I think
the thing that he was afraid of is that you -- if you accept the idea of
white privilege his point was then you have to accept the idea of white
guilt and that`s something he doesn`t seem willing to do. But the two
don`t go hand in hand, frankly.
O`DONNELL: I want to -- go ahead, Justin.
SIMEN: You know, it is really interesting to me, someone pointed at us out
is that when people wake up to racism in America, particularly in a post
Obama, post Oprah America, they have to go through the stages of guilt --
sorry, the stages of grief. And, you know, sometimes they stop at anger
and denial. It seems like Bill O`Reilly is sort of -- is bargaining in
this clip. Hopefully. with a few more appearance, maybe he can get through
depression and hopefully acceptance.
O`DONNELL: Yes. And certainly in all of these kinds of discussions you
see in our media, it is -- no matter who is participating, it`s always
framed from the white perspective on this question, which is what I love
about "dear white people" and there`s this endless debate in America, if
you can call it a debate about affirmative action. "Dear White People"
handles that a little bit differently. Let`s look at a scene about the
affirmative action in "Dear White People."
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: On behalf of all the colored folks in the room, let
me apologize to all the better qualified white students whose place we`re
UNIDENTIFIED MALE: No, it`s fine. We`re OK.
UNIDENTIFIED FEMALE: I`m sorry. Did you get lost? (INAUDIBLE) that way.
UNIDENTIFIED MALE: I know where it is. I`m actually supposed to eat
there. Yes, it is just -- this is the only ding hall that you can actually
get yourself some chicken and waffles. Look, you`re dear white people,
right? It`s funny. It`s funny stuff. It really is. How have we not
staffed you yet?
UNIDENTIFIED FEMALE: Me? On your uninspired humor magazine?
UNIDENTIFIED MALE: It is actually much more than a just magazine
sweetheart. (INAUDIBLE). Same goes for them for comedies.
UNIDENTIFIED FEMALE: And what gives you clubhouse kids the right to come
to our dining hall?
UNIDENTIFIED MALE: You don`t live here. What are you doing?
UNIDENTIFIED FEMALE: So you can`t eat here.
UNIDENTIFIED MALE: Chill, Sam. Let the man --
UNIDENTIFIED FEMALE: Got this.
UNIDENTIFIED MALE: Got this. Who are you to throw me out?
UNIDENTIFIED FEMALE: I think I`m head of this house and I`m doing things
(END VIDEO CLIP)
O`DONNELL: Justin, that`s the perspective we never get in that discussion.
SIMEN: Well, you know, that`s what I wanted to do. I wanted to attack
these things from a black point of view. Because, you know, so few times
have we actually gotten into the complexity of American life from a black
point of view. And that`s what I wanted to offer up with this film.
O`DONNELL: So Tessa, you get the script and you start reading from page
one, was it just one of those fun things all the way through and
recognition of all of these things you`ve gone through yourself?
THOMPSON: Absolutely. And some ideas we`ve seen explored but not in a
very long time in film, in about 25 or 30 years. And to be approached with
such a fresh voice, it felt like, you know, a new time. It felt like the
perfect post Obama movie, frankly.
But the truth is Justin has been working on getting the movie made for
about eight years at this point. So it`s interesting when people say it`s
so timely, that`s kind of our nation, isn`t it? It remains timely.
O`DONNELL: Well, but Justin, it is one of those movies that -- I don`t
care when you release it, it`s timely.
SIMEN: Yes, it`s true. I mean, it`s just so interesting that so many
topics brought in the film. You know, it`s a satire. And when you write a
satire, you know, the intention is to sort of stretch the reality in the
film just a little bit further than everyday life. But unfortunately, you
know, our nation is really caught up, at least in, you know, in the
zeitgeist, in the public conversation, has really caught up to a lot of
things going on in the movie.
So it really does feel like it`s a movie of today, even though I have been
work on it and dealing with these things, you know, for some time.
O`DONNELL: That`s one of the things I love about the humor is that you
don`t actually stretch the reality to get to the joke. The joke is the
SIMEN: It is the reality.
THOMPSON: You know, I hoped that if somebody like Bill O`Reilly can see
this movie. Because I think in a conversation about things like white
privilege, evidence is not really the thing that`s necessary. I think it
is empathy. There`s evidence on both side. You can cite Oprah, you can
cite, you know, Asian-Americans which made my cringe, but by the way,
But you know, I think the thing is just to be able to see the other and
understand their experience and to take an honest inventory, and that`s the
way that we can --
O`DONNELL: Let`s look at another clip from O`Reilly, just to continue to
make our points here. Where he didn`t understand what it meant to grow up
where he grew up. And it took Jon Stewart to point it out to him. Let`s
listen to this.
(BEGIN VIDEO CLIP)
JON STEWART, COMEDIAN/HOST: Let me just ask you a question.
BILL O`REILLY, FOX NEWS ANCHOR: Yes.
STEWART: Did that upbringing leave a mark on you even today?
O`REILLY: Of course. Every upbringing leaves a mark on people.
STEWART: Great. Could black people live in Levittown?
O`REILLY: Not at that time, they could not.
STEWART: So that, my friend, is what we call in the business, white
(END VIDEO CLIP)
O`DONNELL: And Tessa, he didn`t quite get that part.
THOMPSON: No, he didn`t. And I loved it when he went on. He said well,
could black people live this in the `60s? And he said I`m not sure. And
Stewart said well, no, I did the research. He goes I could find one.
O`DONNELL: Not even.
SIMEN: Yes, not even.
But it is -- the funny thing is, he was able to recognize that the way he
was brought up directly impact the his present. But at least in that
moment wasn`t quite able to realize that the way other people were brought
up, the other experience in America, you know, might impact them in the
O`DONNELL: What does the feeling of exclusion feel like? He doesn`t know
O`DONNELL: Tessa Thompson and Justin Simen, thank you both very much.
THOMPSON: Thanks for having us.
SIMEN: Thank you so much. Glad to be here.
O`DONNELL: Coming up, in a remarkable investigative piece, members of
Congress tell "Esquire" magazine what they hate about Congress. And yes,
they name names.
O`DONNELL: We have breaking news. That`s the aircraft carrying nurse Nina
Pham from Texas. It`s just arriving in Maryland in Frederick, Maryland.
The flight -- she`s going to be transported from that aircraft to the
national institute for health where her treatment will continue there. She
was one of the two nurses who contracted Ebola while treating Thomas Eric
Duncan who caught Ebola in West Africa.
"The rewrite" is coming up next.
O`DONNELL: In the "rewrite" tonight, blasphemy. Life in Pakistan is
anything but peaceful for Pakistan`s first winner of the Nobel peace prize.
In fact, life in Pakistan is so dangerous for Malala Yousafzai, who is also
the youngest recipient of the Nobel peace prize that she cannot actually
live in Pakistan anymore. She was blown to England after she was shot in
the head by the Pakistani Taliban for what they viewed as the crime of
going to school and the even worse crime of urging other girls to go to
She won her well deserved Nobel prize by being a crusader and by being a
victim. She did not capture the world`s attention simply by going to high
school in Pakistan and urging other girls to go to high school in Pakistan.
Her crusade was unknown to the world when she was simply going to school
and urging other girls to go to school. Malala got the world`s attention
the hardest way possible, when she was shot in the head by religious
fundamentalists whose guns win far too many religious arguments in
The crime of blasphemy in Pakistan, which carries the death penalty is not
the product of 21st century religious extremism. It was written into the
Pakistan penal code 28 years ago in 1986, and first included two possible
penalties -- life in prison or death. But in 1990, the Sharia court ruled
that quote "the penalty for contempt of the holy prophet is death and
Today, the high court of appeals upheld a death sentence of a Pakistani
Christian woman convicted of blasphemy against Islam, the only religion
that can be blasphemed according to the law in Pakistan.
