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Live Blogging the Congressional Hearings on US Ebola Response

Disclaimer: This is not a panic/hysteria site.  We’re interested in learning all we can about the US response to the disease and whether our governmental institutions are funded adequately to respond optimally.

With that in mind, you can watch the hearings online at PBS.org.  So far, we have had opening statements from the CDC (Friedan), NIH (Fauci), BARDA (Robinson), FDA (Borio) and a representative from Texas Health Presbyterian Hospital.

The most notable announcement so far was from Anthony Fauci from the NIH.  He says that Nina Pham will be transferred to the NIH this evening for further treatment.

Also note that there will be a lot of Republicans and Democrats on this committee who voted to cut the budgets of these institutions when they approved the sequester.  So, keep that in mind when you listen to these bloviators.

And, now, on with the live blog.  Geeks are encouraged to comment because I’m pretty sure there is going to be technical information presented, especially wrt to drug discovery efforts.

 

120 Responses

  1. Friedan says that nurse Vinson called CDC about her travel arrangements but did not discuss whether she was symptomatic.

    • She did discuss that she had a fever. She WAS symptomatic.

      • Friedan says he doesn’t have a transcript of the conversation but it was his belief that she didn’t say she was symptomatic.

        • I need to pee and have something to eat. Do you have time to take over for a while?

  2. Fauci says that nurse pham is being transferred to NIH because it has state of the art (implying that Texas presby doesn’t). Beds are very limited.

  3. Why are we not restricting flights? Friedan says not helpful to curtail flights. I agree with this. But this doesn’t mean we can’t screen and quarantine people once people get here. Ellis Island performed this function.

    • My dad was talking about Ellis Island. It’s probably out of date now, but surely there’s someplace available in this huge country?

      • I need to pee and have something to eat. Do you have time to take over for a while?

  4. Friedan says we can track anyone who enters the country.
    Bloviator asks why we can’t quarantine everyone.

  5. Diane DeGette (D- CO) asking a series of fact finding questions regarding burgeoning epidemic. Oooo, she’s good.
    Did the hospital provide training?
    Hospital: No
    OMG, she must have been a killer lawyer.

  6. I’m riveted.

  7. How long did it take to put the shoe covers on? Hospital doesn’t know.

  8. What were the nurses wearing before ebola diagnosis? Friedan: additional covering is recommended when patient presents Duncan’s symptoms and travel history.

  9. Friedan: someone at CDC talked to Vinson. DeGette asks if guidelines were followed.

  10. There is a discrepancy there. It looks like CDC may have sent Vinson mixed signals.

  11. Upton (R-MI) Wants to know does the president have authority to impose travel ban.
    Friedan says he doesn’t know.
    Upton says he does.

  12. So,it looks to me that the Republicans are trying to paint the president as culpable because he is not preventing flights. Democrats seem to be trying to find out where the breakdown in the system was.
    Ehhhhh, I’m going with the D’s on this one.

  13. Friedan: Borders are porous, especially in west africa. People will cross borders to other countries that are not travel restricted. Then we couldn’t monitor them.

  14. Waxman (D): Says the CDC can’t just step in and take over. They need to be invited by the state health boards.
    I think people need to remember this.

    • Maybe that should change or each state should have an Infectious Disease Coordinator. It’s all too risky to let every hick hospital be a disaster vector.

  15. Waxman: We need to monitor health care workers. But why can’t we just restrict travel? Waxman shows map pointing out that people from West Africa can travel anywhere in the world before they get here.

  16. Fauci also says that screening at port of entry and monitoring is enough.

  17. Fauci: sealing off the border seems an easy fix but ignores the complexity of the disease and various travel options

  18. Blackburn (R-TN) Totally clueless about borders. Fauci:Porous borders refer to West Africa. Blackburn thinks we need to keep more mexicans out.
    What a ditz

  19. Blackburn: is ebola waste as contagious as a patient with ebola.
    Friedan: waste can be easily treated.
    Blackburn: Does CDC work with hospital to get rid of waste?
    Friedan: Yes, we work with DOT
    Blackburn: Seems to be going with NIMBY argument.

