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tv   Inside Story  Al Jazeera  October 14, 2014 3:30am-4:01am EDT

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film with with a high turn out showing that audiences here are ready for bollywood to take a stepping in a new direction. al jazerra. mumbai. well, you can find out much more about the mumbai film festival on our website. and there you will find the other stop towers the top stories hong kong police clearing protest sites. ebola is hard to catch, and unlikely to spread in the united states. while both may be true people have caught it, and it has spread. no what? that's inside story. >> hello, i'm ray suarez.
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a man with ebola present himself was mistakenly returned home. but when he came back he eventually died, but not before infecting one of the healthcare workers treating him. in spain healthcare workers accuse authorities not equipping them. there is a lot to know about ebola. we look back at the early days of this outbreak and forward to prevention. >> we have to rethink the way we address ebola control. even a single infection is not acceptable. >> what has been called a breach in protocol as the first
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transition of the disease on u.s. soil. >> it's a detailed investigation to better understand what might have happened with the infection of the healthcare worker. we look at what happens before beam go into isolation. what happens in isolation, and what happens when they come out of isolation. >> over the weekend a health worker in dallas fell ill with ebola after treating patient thomas eric duncan. he went to the hospital in dallas. despite the fact that he had told the emergency team that he just got back from nigeria, the hospital sent him home. two days later he was hospitalized, and last week he died. they cannot pinpoint when the transition between duncan and the nurse happened. >> we wish this individual had not been infected, and we're concerned there could be other infections in coming days.
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>> the cdc began their containment effort by monitoring 48 people who came in contact with duncan before he was officially diagnosed and hospitallalized. to none of those people have become symptomatic. now there is a new infection in the u.s. the cdc will actively monitor all the healthcare works who came in contact with him. >> we'll increase the awareness of ebola and increase the ability to respond rapidly. >> in the healthcare workers community anxiety is abundant. >> we do have to step up training. this is one of those things where you need constant attention and people need to go to the next level. >> the national nurses a nighted staged a protest over what it says is lack of protocol or training across the country. the protective gear can be a
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challenge in itself. it must be carefully cleaned and removed in a ridge process in a way meant to keep the disease from spreading. jacob ward demonstrated how difficult it can be to dispose of suits if you're not fully trained. for every person you want in one of these suits out treating people you need a second person also trained in the use of the suit to get that person out of it. that buddy system is essential in creating the ritualized process that will keep me from being infected. >> the strategy of immediately transferring new ebola patients once diagnosed to a hospital equipped with a highly specialized containment unit is also being considered. but only four hospitals in the u.s. have one. as dr. frieden walked away from the podium he was asked one more question, should the public be confident that the cdc knows how to deal with this? >> if this is stopping ebola,
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absolutely. we know how to do it. we know how to break the chains of transition by making sure that people who develop symptoms are rapidly isolated, and effectively cared for. we know how to do it by making sure that care of patients is safe and effective. right now we have to make sure that that care is done safely and effectively everywhere particularly in dallas where there is a patient today. >> once you concede that mistakes were made in the early days of the outbreak what are the measures called for . we want to start our program in dallas today, and heidi zhou castro, who has been covering the story there since the beginning. heidi, welcome to the program. we see people in hazmat suits
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and we see taped off scenes and barricades. what's going on in those scenes where we see people in hazmat gear and cleaning equipment. >> ray, it's great to be here. i was asked by health workers earlier today. it is a very quiet normally residential area. and of course her apartment complex, her building has cordon cordoned off, we know they have the steps going down into the curb. but we were told they hadn't decontaminated the inside because there was still a dog as of this afternoon. this is the health workers' dog. everyone else had been forced evacuated from this building. but the dog presents an unique challenge for health officials here and it's important that the pet of this patient, the dallas
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county judge, he's taking it as a personal mission to make sure that this animal is treated humanely whatever authorities end up deciding what must be done with this dog. it could possibly carry ebola. studies have found that canines can carry the virus although they may not develop symptoms. >> are the neighbors in that apartment building being held in one place being asked not to have contact with on or about people? >> they have all been contacted by various methods "public health authorities. the sunday morning those neighborhoods would have woken up to find the flyers, the symptoms of ebola and explaining someone exposed lived on their building. they were contacted but what
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officials call reverse 911 calls. that's when the phone rings automatically and someone from the 911 center tells them to be aware that this patient was living on their block. finally there have been direct contact as well. city leaders knocking on doors themselves. that's not simply to communicate the message but also to tem straight that these leaders are still active in the community. they're meeting people. they're shaking hands, and that is their attempt to project the the sense of confidence that the city has a handle on things when there is so much rampant fear. >> if you live down the hallway from this woman are you asked to stay home? submit samples for a blood test? >> you know, we're trying to get to the bottom of this. yesterday i can tell you that there was a gentleman look out another window.