The Christian woman`s blasphemy case began before Malala was shot. It`s
one of the stories Malala tells in her book describing how, as she put it,
our country was going crazy in that period that preceded the Taliban`s
attempt on her life.
Malala writes, one day in November 2010, there was a news report about a
Christian woman called Asia Bibi who had been sentenced to death by
hanging. She was a poor mother of five who picked fruit for a living in a
village in Punjab.
One hot day she had fetched water for her fellow workers but some of them
refused to drink it saying the water was unclean because she was a
Christian. They believed that as Muslims, they would be defiled by
drinking with her. One of them was her neighbor who was angry because she
said Asia Bibi`s goat had damaged her water trough. They had ended up in
an argument and of course, just as in our arguments at school, there were
different versions of who said what.
One version was that they tried to persuade Asia Bibi to convert to Islam.
She replied that Christ had died on the cross for the sins of Christians
and asked what the prophet Mohammed had done for Muslims. One of the fruit
pickers reported her to the local imam who informed the police. She spent
more than a year in jail before the case went to court and she was
sentenced to death.
In many cases, the government never gets a chance to impose the death
penalty on suspected blasphemers because as "The New York Times" reports
today, such allegations have frequently led to deadly vigilante attacks on
the accused or their lawyers.
On August 1st, 2009, 40 house and a church were burned by religious
extremist in Punjab. Nine Christians were burned alive because they were
suspected of desecrating the Koran. The brave Muslim governor of Punjab
province was outraged by Asia Bibi`s blasphemy conviction and death
sentence and he publicly and loudly campaigned for her release and for at
least a rewrite of the blasphemy law.
Some in Pakistan regard lawyers who defend blasphemers in court or anyone
who publicly plead for mercy for blasphemers or changes in the blasphemy
laws to be guilty of blasphemy themselves.
And so after a couple of weeks of protesting Asia Bibi`s conviction of
death sentence, the governor of Punjab was shot at point blank range 27
times by one of his own security guards standing right beside him. The
security guard smiled upon completing the assassination of the governor and
surrendered to the other police officers around him.
When he made his first appearance in court, he was showered with rose
petals by lawyers who treated him as a hero. And the judge, who had no
choice but to convict him of murder then had to flee the country. Not far
from the Pakistani capital, there is now a mosque named in honor of the
assassin of the governor of Punjab province.
But it isn`t big enough for all of the worshippers who come to the Friday
prayers, and so "the Guardian" reports that the mosque is building an
expansion. Ali Hader, 27-year-old, who runs a mobile phone store near the
mosque tells "the Guardian," every one gives the assassin respect. He was
prepared to protect his religion and any one of us who have done the same
Late 20th century Pakistan seems to be headed in a different direction. In
1988, two years after blasphemy was written into the penal code, Pakistan
elected its first and only woman prime minister, the Harvard educated
Benzir Buto. But in 2007, when Benzir Buto was making a comeback in
Pakistan politics, she was assassinated.
According to a "Reuters" report by (INAUDIBLE), in Pakistan today, this
year has seen a record number of blasphemy cases, as well as an increasing
violence against the accused.
Having lost this round of her appeal, Asia Bibi will now appeal her
conviction to Pakistan`s Supreme Court. The assassin of the governor of
Punjab province continues to live comfortably as a hero in prison. It
seems it will be a long time before Pakistan`s first winner of the Nobel
peace prize can live peacefully in Pakistan.
O`DONNELL: You`re seeing live pictures of the aircraft that has just
brought nurse Nina Pham to Maryland where she will be brought for treatment
for her -- treatment for Ebola. Bryan Walsh rejoins me here as we watch
the landing of that plane.
Bryan, we`ve been saying, or since this crisis coverage started that
American hospitals are ready to handle Ebola cases. We know how to do it.
We have plenty of people on before it got to the point where American
hospitals were tested on this saying that they could do it.
But the first cases we saw went directly to Emory, the highly specialized
location for this. And now we`re seeing a major American hospital, I don`t
know how to interpret this. I mean, can we say giving up in Texas on
trying to provide the best treatment and simply saying there`s a better
place to go? Which, let`s point out, in American medicine is not unusual.
There`s plenty of places you can be, world-class institutions who say the
best treatment for this is actually in New York or in Minnesota and you
should go there for that.
BRYAN WALSH, TIME FOREIGN EDITOR: Well, I think I think this is showing
that now we`re going to move these patients as much as possible to these
specialized institutions where the training is in place, where the beds are
in place, where they`ll get the best hospital care and probably more
importantly, actually, they`ll pose the least danger to the health care
workers who will actually be treating them. And that just wasn`t the case
obviously with this hospital in Texas. They were clearly not prepared.
And, to be honest, it`s not clear that any ordinary hospital wow been
prepared in the same way. So the problem is if we do see additional cases,
there are only so many beds in Emory.
O`DONNELL: How many are there?
WALSH: I think there is barely ten when you actually ads up all.
O`DONNELL: Because they have to be isolation units. So that takes up a
lot of real estate.
WALSH: Right. Takes a lot of real estate. Takes a lot of care. So it`s
not something you can just sort of suddenly expand overnight. We`re
obviously not really -- I wouldn`t say not prepared but certainly we are
not ready to on that scale to take those kind in a lot of a very big
O`DONNELL: Now, let`s say -- I mean, if there`s ten isolation units in
that facility that they could use, it would seem to me that protocol
probably calls for ten separate teams of treatment personnel. You wouldn`t
have a nurse go from doing a round of duty on patient one to the, you know,
then moving over to patient two.
WALSH: I suspect not. I mean, it`s a very high, intense workload really
when you`re dealing with these kinds of patient, especially when the
symptoms are at their worst, where you have vomiting, where you have
diarrhea, a lot of waste being produced. And as we have seen before here
are the real risk area for health care workers is when they get fatigued,
when they get tired, when they`re taking off the protective equipment. So
you really would want to in any kind of situation as much as possible, try
to expose as few workers as possible to these patients when they`re
actually dealing with them.
O`DONNELL: And you know, I`m not sure about this treatment, but in most
hospitalizations, the medical personnel do not have to actually be in the
hospital room with the patient most of the time, in fact. And so, there`s
a -- I don`t know whether they`re -- what the protocol for this is whether
they do say we want constant observation of the patient or whether it`s --
which raises the question of the of breaks for the medical personnel and
how they would disrobe from all of this protective gear that they have on.
How many times a day in a shift would they have to do that.
WALSH: Well, I would imagine they would be doing it when they`re done with
their shift, and it would also depend on how close contact you ear talking
about when you`re dealing with a patient. A lot of this is going to be,
you know, not event from the flight, these are essentially (INAUDIBLE) at
Emory, they drilled repeatedly in these kinds of procedures. They`re
ready, they know. And they will do a great job. I have no doubt.
The question, really, is if you have additional cases, how prepared will
you be? I mean, we don`t know where the next case will be. It could be
another important case, could be anywhere in the U.S., and that`s where you
get concern. Maybe we should have moved these patients into these kinds of
facility from the beginning. But I think there was a hope that well, we`ll
show that an ordinary hospital could do that. Because if this where to get
big, that would have to happen.
O`DONNELL: Yes, it absolutely would. I mean, I should have know that as a
patient myself, I would be asking for where is the best place for me to be?