  20. Blackburn: Will troops be working with ebola patients?
    Friedan: Not planned.
    Blackburn: self-reporting not enough
    Why is she asking questions?? She just irritates me.

  21. Braley (D-IA): Are we doing sentinel reporting? (Is this like retrospective analysis?)
    Friedan: Yep. Epidemiologists are doing contact tracing etc.

  22. Braley: Will protocol be updated?
    Friedan: Duh

  23. Braley: Vaccine manufacturer is working on scaling up. They have requested assisted with HHS. What is HHS doing to move contracts forward?
    Robinson: accelerating contracting with HHS.
    Fauci: HHS working on phase I trial.

  24. Braley: travel restrictions- strengths and weaknesses
    Wagner: We can check passports for travel to africa.

  25. Burgess (R-MD): We need to have a vote on travel restrictions, by golly!

  26. Burgess: Pham is being transferred because the other nurses are not willing to care for them, right?
    Hospital: blather and misdirection

  27. Burgess: pictures from the CDC are misleading, right?

  28. Burgess seems to be suggesting that health care workers are in grave danger. The only way to protect them is a travel restriction.

  29. Burgess: What did you think patient zero was going to look like?
    Friedan: Our goal was to get hospitals ready.

  30. Shakowsky (D-Il): Weak health systems spread ebola. Wants to focus on US hospitals. Do we have ability to train and equip our hospitals and staff?
    We still don’t have a good answer as to why 2 nurses caught ebola. What was wrong with the protocols?

    I find these questions to be useful.

  31. Shak: How come the nurses in Dallas weren’t protected.
    Friedan: The first three days, no one knew Duncan had ebola.
    Degette: But the protocols said the hospital should have taken precautionary measures, right?
    Friedan: Yes, he was being isolated. But in first 3 days, there was variability in protocol execution.
    Shak: How do we train health care workers?
    Friedan: 1.) Train nurses 2.) awareness 3) contact CDC for immediate response team

  32. Unknown bloviator without name tag (presumably Republican) abbreviated UB.
    UB: Protocol breakdown! Pham was using full protective measures. What breaches caused her infection?

    I’m seeing another trend here. Republicans don’t seem to be interested in improving protocols or response. They seem to be interested in pointing out how government institution protocols are completely useless against this disease.

    How is this helpful?

  33. So are they saying that the only rational response is to keep Africans out of the US and forget about the CDC as a useful disease control institution?

  34. UB: On the issue of elevated temp, what is the right threshold? How can we be sure? Duncan had a temp at the hospital. When should parents be concerned?

    In other words, what’s the point? Why not just close the borders?

  35. Friedan: Parents should not be concerned unless they live in West Africa or have had direct contact with an ebola patient.

  36. Castor (D-Fl): Wake up call about NIH funding.

    YES!!!!
    Finally someone says the obvious.

    She says vote to restore funding failed on a party line vote.

  37. Castor: Not a large private market for Ebola drugs and vaccines.

  38. Castor: Why is government involvement important?
    Fauci: Rare diseases are not commercially viable. We struggled for years to get pharmaceutical partners and finally got some after many years.

  39. Fauci: Companies don’t like to take risks

    Great understatement of the Decade

  40. Castor: what is status of vaccine?
    Fauci: Vaccine is not ready for prime time. Vaccine may be used to just control, not eradicate epidemic. We might have logistical trouble getting trials.

  41. Castor: What are improved diagnostics?
    Fauci: CDC helpful. Several grants out for improved diagnostics.

  42. Gardner: Why can’t we screen 100% of entries?

    Why is this guy leading in colorado?

  43. Gardner: how many flights to get supplies and personnel to affected areas?

  44. Gardner: Asks stupid question about travel from Liberia to Nigeria.

  45. Gardner doesn’t seem like he’s up to date on this subject.

  46. Friedan: points out that if passengers can’t come here directly, they might take a different route and we won’t be able to monitor them.