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this is an argument that i believe has four units in it. he woke up, looked out the window and he didn't know what was going on. he found out and he discovered the flyer. day when i went back i didn't see any movement in the building, and the long building had been cordoned off. we're not sure if the others who shared the same building as the healthcare workers if they were moved by force or other means. >> thanks a lot, heidi. we wanted to continue the health in the united states.
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our guests, deann, let me start with you. dr. frieden got a lot of push back after he noted there was a breach in proper protocol, and that's how this heat care worker got ebola. what went wrong? >> that goes to show that protocol, policies and procedures are not enough. optimism care needs to be provided. protection needs to be provided to the workers. we're not going to scapegoat the cdc. they've done very fine work in this area. we're not going to scapegoat patients or nurses. we need to stop ebola. we need to stop it effective ly
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by hands-on training and education. you can't just hand somebody a piece of patriot with a protocol on it. >> not only were the national in nurses union out. but they throng the health ministry in madrid complaining they hadn't been taught enough about how to limit the spread of this disease. we saw in madrid a nurse treating a patient who later died of ebola, and also contracted the disease. are there routine training programs? are there routine practices of how to get in and out of the suits, for instance? >> we have a lot of routines in place, but these are not the sort of things we need to do for ebola. no one who works in an american hospital has any experience with the exception of those in nebraska, emory and now dallas
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have any experience at all dealing with ebola patients. that said we have all the technology we need to take care of a patient with ebola and stop the spread of oath, but it's impossible--well not impossible but difficult to get everyone to do the right behavior at the right time with such short notice. that's why everybody needing to through the same training, and everywhere across the united states , all the nurses, all the doctors, all the nurse's aide. anyone who will come in contact with these patients needs to training with they get a chance to practice and be used to things like the buddy system, that will really help make this process go better for every. >> the cdc has been praised and knocked around a little bit this week as a lot of measures have
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been put in place. and we have a new infection at the same time . >> how do you "walk the line" of prudence and overreaction? >> i think that you're absolutely correct. there is a lot of needle threading that needs to be done. the previous speaker said things quite well. the healthcare worker is on the front line of this situation. the risk involved is not the same for everyone. but when you have people coming in oh direct contact with patients, and they're being instructed and taught how to deal with a situation that they haven't seen before, it makes it
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quite dill for someone to do things correctly all the time, especially when there has not been all that much time to prepare. i think you're right. the cdc has done quite a good job keeping the public informed, health care workers informed. i think protocols need to be carefully reviewed. what went wrong needs to be found out, needs to be corrected. there is going to continue to be a need for a lot of fine tuning to be done. >> when we come back with more inside story we'll continue our look with the attempt to stop the spread of ebola in the united states and around the world. once the disease broke out of >> a firsthand look at the isil fight >> you can see where the bullets ripped right through... >> refugees struggling to survive >> the government, they don't help us... >> but who is fueling the violence? >> if they had the chance to kill each other, to make more territory, they would do it >> fault lines, al jazeera america's hard hitting...
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>>on tech know, the agricultural community is in crisis. >> more prolonged drought could become the new normal >> desperate for solutions >> we can make clean drinking water just using the sun >> conservation, science and hope... >> the snow is really a critical resource... >> tech know's team of experts show you how the miracles of science... >> this is my selfie, what can you tell me about my future? >> can effect and surprise us... >> sharks like affection >> tech know, where technology meets humanity only on al jazeera america >> welcome back to inside story on al jazeera america. i'm ray suarez. once it was realized that thomas duncan, a liberian who traveled
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to texas, was infected with ebola was put in place in the hospital, and everyone who was in contact with the young man was screened, it wasn't enough. what happens now is the focus on the program. dr. landon, the disease is progressively more infectious as the patient gets sicker. infect the virus is trying to burst out of the body to move to its next host. should the protections that medical personnel use also be graduated as they spend more time around the sufferers? >> first of all, you're totally right, ray. as ebola is so bad for us that it only takes a tiny amount of the virus to make us feel sick in the first place. and that's why people just aren't infectious until they begin to feeling sick. then they become more and more and more infectious close to the end of life.
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those who are about to die from the disease are the most infectious of all. their immune system was not able to control the virus. that's why they have so much virus in the bodily fluids. that's why the tiniest breach of infection control near the end of the patient's life can be devastating. that's something that can be very difficult for us to do in the united states. but i think many hospitals are now suggesting that perhaps we should change the way that we handle these patients as they get sicker and sicker. i personally believe that we need to do as much from the very beginning,ed a we need to have one system in place that will be the best for everyone. at the hospital we have one set of ppes for the patient and one set of pe
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pes for those who take care of the patients. i think a lot of hospitals will go to methods like that. >> doctor, when we're having our first national experience with maximal in our approach, for instance, any remaining fluids or anything that fluids may have touched should be considered infectious for a long term. even after a patient has moved on, died, we go to their apartment after they're being treated, anything, spew item sputem, spit, vomit, everything should be considered a hazardous material bus we don't know how long the virus will stay alive.