WALSH: Right, and this would be a the best place. It is just that when
you are dealing in infectious disease, numbers will eventually start to
become an issue. With all hope, it will stop here. We won`t get
additional cases. That`s entirely possible. I mean, in a place like
Nigeria, actually where there is obviously a lot closer to West Africa than
the United States, they managed to control and snuff out their outbreak.
And they haven`t seen new report of the case. So I really do hope, you
know, we won`t see any more beyond this, but we have to prepare for what
will be obviously a worst case scenario.
O`DONNELL: I`m wondering if after we brought the first two Americans back
from Africa with this disease and basically cured them rather quickly,
first patient who arrived back, we actually watched him walk under his own
power out of the ambulance and into Emory. I wonder if that gave us too
much of a sense of optimism of what`s possible here.
WALSH: It`s possible. I mean, of course, they were also being treated by
an experimental drug that is no longer available as well. And we don`t
know actually on how effective that was either. But I think, certainly,
when we had those first two patients come in, we are able to bring them
back from a very bad state. I think it`s possible you look at that and you
say, well, maybe this isn`t as difficult to deal with as we thought.
But clearly, Ebola is incredibly dangerous disease. And it`s just as
dangerous in here in the United States as it would be in Africa as well.
It`s a very high fatality rate. I think everyone knows that now and
they`re very serious about that. And I think the response to this, not
just in terms of the government, in terms of medical team, you can look at
the way communities or even sort of like tertiary connected to this disease
or, you know, closing schools for a period of time, you know, preserving
people who are on a plane or someone who knew someone on a plane. I mean,
that shows just the level of concern, the level of fear concern that comes
with this disease in particular.
O`DONNELL: We`re juxtaposing video that was taken earlier tonight -- today
at the hospital in Texas in Nina Pham`s hospital room before she made the
big journey to Maryland tonight where she is still onboard the aircraft.
It takes a while when these planes land because the way they attach the
stretchers and lock them down inside those air ambulance is very precise.
And the unlocking and movement of them or getting people off the ambulances
is -- off the stretchers is also a slow exercise.
There are two people coming down the steps of the aircraft now. And we do
not know if one of those might be nurse Pham. But it did look as though
one person was being helped down those stairs. And it is hard to judge by
from what we saw in her video at the hospital in full recline there
earlier, what she is physically capable of right now.
WALSH: It certainly is, and I don`t think we can know at this point how
well off she is and how easy it will be to transport her, and that of
course might be a concern as well. You wouldn`t want to transport a very
sick person unless you absolutely have to, and I think in this case,
O`DONNELL: -- the door of that ambulance, so that must have been Nina Pham
walking under her own strength down the stairs, the gangway of that
airplane, into the back of that ambulance, accompanied by two medical
personnel, one on each side, seemed to me assisting her in walking as she
moved there. But if that`s -if those ambulance doors are closed, that
would mean, what else could it mean then the patient is in that ambulance
and is probably now being put on the stretcher in the ambulance and
secured, which takes a few minutes. Ambulances don`t want to move when the
patient is not completely secured, strapped down, in that kind of
situation. But it`s I think you can`t say anything, but encouraging to see
her actually moving under her own power, if that is what we just saw there.
WALSH: Yeah, absolutely I mean it`s really - you have to hope for this
person and you can see from that video before that this is someone who has
a lot of people caring for her. Obviously, her co-workers back in Texas as
well. And certainly anyone who would been watching this, too.
O`DONNELL: And she does have the great advantage that nurses have of being
able to know what her colleagues` taking care of her need and know, in
effect, how to help them with her care, know what they need to hear, about
what she is experiencing, what she is feeling. She is it very alert to
symptoms and to changes in symptoms. It`s - I`m sure a tremendous
advantage to have her own personal medical expertise in dealing with this.
WALSH: Absolutely. And I think shifted for herself to know that, actually
just - going through a lot - treating someone with this disease to
suffering from it, but it`s still hard to see.
O`DONNELL: We don`t yet know whether that ambulance, if the shot widens,
we will be able to see whether that ambulance is still there. Or whether
it`s been moving. There is another angle on it down - at the ground level
that we are seeing. And again, the other video juxtaposed here was taken
several hours earlier today in Nina Pham`s hospital room in Texas. That
was her video farewell to the hospital that she was working in when she
contracted the Ebola virus. And before getting on that plane bringing her
to Maryland where she presumably is now inside that ambulance that we are
seeing there. Very close, within steps of the airplane that just landed
there, the private aircraft that brought her in.
Some of these images are coming to us from our local affiliates there.
Bryan, the - if she has the kind of recovery that we saw with the first two
patience brought back from Africa, it seems like in the event of no
additional infections, that could turn the emotional momentum of this
American story right now into something that it may give people a feeling
that there is more control over this, that we actually do have a handle.
WALSH: It could possibly do that. I mean I think the real key will be -
will, there be additional cases that we see another health care worker
who`s coming out Texas with this. I think if we see an important case, we
see any kind of community transmissions that lasts, especially important,
that would really worry - I think the public alarm level. But certainly,
seeing these nurses who`ve gone through so much and who sacrificed so much
before they even had this disease to actually pull through this would be I
think a great boost for everyone.
O`DONNELL: Yeah, and of course, we are - I mean nervously awaiting out the
weeks from the time that she was on Frontier airliner twice to be sure that
no one on that - those airplanes have any problems. Now, there is the
ambulance moving, and we have every indication based on what we have seen
so far, that is the one ambulance that met that airplane. We didn`t get
any specific identifications of anyone walking down that - and getting into
that ambulance, but we saw three people moved down the steps. And enter -
they entered that ambulance, and it looked like Nina Pham was walking into
that ambulance with the help of medical personnel who are on each side of
Doctor Charles Chiu joins us again tonight from San Francisco. Doctor
Chiu, what would it mean to you if what we saw as I think we have every
indication, every right to believe at this point was Nina Pham walking down
the steps, of that airplane, maybe 20 feet to the ambulance with the
medical personnel on each side of her seemed to be leaning on them but
working under her own strength into that ambulance. What would that mean
to you in terms of a medical observation at this point?
DR. CHARLE CHIU, UCSF: Well, my impression is that this is a very positive
sign. The fact that she is able to walk on her own, or at least walk on
her own with assistance suggests that she is not critically ill and, you
know, hopefully, is - does not have a significant amount of symptoms, but
the fact that she is able to walk on her own is actually a very good sign
and it suggests that her blood pressure is stable, that probably her vital
signs are stable as well.
O`DONNELL: And we are seeing that ambulance now as it pulls away from the
private aircraft that brought her in in the private landing facility that
she came into in Maryland, in Frederick, Maryland, on her way now to the
specialized treatment she will be getting. And doctor, what is the
advantage of bringing her to the National Institutes of Health in Terms of
CHIU: Well, the National Institutes of Health is one of the five, I
believe, facilities, which are especially designed for managing very kind
of high pathogen - pathogen - patients, I think like Ebola patients, for
instance. And these are bio-containment facilities with significant amount
of training and experience. And they know how to - isolate patients and to
take care of patients with highly contagious and deadly diseases such as
Ebola. And this is something that certainly is the state of the art
facility that should have the - all of the resources and the training they
need to take care of patients who have Ebola infection.
O`DONNELL: And Doctor, certainly unlike the facility in Texas, this will
not feel, even though the people may not have treated Ebola specifically at
this institution, it won`t feel as quite so novel a treatment experience
CHIU: I don`t think so, because these are facilities that have been
preparing for a very long time to receive these patients. They do have the
resources. The isolation room, the personnel and the protocols has been
placed specifically to take care of Ebola patients. So, certainly she
would receive probably the best care that she can at these containment
facilities, such as this one in the NIH.
