Thursday, October 16, 2014

'We made mistakes,' Dallas hospital chief says of Ebola crisis


WASHINGTON — Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, on Thursday defended his agency’s handling of the Ebola crisis while conceding the agency may have allowed a Texas nurse to fly on a commercial airline even though she was among a group of health care workers involved in treating the first case of Ebola diagnosed in the nation.


The hearing followed partisan lines, with Republicans pushing their agenda for closing the border with a ban on travel from West African countries where the Ebola virus has broken out. Democrats opposed such a ban and called for greater efforts to fight Ebola at the source in Africa. Some Democrats questioned the effect of GOP-backed budget cuts in curbing efforts to fight Ebola at home.


“People are scared,” said Rep. Fred Upton, R-Mich., chairman of the Energy and Commerce Committee. “People’s lives are at stake, and the response so far has been unacceptable.”


Frieden — as he has throughout the crisis, which began at the end of September when Liberian Thomas Eric Duncan was diagnosed with Ebola — sought to reassure the lawmakers and the nation.


“Working with our partners we have been able to stop every prior Ebola outbreak, and we will stop this one,” he said. “We know how to control Ebola, even in this period.”


Lawmakers also zoomed in on how Duncan, who died Oct. 8., was treated at the Dallas hospital.


Duncan arrived in Texas from Liberia on Sept. 20 and stayed with his fiancee and friends in her apartment. On Sept. 25, Duncan went to the hospital, complaining of fever, and was released with antibiotics. He was rushed back to the hospital on Sept, 28, where he was treated in isolation.


Dr. Daniel Varga, the chief clinical officer for Texas Health Resources, the medical group that oversees the Texas hospital, said that “unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes.”


Rep. Jan Schkowsky, D-Ill., was among those pressing Varga on whether nurses at his facility had received adequate training and material in dealing with Ebola. Varga insisted the hospital had done all it could, though nurses and nurses’ groups have said protective suits were inadequate and protocols were not in place.


Two nurses who treated Duncan have been diagnosed with Ebola and one, Nina Pham, has been transferred from Dallas to the National Institutes of Health in Bethesda, Md., for treatment, officials announced at the hearing. The other nurse, Amber Vinson, was taken from Texas to Emory University Hospital in Atlanta, arriving Wednesday night.


In addition, about 125 people, mainly health care workers, are being monitored for Ebola symptoms such as fever.


That group includes Duncan’s family and friends, four of whom have been in quarantine in Dallas.


School districts in Ohio and Texas have closed some schools because several of their students were on the Frontier Airlines plane that Vinson took on Monday from Ohio to Dallas. The 132 passengers on the flight taken by Vinson have been urged to call the CDC.


On Wednesday, Frieden was insistent that Vinson should not have flown in a commercial plane because she helped care for Duncan and was being monitored. Citing CDC guidance, Frieden said: “We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement,” he said.


But hours after the news conference, CDC officials said Vinson had contacted the agency Monday, before her return flight to Dallas, and reported she had a low-grade fever of about 99.5, two degrees below what then was the agency’s threshold, 101.5, according to the agency. That mark was lowered by the agency Wednesday, to 100.4, still above Vinson’s reported fever level.


Under questioning from Rep. Diana Degette, D-Colo., Frieden seemed to try to sidestep the issue, saying he had not seen a transcript of the call from Vinson to the agency, but it was his “understanding that she reported no symptoms to us.”


Although lawmakers were split on issues such as the effectiveness of the travel ban, there was bipartisan agreement among the panel on the dangers and fear of Ebola spreading in the United States, a growing drumbeat since Duncan died at Texas Health Presbyterian Hospital in Dallas.


Rep. Henry Waxman, D-Calif., complained that budget cuts are partially to blame for the Ebola crisis. Those budget cuts were generally backed by Republicans.


Throughout, Frieden sought to present a calm exterior, reassuring that all was being done. He cited stepped-up screening at five U.S. airports of travelers arriving from Africa and the creation of a high-level CDC team to help local hospitals deal with Ebola issues.


“There are no shortcuts in the control of Ebola and it is not easy to control it. To protect the United States we need to stop it at its source,” Frieden said.


“One of the things I fear about Ebola is that it could spread more widely in Africa. If this were to happen it could become a threat to our health system and the health care we give for a long time to come.”


Still, in this election year, with the control of Congress an issue to be resolved in less than three weeks, several Republican lawmakers pushed hard for a travel ban for people who have been in West Africa.


“You’re right, it needs to be solved in Africa. But until it is we should not be allowing these folks in, period,” Upton told Frieden, who said that 100 to 150 people daily arrive from danger zones into the U.S.


Frieden, along with President Barack Obama, have said they oppose such a ban.


But Frieden noted that: “We will consider any options to better protect Americans.”


Levey reported from Washington; Muskal reported from Los Angeles. Times staff writer Geoffey Mohan contributed to this story from Dallas.


©2014 Tribune Co. Distributed by McClatchy-Tribune Information Services.



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