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>> we don't know to the hour but we know that viruses don't stay alive outside of the body. there is a lessoning risk as time goes by. i do think we should be on high alert from the start. and i gray we need to be on high alert for some time after a patient has either been recovered and been discharged from the hospital, or has died. surfaces should be decontaminated, of course, but i don't think that decontamination process needs to go on forever, and i think we know how to rid all traces of the virus to render them non-infectious. >> are your members being told enough in a timely enough manner to have confidence as they begin to treat more people with this disease? >> we've done a national survey
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as of sunday. over 2,000 nurses from over 700 facilities are saying 76% of them have not been provided information specifically. over 85% said they have not been given hands-on training. and i agree that we should start with the optimal level of protection as those workers who transport it in the ebola patient to emory university because we simple by don't know. hazmat suits, res pe respirators with hoods, sealed face masks because even the experts are saying, the cdc is saying we don't know how long these bodily fluids could could--until they--how long those particles remain in the air. it's not about what's right or wrong in terms of the precautionary principle. we always have to
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error on the side of the highest standard even though there is no scientific evidence to the contrary available. we can't wait for the jury to come in. >> or error on the side of the highest standard. i like that phrase. right now patients who come in to the hospital with fevers are being held under observation in hospitals and in other cities around the country. they haven't necessarily been in west africa. they just came in to the city with un identifiable fevers. right now they're under observation. do you think that's a good idea? >> well again you have to have a history. they have a history of contact. they have a history of travel. they have a history of living with or caring for somebody who has traveled to an area where this is endemic. again, just hospitals pick and
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chews which types of ppes are available is not the highest standard. a mask is not a mask is not a mask. we need full suits. full respiratory protection. and when a patient meets those criteria. >> we'll be back with more inside story after a short break. in medical emergencies over response is expensive and sometimes counter productive. in the case of ebola how do you design a response that reflects the unlikelihood that the disease will become a problem nationwide? stay with us. >> america votes 2014 go behind the scenes in the all important swing states >> this could switch from republican hands to democratic hands >> with the senate and congress up for grabs... >> it's gonna be close >> these candidates will stop at nothing to get elected. >> iowa was never sent a woman to congress...
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>> you're watching inside story on al jazeera america. i'm ray suarez. we're talking about how to
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design a response to ebola in the united states. the president is meeting with his health team to track a response. if you want the public to take it seriously and react with prudence instead of panic what now. still with us, a professor of global health and george washington school of medicine. and deann mcewan, . >> dr. waldman when i covered the h1n1 outbreak in mexico city i was walking through empty streets through one of the world's largest streets, and finally business people said this is killing us. hundreds of millions of dollars of commerce was not being done to break the back of an illness
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that was not making people that sick. how do you match it so something that is proportional and have the public go along with it. >> we have to try everything we can as health professionals to educate the public as to the nature of these conditions, and try to stay away, as you said earlier, from anything that can disseminate any panic at all. there is a rational approach to this condition as there has been to others. for one thing ebola is very different from influenza. the example you cite, in that it is much less likely to spread rapidly. it is not spread through the air. it is spread only through contact with bodily fluids with someone who is exis exhibiting symptoms of the disease. there is a clear transmission
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that people with fevers who oh do not have a history of contact with anyone who has traveled with west africa or cared with someone with ebola, someone who cuss not have travel histories themselves, they are no risk of contacting the disease. >> is there a mass mitch with men in hazmat suits spraying down sidewalks. >> it is been firmly entrenched. no one knows what is contaminated and what is not contaminated. what we have in the united states is very different from that. but i want to make a very, very important statement. anyone can put on a tyvek suit, you taking it off is nearly
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impossible to do without contaminating yourself without strong and long-term training on how to use that kind of equipment. it bears no one any help icing a full-body covering with shoe and leg covers as well. the only benefit is comfort. it should be used if you can train people to use it. but with our first contact responders the most important thing is to safely and quickly take care of the patient, not as much that they're comfortable doing it. i hate to say that, i want our people to be comfortable, but i really want them to be safe. >> dr. landon, we'll have to end it there. thanks for joining me. that brings us to the end of this edition of inside story. thanks for being with us at home. from washington, i'm ray suarez.
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>> on "america tonight": how did it happen? a dallas health worker becomes the first in the u.s. to contract ebola while trying to help a sick patient. are u.s. health officials doing enough fast enough do they know enough to protect us? fears from the airport gates to hospital corridors. >> we're anxious every day. i look at the reports about our monitoring of people and it's a concerning thing. >> with "america tonight's" adam may in dallas, a city reeling


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