O`DONNELL: And Bryan, do we have any indication on the reporting today
that this might actually be happening at the request of the patient in this
case, at the request of Nina Pham?
WALSH: You know, I don`t know actually. I have not seen any reporting
indicates that might be the case and certainly seeing the - the other
patient move to Emory. I think it seems that the decision is being made to
take a greater sort of control of these cases to move them into the
institutions that are best prepared for them. And again, also that`s where
- you know, the workers who were working with them, best defending against
any - infection as well.
O`DONNELL: And Dr. Chiu, it certainly - it would seem to me it helps
clarify communication channels for the CDC, since they are getting all the
questions about this every day. The director of CDC is getting questioned
as if he is in charge of the specific treatment of these patients.
Bringing it a little bit closer in the communication chain seems to have an
CHIU: I think certainly, it would help to have an ability to consolidate
all of the information that`s coming in - and this data. And really, this
is - I cannot stress enough that really, at every level of government in
the federal, state and local level, we are really, really handling this on
the fly. And we are really learning from this experience. So, I think it
certainly makes sense to try to consolidate all of this data that is coming
in from the treatment of the Ebola patience in the U.S.
O`DONNELL: And on the other hand, Bryan, 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 everything that happens here
should happen flawlessly.
WALSH: Absolutely. And I think if something were to go wrong here, if
you were to see obviously an additional infection of a health care worker,
at NIH, I think that would be very alarming. I mean certainly, to the
American public and certainly to the institution itself.
O`DONNELL: The ambulance continues to make its way, obviously, without any
traffic at all at this hour in that area of Maryland. And very much in the
dark as it makes its way to this new hospital treatment facility for Nina
Pham, who very bravely tonight made a video for all of us to see. And
Doctor Chiu, I have the feeling that she was doing her part for public
health in that video, and that it wasn`t just a patient that we were
seeing. But it was a conscientious nurse who really wanted America to know
that she was doing better than we may have thought she was doing. I don`t
think America expected to see pictures of her tonight sitting up in a bed
like this looking to our observation in that shot healthy. And certainly,
you know, in very good spirits. And chatting in a very positive way with
CHIU: I agree. And I am actually quite astounded at how brave she was.
And - and really, this is - this is a heroic act that she has been doing in
taking care of Ebola patients, which is really - which is really a credit
to the nurses and the doctors who have to deal with this very difficult
O`DONNELL: Yeah, it` you can`t look at that, Bryan, and not - I don`t
think, and not think Nina Pham felt as a nurse that she had a
responsibility here larger than some other patient might have, that she
had- that she was in a unique position to communicate possibly some calm to
people out there who are worrying about not just how she is doing, and they
are worrying very specifically about how she is doing, but what her health
or her illness level means to the rest of the country.
WALSH: And it`s all the bravery when you realize how frightening the
actual experience must be, it`s not just that you have Ebola, that you -
obviously, are very sick, but you are being treated in an isolation room,
as you can see in that video, you are being treated by your colleagues who
are in hazmat suits. There is no way to touch you. It`s a very isolating
experience. And I think to really extend yourself in that way and put on
that - you know, to show how brave she is and show how this actually works,
this is actually one of her few glimpses into the room of someone actually
being treated. It`s a great public service to the entire country.
O`DONNELL: And Doctor Chiu, there are a lot of medical personnel all over
the country tonight wondering if this is going to come their way. There
was no way in going to work at a hospital in Texas that you could think you
are any more likely to be exposed to Ebola then people going to work at
hospitals in New York or Boston or Washington D.C., with - especially with
- in airport zones that seem more directly related to West African air
traffic. But what message do you think she is trying to send to her
colleagues in the medical community with that video tonight?
CHIU: Well, I think with that video, I mean it`s clear that she still
trusts the medical system and really trusts kind of the extraordinary
health care infrastructure that we do have in this country. And I think
that, to her credit, you know, this is although something terrible has
happened to her, I think the positive note is that she appears to be - you
know, the fact that she was able to walk out of that ambulance and the fact
that she was able to sort of maintain a kind of calm in sort of a very
scary, a difficult situation, you know, we really as we said, it`s a credit
to her profession and also really suggests that it`s a tribute to kind of
the quality of the care that we can - that we do get in the United States
as well as the extraordinary care that is done by the hospitals.
O`DONNELL: We are joined now by Karin Huster, a registered nurse with a
master`s in public health. She`s trained Ebola health care workers in
Liberia. Karin, the video that we saw earlier tonight, the live video of
Nina Pham walking off of that airplane, walking down the game way with two
medical workers fully protective gear on each side of her. They are to
help her walk, but it did not seem as though she needed very much help
walking down the stairs and walking the 20 or 30 feet or so across the
pavement to walk into the back of that ambulance. She did all that walking
under her own power. What does that suggest to you about her medical
KARIN HUSTER, REGISTERED NURSE: Well, I think - I mean I don`t know what
is - you know, from her medical conditions, but what I can tell you is that
it definitely reinforces to me the idea that aggressive, early, aggressive,
supportive care is essential to survival. And I think Doctor - mentioned
this many times. In the United States, the care that you can receive being
a patient sick with Ebola can be very different from the care that you can
receive in Africa, where its mostly, you know, getting oral fluids. Here
in the U.S., you can get IV fluids, you can receive blood, you can be
monitored all the time, making sure your blood pressure is OK and we are
replacing your fluids. So early, she probably is getting early,
aggressive, supportive care, which I think is good. It just shows that our
system is a very good medical system. It`s just, you know, it`s tough to
never make mistakes.
O`DONNELL: Yes, of course. And I think there has been a lot of public
commentary about this, which strikes me as a little odd, which is
essentially, how could these people in Texas who were faced with a first
time in a lifetime situation possibly get any part of it wrong or handle
any part of it imperfectly? I think it will be quite amazing for people
who had never been exposed to handling such a situation before to handle it
perfectly. But, Karin Huster, what do you think the advantages are of
having her transported to the National Institutes of Health for the
HUSTER: Well, I would imagine that the staff there is fully ready, almost,
you know, as if it`s an - as if it were an Ebola treatment unit or the
staff is fully ready to welcome her and to treat her with the best medical
knowledge that we have. So, I imagine that the nurses and the physicians
and everybody who is going to be in contact with her will have been trained
on how to be safe, you know, how to put on their protective gear the right
way, how to take it off, most importantly, the right way. They will have
been completely prepared. And I think in Texas it might have been a
different situation where there were probably caught off guard and mistakes
were made. In that case, I think we are all watching. So, I know that
everybody is super prepared to.
O`DONNELL: Well, let`s listen to what Dr. Daniel Varga, the chief clinical
officer and senior vice president of the Texas Health Resources, Texas
Presbyterian, let`s listen to what he said today about what happened at
(BEGIN VIDEO CLIP)
DR. DANIEL VARGA: Unfortunately in our initial treatment of Mr. Duncan,
despite our best intentions in a highly skilled medical team, we made
mistakes. We did not correctly diagnosed his symptoms as those of Ebola,
and we are deeply sorry.
(END VIDEO CLIP)
O`DONNELL: Bryan, people were waiting to hear that for several days now.
WALSH: You know, absolutely. I think it`s very clear that there were
mistakes made along the way. We still don`t really have clarity. I think
in the terms of exactly what was going on there, we see some backtracking
in terms of when symptoms might have begun with Amber Vinson, the other -
the other nurse. So, it is very concerning, I think, that this is what`s
happening. And we really need a lot of work to get to the bottom of this
question to go back and figure out what went wrong. If only so we can
learn to know how to do this better in the future.
O`DONNELL: We are joined now by Shomari Stone who is at the airport where
Nina Pham`s plane landed. Shomari, did we see Nina Pham walked under her
own power down the steps of that aircraft into that ambulance?
SHOMARI STONE, NBC CORRESPONDENT: Yes, we did. That plane arrived a short
time ago, and she walked off of the plan into an ambulance. Keep in mind,
the special medical team helped her down the stairs as they put her into
the ambulance. Right now she is currently being transported to the NIH and
that`s approximately 35 miles away from the Frederick municipal airport.
Now, tonight, the mayor of Frederick says that a lot of folks need to calm
down. There`s no reason to panic about the Ebola virus. He told me that
the state department and the Centers for Disease Control are working to
make sure that this medical transfer goes safely. Now, a specialized team
is going to be with her, and basically they are going to put her in
isolation and make sure that she is OK. They are going to monitor her very
closely. And keep in mind, Nina Pham is one of two nurses who contracted
Ebola in Dallas. She was diagnosed with the virus after treating Thomas
Duncan. A lot of folks in the Frederick, Maryland community, came out
here, and some of them are supportive, saying, you know, we hope that you
are OK, Nina. But then there are some people that do not want this in
their region. A lot of folks are concerned about Ebola. There`s a lot of
misinformation, but many of them are understanding that this is something
that we are dealing with. And a lot of folks tell me that they are going
to be monitoring this on the news very closely.
O`DONNELL: Shomari, do you expect it to be encouraging to the people who
were kind of panicking about this, to see her actually walk out of that
plane and walk across the pavement and step right up into that ambulance
under her own power?
STONE: Yes. Basically, you have to keep in mind that she walked outside
and basically she had on the protective suit with the gloves, the suit, and
just to make sure that no one becomes in contact with the Ebola virus. The
CDC up here, so from where we were standing, were taking very serious
precautions, making sure that this virus does not spread.
O`DONNELL: And Bryan, the - what Shomari said there about people worried
about, you know, this patient even being brought into their area, I mean
such is the kind of out of control worried that is going on out there about
this. You couldn`t possibly have anything to worry about and watching what
is going on there tonight.
STONE : No, not at all. I mean this virus poses virtually no threat to
the community. Certainly, if this particular patient going to where she is
going. Poses no threat to the community whatsoever. But again, it really
just drives home how frightening this disease feels for a lot of people.
Not just because I think they see the high death rate now, but also there
is something about Ebola that is particularly frightening, the symptoms,
maybe it is, the high mortality rate. But just the idea that it`s even in
your community, even if it`s kept safely in managed hospital, is definitely
going to worry some people. But they really don`t need to be.
O`DONNELL: Karin Huster, what would you say to people in the area of a
hospital that`s treating an Ebola patient who are worried for themselves?
HUSTER: I would say they don`t need to worry at all. I think the patient
and definitely in that case, the patient is brought in under very
controlled conditions and is going to be put in an isolation room. The
staff is going to be wearing protective gear. They are going to be
trained. And I think that we are learning from our mistakes. So,
definitely, I think, there will be even more protection for everybody going
forward from what there was before. So, I think really, the message that I
want to sort of remind people is that the best way for the U.S. public to
protect themselves is to really invest resources and staff and equipment in
West Africa, because it is when we go and do this that we will be able to
control the disease in West Africa. Then we can ensure also that it
doesn`t come within our country.
O`DONNELL: And Bryan, prior to this week, I don`t think that was a point
that possibly - that could be understood in a widespread way in the United
States of America. Why Ebola in West Africa months ago was our fight.
WALSH: Absolutely. I mean I think this really brings that fact home, the
fact that someone could get on the plane out of Liberia, bring this disease
here to the United States. And that is a direct consequence of the fact
this outbreak is completely out of control in these countries. And that is
something we really have to drive home. As important as these individual
cases are in the U.S., there are thousands of people who have Ebola and
thousands of people who are dying of it in these countries. And at this
point, there is no indication that we are getting on top of this. And as
long as that continues, you will have the risk of this spillover in the
O`DONNELL: Joining us now is Dr. Kent Sepkowitz, he is deputy physician in
chief for quality and safety at Memorial Sloan-Kettering Cancer Center.
Dr. Sepkowitz, we have been talking about medical centers around the
country and how prepared they should feel now. It seems to me that after
this media alert this week that every medical center in the country has to
be thinking specifically about what happens the day someone shows up in our
facility with Ebola.
DR. KENT SEPKOWITZ, INFECTIONS DISEASE SPECIALIST: Absolutely. I think
that the amount of effort THAT has been made in the last few days at every
hospital to make sure that we are ready. That said, I think that the CDC`s
decision to move patients with proven Ebola into hospitals that have even
more practice and even more expertise on it, both to protect the - the
health care workers who are taking care of the patients, who need to learn
a level of sophisticated and meticulous technique that is not intuitive,
but also patients are doing better. And we should point out that the
patients treated in America are doing quite well in terms of survival.
That speaks somewhat damningly about a neglective - all of the patients
dying in Africa. But it does show that this is a disease in modern
hospitals that can be handled - with, you know, pour Mr. Duncan died, but
there is hope for people with the disease. If the can get appropriate
O`DONNELL: And certainly, speed of diagnosis seems to be critical here,
SEPKOWITZ: I think speed of diagnosis is absolutely critical from the
public health and health care workers` safety perspectives. So,
absolutely. You know, if they diagnosed Mr. Duncan sooner, my guess is,
although we don`t know, my guess is that the two nurses would not have
caught the infection from him. Whether or not earlier diagnosis would have
changed Mr. Duncan`s outcome or other peoples` - it`s still not entirely
clear to me. We don`t know enough about the treatment. But I think it`s a
O`DONNELL: And Dr. Sepkowitz, part of what we are watching tonight is
something that happens every day in America, is that a patient is in a
certain medical facility and it comes to the conclusion that the medical
team comes to the conclusion that they - actually the very best treatment
for this would be at Sloan-Kettering, so I think we are going to send you
over there. Or at some other institution. And transporting patients from
one hospital to another in order to improve the treatment team is something
that happens all the time.
SEPKOWITZ: Yeah, I think the difference here is that we are not only
moving the patient for the patient`s sake, but also for the safety of the
health care workers. And so, I think there is a double reason to bring
these patients to expert centers. That it`s safer for the people taking
care of them, and we have learned that the hard way. And spending money
(ph)- that`s the hard way as well. But also, it does seem that the
patients have done extremely well. I think we are up to now six or seven
patients that have been treated in the U.S., and only Mr. Duncan has died.
O`DONNELL: Yeah. Bryan, the - still the questions will come, and they
won`t stop. And it`s your job at time magazine and others to keep asking
those questions. And so, the medical personnel at the Texas facility were
caught between trying to devote as much energy as they possibly could to
their patients and then to also l try to be accountable to the public about
what had already happened there. And now, to the extent that those
questions are coming, at least it is not a distraction to the treatment of
WALSH: Absolutely no. I mean at this point they should be able to focus
on this and really do some after action investigation. I mean again, it`s
obviously questions that we all want answered in the media and the
government as well. But if I worked in this hospital, I would want to know
what went wrong. There`s clearly something did go wrong along the way.
Something in protocol, something in equipment, something in obviously, we
know, for sure in diagnosis early on with Mr. Duncan, which had obviously a
serious effect , I think, on him and also on -- in terms of spreading this
disease beyond that. So, all of this has to be looked at. And try to
figure out well, what can we learn and then what could we take from this to
other hospitals that may have to deal with this?
O`DONNELL: Let`s listen once again to Nina Pham speaking from her hospital
room in Texas before she left to get on that plane to fly up to Maryland
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Hi!
NINA PHAM: (INAUDIBLE) everything. Everything.
UNIDENTIFIED MALE: Partying. Partying in Maryland.
NINA PHAM: Partying in Maryland.
UNIDENTIFIED MALE: OK.
NINA PHAM: (INAUDIBLE)
UNIDENTIFIED MALE: Please no crying. You are (INAUDIBLE).
NINA PHAM: (INAUDIBLE)
UNIDENTIFIED MALE: We love you, Nina.
NINA PHAM: Love you.
(END VIDEO CLIP)
O`DONNELL: Karin Huster, her spirits seem to be great. And as a nurse
herself, I am wondering what it`s like in terms of her as a patient. There
must be some real advantages to her as a patient, both for herself, being
aware of her symptoms and being extra alert to that, but also being able to
communicate so clearly to her physician team and the other medical team
around her about what she might need.
I guess we don`t have Karin Huster on the line.
HUSTER: No, no, I am here, but I didn`t hear your question. I`m sorry.
O`DONNELL: I was just wondering when we showed the video of her in her
hospital room in great spirits talking about, let`s party in Maryland when
she gets there, that there must be advantages that nurses have in this
situation when they find themselves as patients, including the fact that
she has seen people in much worse condition than herself come through and
be completely healthy. But also, that she is in a very good position to
communicate everything she seems to be feeling in terms of symptoms to her
HUSTER: Yes, I think, I think definitely we know, you know, being insiders
to this whole process, that I mean still, I think she`s very scared,
probably, inside, but she knows that she now has the best of teams that`s
surrounding her, that she also knows that her disease was taken on and
identified early. And that I think, it makes a big difference in survival.
And she knows that - I think she knows she feels good, and these are all
important things. So, and she is definitely in the best place that she can
be right now. So, so these things ought to make her feel pretty good. But
still, I think that deep down you cannot help but be really scared. This
is a scary diagnosis.
O`DONNELL: And Bryan, there has been a lot of questions about exactly who
is in charge in this situation. It`s not a quick answer, but what we do
seem to be seeing in a certain sense, is a kind of centralizing of these
cases. A little more clarity about who to ask about what`s going to happen
tomorrow in this situation with these patients now being brought to these
WALSH: I think that`s sort clear of the case. So, I think, you know, the
CDC maybe is thinking now that kind of centralization would have been a
good idea, whether it was actually sending forces early on, sort of
infection control teams, epidemiologists, to Texas or now, of course,
taking these patience and putting them in more centralized locations, more
experienced locations, will know they should be running the show from here
on in. And we will see what happens with - if there is another case
somewhere else in the United States, but I have a feeling this is going to
be the strategy going forward. And I do think it`s - I think it`s a wise
O`DONNELL: And Dr. Chiu, there is a large West African community in that
area in Texas near that hospital where the first case showed up, and so it
would seem that if we are going to have more infection, since that`s where
we have had three people who have been infected in that area already, it
would seem that is probably the place to look for the next possible
infection coming up.
CHIU: Well, certainly I mean, here is a possibility, especially with -
because, you know, the cases are really in West Africa. And what we have
been seeing our large, the imported cases. I mean there has been a case of
- two cases of hospital transmission now, but I think that we`ll be for it,
we are far more likely to see additional cases from Africa, from areas and
affected countries, which really highlights kind of a point made before.
That it`s really critical that we try to do our best and provide all the
resources that are needed to try to contain the outbreak in West Africa.
Because really, that`s going to be the best way that you can protect us
back here in America, by dealing with the outbreak and containing it at the
O`DONNELL: Karin Huster, I`d like to get your reaction to the discussion
and debate we might call it that went on in Washington today about the
possibility of banning travel from West Africa to the United States.
HUSTER: I think that would be a tremendous mistake. Number one, we need
to urgently send health care workers to West Africa to fight this disease,
so that would be all of a sudden, impossible. Number two, I think that
people would find other ways to go and get in the country. For example, I
came from the U.S. to Liberia, it was the last flight with Delta Airlines.
So, on the way back, I went from Monrovia to Morocco, from Morocco to Paris
and from Paris to Seattle. And it`s really easy to lose somebody. And
eventually they will make their way where they want to be, and you will
have lost that opportunity to track a person and monitor them. And so, and
so I think it`s never a good idea to try to quarantine an area and say,
well, this is how we are going to protect ourselves.
O`DONNELL: Bryan, it seems the president is going to continue to come
under pressure on this issue of a travel ban. There is Republican
rhetorical momentum for a travel ban that developed today in Washington. I
don`t see what will soften their arguments about that.
WALSH: I don`t either. Yeah, I don`t either. I mean I think there is a
really, a human instinct right here to say, well, if we can just cut the
problem off, build a wall, separate ourselves in some ways and then we`ll
be safe. But that is not the case. This disease should really show to us
that we are so globally connected now that a disease that begins somewhere
in a forest on the border with Guinea has now flared up all throughout
these three countries in West Africa, has spread individually again into
countries, I think to the U.S. and to Europe. I mean we have to deal with
these things at the source, in fact, actually, even beyond this Ebola
outbreak, we have to give a real great thought to better work in detecting
these kind of outbreaks at the start. Imagine if we had actually known
this was happening back in January. We may have stopped this from ever
becoming a problem, certainly for these countries and for the United States
O`DONNELL: Karin Huster, what could we have - what could we have done
months ago if our mission had become, let`s stop this before it becomes any
kind of crisis in the United States?
HUSTER: Well, I think even before then, I think we should have done much
better preparedness. We should have invested in West Africa`s health
systems infrastructure. We should have invested in West Africa`s roads.
We have done none of that. And so, when the smallest, you know, our world
that the smallest disease shows up, it becomes immediately a catastrophe,
and we get into disaster response. And I think had we prepared those
patients much better, then they would have been able to contain this much
faster. And, of course, our response was extremely slow and continues to
be extremely slow. We - we still have, I think in Liberia, at least there
are six Ebola treatment units out of the 28 that are needed. And that, we
have been waiting for these treatment units for many months, and they are
still not coming. We still have shortages of equipment. So, the response
should have been from the get-go, immediate and massive, knowing that the
structure was very weak at the beginning.
O`DONNELL: Doctor Sepkowitz, working in New York City as you do, anyone in
New York City knows that every day there are planes landing from all around
the world at JFK, also at Newark Airport and that people are streaming into
the city of New York every day from all over the world. But in particular,
patients showing up from around the world to your hospital every day for
treatment. When you first saw this occur, this infection diagnosed in
taxes, did you begin to think the pressure is on New York at the same time?
SEPKOWITZ: I think New York is used to the pressure. I mean I think that
Amtrak`s happened here. We were worried about SARS. Here we prepared
quite a bit for that. So, I think New York always thinks the worst thing
will happen, you know, in New York because of its great international
population. So, I think maybe we had gotten used to getting ready. I
don`t know that Dallas was quite as used to getting ready. But absolutely,
when that guy (ph) was diagnosed, you know, my jar dropped, I was not
expecting it at all. That said, we had already prepared. In response to
that, we and every other hospital in New York, and I suspect everywhere,
has added a series of questions about recent travel for intake for every
patient. And, you know, that takes five seconds per patient. It doesn`t
mess up anything in terms of efficiency. And it`s something that we have
all done. And, you know, it does - it`s a big fact going forward when you
have so much recent travel history. So, yeah, everyone`s made an
adjustment. But I do think like I say, New York, is kind of - we always
feel like something - the next thing might happen here. I guess 9/11
thing, but the first of those massive events of this century.
O`DONNELL: The director of the CDC Tom Frieden said this about a bigger
(BEGIN VIDEO CLIP)
TOM FRIEDEN, CDC DIRECTOR: There`s zero doubt in my mind that barring a
mutation, which changes, which we don`t think is likely, there will not be
a large outbreak in the U.S.
There will not be a large outbreak here barring a mutation.
(END VIDEO CLIP)
O`DONNELL: Doctor Charles Chiu, you are the resident expert here, and this
kinds of diseases, what does he mean by a mutation?
CHIU: Well, Ebola virus is a norovirus (ph), and because it`s a norovirus
like other viruses, it will mutate. Meaning that it will change. And the
worry is that it may mutate into perhaps some form that is more virulent,
potentially more transmissible. I think that the worry that it may mutate,
where it changes its mode of transmission from a direct contact to airborne
is extremely unlikely. It has never been reported really in the history of
what we know of (INAUDIBLE) viruses. But certainly, the probability of
changing to a form that is more virulent, that perhaps, may be more
transmissible to the same mode of transmission, or potentially - mutating
so that it may evade existing therapies, including convalescent serum,
experimental drugs and even vaccines, it is certainly a possibility. And
this is another reason why it will be really important to continue to try
to contain the outbreak in Africa because with each cycle of replication,
as the virus infects more and more people, it has more of an opportunity to
O`DONNELL: But so far, Dr. Chiu, what we have seen in Africa is the same
unmutated strain, is that correct?
CHIU: That is correct. We have seen mutation, but this is a virus that is
mutating. You know, however, it does not look as if we`ve seen a mutation
where it may affect, for instance, the efficacy - the efficacy of
experimental drugs that are being used for Ebola. The reasons I`m worried
about, because of the mutations, for instance, are having mutations in some
of the sequences that are used as targeted sequences for diagnosing it and
detecting Ebola virus. And this also highlights the importance of not only
- of not only, of really monitoring how the virus is mutating, which is why
- even I know that - that the public health`s response is paramount, but
it`s probably equally important to continue the search, to continue
tracking and sequencing of the virus as it continues to spread in the
population, especially in Africa, to see exactly what changes and how is
the virus evolving with time?
O`DONNELL: And Dr. Chiu, the vaccines the experimental vaccines that were
used so successfully, vaccine is not right word, I suppose to, for the
very- the first American patients to be brought back from Africa with
Ebola, why don`t we have more of that ready to go now?
CHIU: Well, that`s a very complicated question, but in short, it has been
because the really - there hasn`t been an emphasis on vaccine. There
really hasn`t been kind of a specific funding that`s been provided to
really develop vaccines. It has largely been something that`s been funded
as part of -- it began in 2001 with the kind of - the 9/11, where there was
specific funding by the government for managing bioterrorists, dealing with
bioterrorism, such as vaccines. But the other problem is that vaccines
have been - there have been really been kind of commercial incentive or
business models for production of vaccines. And deployment of vaccines.
And I think now this is changing. Traditionally vaccines have a very long
period of validation were you have to enroll, patients - and this process
can actually take years. Involving thousands of patients, but now the
government and the FDA appear to be providing expedited pathways so that we
can really get these vaccines, you know, hopefully in time to help manage
and contain this outbreak.
O`DONNELL: Bryan, it seems to me when the public is aware that when we
brought our first two patients back, we had an experimental medicine ready
for them. That apparently, at least in the public perception, it did the
trick. The idea that that isn`t ready for the next patient is kind of
shocking to Americans.
WALSH: I think it is. And we are very used to having - what we want when
we need it actually. Especially when it comes to medicine, there`s a lot
to think about our health care system, maybe expensive, but generally has
what we need. But that was not the case here. And that really - as Dr.
Chiu said, there was not the demand, there wasn`t the business model for
this drug then it will be going forward. And then when you think about a
vaccine, I mean Dr. Francis Collins, who is the head of the National
Institutes of Health said earlier this week that if there hadn`t been
funding cut in his organization, they may have had a vaccine ready already.
We don`t know that for sure, but certainly, it is not something that has
been anywhere near the level of emphasis that I think we now see we really
O`DONNELL: And Karin Huster, what would you recommend, talking to your
friends, nurses, doctors in American hospitals just out there in places
that where they are not near major airports, but at some point you never
know this patient could walk in with this situation. What would be your
coaching to them about how to handle it?
HUSTER: Well, I think that now American hospitals are receiving a lot - I
mean there is a lot of publicity about Ebola and so I think that there are
definitely the infection control teams in every hospital. As probably
running on high gear, preparing everybody who could, you know, from the
triage stations all the way to the ICUs to - to be able to handle a patient
properly. What we did in Liberia, which is a little bit different, is that
we in our training actually recommended to have an initial triage going
outside of the clinic or the hospital. But there is a different set up,
because it is an outbreak area. So, you have - a lot of people who could
have Ebola. And so somebody walking in your hospital with a fever or
nausea and vomiting, you don`t really want them in your yard. You want
them - you want to catch them before they get in your ER when they are
But I think this is not really applicable in the U.S., because there should
be very few cases coming in. But definitely a lot of protecting yourself.
I think washing hands is something that we don`t do enough of and we don`t
do well. So, a lot of that, I think we need to do a lot of cleaning of
surfaces, definitely, in places where there are a lot of patients coming in
and getting out, just re-enforce infection control. I think this is
probably the fastest (ph) infection control and prevention has ever been.
O`DONNELL: Yeah, it`s the most attention it has been getting. And Doctor
Sepkowitz, , we just heard Karin Huster talk about washing hands, which I
think a lot of people out there will say, what? How could you be talking
about something as simple as that? But recent experience in hospitals, and
I kept seeing these signs up around from the medical personnel, reminding
them about the importance of washing hands, which you all know, all the
people in medicine know this, but it turns out we have statistics showing
that a shocking amount of infection in hospitals occurs simply because
medical personnel not washing their hands frequently enough. It`s just
that the human condition, that absolute perfection is not easy to achieve.
But it is I think surprising to a lot of people out there that kind of
reminder is necessary in a medical professional environment.
SEPKOWITZ: Yeah. I think that Ebola is going to go a long way to make
everyone wash their hands a whole lot more. I also think the advent of the
alcohol hand rubs, Purels and go assertive, things with the automatic
dispensers on the wall. I think that hand hygiene and cleaning has gone
way, way up. And absolutely, is - the alcohol absolutely kills Ebola virus
and most other viruses. So, it is very effective against this. The tricky
part of Ebola where hand hygiene is necessary but not sufficient to stop
transmission is that it`s - if it gets to you it might not just be on your
hand. So, you know, because it`s blood, and because - and the bloody
stool, and bloody urine, there`s often kind of a big mess. And so, it`s
not a simple matter of just cleaning your hands after seeing patient. So,
I think the degree of difficulty for a worker taking care of a patient with
Ebola to get clean is 100, 1,000 times harder than a routine visit. I do
suspect and I remember this with other outbreaks that we have seen, an
enormous improvement in hand hygiene after this sort of thing happens. I
mean everyone is incredibly mindful of the importance of it. and they use
it as a self-protective mechanism, which is a great part of ...
O`DONNELL: We are seeing in our live video image here the ambulance
carrying nurse Nina Pham, who is, of course, infected with Ebola, from the
aircraft that flew her from Texas to Maryland approaching the National
Institutes of Health, where she will be treated by experts in the field who
are ready to receive this patient certainly. And Dr. Chiu, imagine for us
what it is like for the medical personnel inside the facility knowing that
this ambulances is on the way.
CHIU: Well, certainly, I think there`s a combination of feelings. I mean
there is certainly anticipation, because - especially the medical personnel
at these dedicated facilities, they have been training for months. They
have the protocols in place. But this is a real thing. I mean this is -
this is basically, they are going to receive a patient who has Ebola virus
infection. So, I think to some extent, there probably is anxiety and yet
there is also anticipation, because this is exactly what medical
professionals have been trained for, the nurses, the doctors, other health
care personnel, and really at all levels and the hospital, to really manage
and properly take care of the Ebola virus patients in the safest way
O`DONNELL: We see the ambulance now backing into position, its final
position, as it pulls into a parking area there for ambulances in Bethesda,
Maryland. And Bryan, this is a completion of what seems like a very
important journey in what may be a very important chapter in this situation
in the United States, bringing this nurse up from Texas, seeing what good
spirits she was in in her hospital bed in Texas before she left, joking
about partying in Maryland when she gets there. Then the big surprise
actually of seeing her walk down the steps of that aircraft tonight on her
own legs under her own power with medical personnel on each side of her,
but then walking across the pavement and stepping up into the back of that
ambulance, just walking herself from plane to ambulance. That has to be
the most hopeful thing we have seen so far in her condition.
WALSH: It is. And I think this is, you know, one step in her journey. Of
course, I mean this is still a very serious illness and - she faces a long
road here, but, of course, there is really no better place, I think, for
her to be treated than where she is right now, and I`m sure the doctors and
nurses of the NIH will be doing everything they can to help her.
O`DONNELL: And Doctor Sepkowitz, tell us what it`s like in a major medical
facility when you have a patient of this kind of importance, worldwide
attention on the arrival of a patient in a medical facility like this.
SEPKOWITZ: I can`t claim that I have taken care of a patient with this
much international focus. I think that the thing you have to guard against
when you are taking care of a highly visible patient is the tendency to
second-guess yourself, that you fall out of your routine, you are overly
deliver it in a certain sense and all the sort of skill that you have honed
through the years, you start to second-guess herself so much. That is
somewhat inevitable when there is this much of a high-profile situation.
On the other hand, it`s like, I guess, Jitters early in an important game.
Once you kind of get into it a little bit, - go away and you resume your
usual routine, chronic (ph) behavior. But there always is a concern any
time there is a high profile.
SEPKOWITZ: That people start to act differently.
O`DONNELL: The ambulance is parked in an area where it is partially
covered, and so it`s not easy for us to see in this helicopter shot exactly
what has happened there or is happening there, but there was some movement
inside the hospital that we could see through those windows on the first
floor. It may be that Nina Pham is already inside the facility. We don`t
have confirmation of that, but there seem to be some movement inside the
facility there, just at those windows, including the movement of one
stretcher that seemed to be rolling through there. We can`t - we can`t say
for sure whether that has actually happened. But Karin Huster, tell us
what you would imagine is going on inside that hospital now that the
ambulance is there and presumably it looks like Nina Pham may already be in
HUSTER: Well, I imagine that she becomes just like an ordinary sort of
quote-unquote patient who comes in and rolls through your doors and is - to
an intensive care unit. So, you will have a team of doctors, and nurses
ready to receive her, most likely she will be hooked on a monitor where her
vital signs will be able to be looked at constantly. So you`ll know her
heart rate, her blood pressure, you know, her temperature, things like
that. And then I think they are going to take it from there. Depending on
how she is, she might need fluids. She might need nothing. I think it
might be a wait and see game. I don`t know, but definitely I know that the
teams of nurses and doctors are going to be completely ready, dressed in
full suits, you know, their full protective equipment, ready to take care
of her as best ways that they know.
O`DONNELL: That is what we saw through the window there. There are people
- they were in full protective gear, the people we saw moving through that
window there on the screen, it would be to the right of the ambulance, the
most brightly illuminated interior part of the building is where we saw the
movement around. They moved around that corner. One actually running, one
of the personnel ran a little bit there.
Dr. Charles Chiu, what do you anticipate to be the intake procedure that is
going on there now?
CHIU: Certainly what they would want to do, is they would want to
interview her in full protective gear, of course. They would definitely
want to talk with her to find out how she is doing. As the nurse
mentioned, they certainly would want to check her vital signs. Very likely
what is also done is that there will be an initial set of blood drawn to
send for chemistries and laboratories, things like white blood cell count,
et cetera. And really from there, it`s really making sure that she is
comfortable and everything looks like it`s going fine. If she needs fluids
and if she needs other kinds of support, it would be available there for
her. And really sort of kind of really being able to meet all of her needs
is going to be part of this.
O`DONNELL: What are the basics of the treatment at this point?
CHIU: The treatment for Ebola virus infection has been primarily
supportive. What that entails, is these patients can lose a large amount
of fluids. Especially as they become more symptomatic and the diarrhea and
the vomiting become more -- they can lose -- it has been reported from Dr.
Ribner (ph) in Emory that they can lose up to five to ten liters of fluid a
day. This fluid need to be replaced, either as fluid and electrolytes, et
The other kind of negative outcome that can occur is because of the loss of
fluid, that also have -- they can have severe electrolyte abnormality.
This can actually cause cardiac arrhythmias, abnormal heart rhythms as a
result, which can be life-threatening. So because of that, they have to
also, the doctors and nurses will be carefully monitoring her electrolytes
and sodium/potassium levels et cetera, making sure they replace those
levels and correct these electrolyte abnormalities they can get with the
They certainly will be looking into whether or not she is potentially a
candidate for experimental therapies. And also, this would be in
conjunction with the CDC and biopharmaceutical companies in terms of what
investigational drugs may be available for her, and whether or not she
would be a candidate for one of these experimental therapies for Ebola
O`DONNELL: The image you are seeing on our screen now was moments ago,
that we are going back to, to show you what I was talking about when we saw
the movement through the window there. We clearly saw fully protected
medical personnel, a stretcher moving, presumably with Nina Pham on it.
She would have been on a stretcher inside the ambulance. And the easiest
thing would have been, as they normally do, just to take that right out of
the ambulance and into the hospital. They were moving at a fairly quick
pace. It gets to the point where in this frozen frame piece we have seen
here, the person in the white protective gear had to actually run a little
bit to catch up with that stretcher as it was going around the corner.
Bryan, this is now the new chapter in this story, is what happens when the
National Institutes of Health takes over.
WALSH: They will treat her as best she can. As Dr. Chiu mentioned, it`s
supportive care, which may sound surprising. It does not sound so
complicated. Essentially you are just trying to keep this patient in the
best shape as possible, to keep those fluids going, to make sure they don`t
fall into shock. It`s really no different from what you would be getting
in a good hospital in Africa. The difference is you will have all the
doctors and nurses focused on them. And most importantly, I think you
won`t have to worry, or hopefully the risk of infection from outside, from
beyond Nina to those health care workers. That is something I think they
will be very focused on. I would be incredibly surprised to see that
O`DONNELL: Bryan Walsh, Dr. Charles Chiu, Karin Huster and Dr. Kent
Sepkowitz, thank you all very much for joining me tonight. I really
appreciated it, covering this breaking news story of the movement of Nina
Pham into the National Institutes of Health. Thank you very much for
joining me. Rachel Maddow is up next.
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