    Must speak to Gardner slowly and repeat this point over and over again.

  47. Welch (D-VT): Is it feasible for all of our hospitals to provide state of the art treatment? or do they need to transfer patients?
    Friedan: Call CDC and we will assess.

  48. Welch: Public health can control this, right? What about travel. It seems like an easy answer. What’s the debate about? (In other words, Republicans aren’t getting it)

    Friedan: (must be getting tired of answering this) Most entries are American citizens.

    Welch: If a full out ban, you have trouble monitoring people getting around roadblocks, right?

  49. Welch: About funding. We may want to have a hearing about funding requirements to ensure that response is robust and ready.
    We cut funding by 20% at NIH and 12% at CDC. That was reckless.

    THANK YOU!!

  50. Taking a break. I’m hungry. Can someone else take over?

  51. Yarmuth (D-KY): points out article on US institutions to combat ebola.
    Can we test ebola before symptoms?
    Friedan: Nope

  52. Yarmuth: Media can sometimes go overboard. (Ya’ think??)

  53. Yarmuth: has the media coverage been helpful or harmful of your efforts to educate public?
    Friedan: Understandable that there is coverage. Coverage is important to alert health care workers.

  54. Friedan: Some coverage exaggerate and mislead. We know a lot about ebola.

  55. Friedan: Barring an improbable mutation, there will not be a large outbreak in the US

  56. Yarmuth: What can we do to make your job easier?

  57. Friedan: We’re looking into it.

  58. Johnson (R-OH): We don’t know what we don’t know. Somebody needs to know the details. Do we know how the nurses got ebola?
    (same stupid questions)
    Friedan: Investigation still ongoing.
    Johnson cuts him off.

  59. Johnson: As a military war planner (which is so much like an epidemiologist), we don’t wait for the bullets to start flying. when was the CDC aware of the outbreak in West Africa.
    Friedan: Late March
    Johnson: Military does pre-planning. It knows what to do (which is why we were so on top of ISIS, but I digress)
    Friedan: Yep, we do that kind of stuff.
    Johnson: Which hospital in OHIO had that kind of strategic planning?
    Friedan: Don’t know

  60. Ok, I really do need to break now. The bloviating is getting to be obnoxious.

  61. Johnson: Health care providers need more extensive training because apparently they don’t follow the news and have no idea that patients from west africa might have ebola.

    Yes, let’s insult the intelligence of all nurses in America.

  62. I’ll see what I can do

  63. Matheson: Are you restricted by funding?
    Friedan: We are getting funding through an anomaly by congress (that sounds interesting)

    • I read this morning that the CDC funding was slashed in 2003 and it’s been funded on a year by year basis since then.

      • Yes, that sounds sensible, doesn’t it? Because we can predict in advance what years we will have highly contagious incurable diseases.
        {{rolling eyes}}

  64. Matheson: Limited personnel of CDC may need to be addressed to respond.

  65. Matheson: how can we combat variability of response?
    Friedan: We support regional centers to provide new ways to combat infection
    MAtheson: is state agency model sufficient

  66. Matheson talking about what we’re learning from this Ebola experience that would help with a more easily spread pandemic illness.

  67. Matheson: ebola not airborne. Buit there are other airborne pathogens. How do we learn from this ebola outbreak?
    Friedan: To prevent disease at the source and support hospital, community and public health efforts

    • I find it hard to follow Friedan’s speech patterns.

      • Really? Maybe it would help if he wasn’t constantly interrupted.

        • I’ve been listening to him for however many weeks and he pads his statements with a lot of bureaucratic gibberish.

          • That’s funny. I don’t find him hard to understand. I think the problem is that the CDC is not a free man in Paris. It needs to operate through state agencies. That might explain why he sounds bureaucratic.

  68. Long: Tugging heartstrings. Poor nurses. So sad. If you need personal contact, why is that airliner being scrubbed 4 times?
    Do you need a fever to be contagious?

    • I’m assuming the plane is being scrubbed 4 times for cooties. So they can say, “SCRUBBED 4 TIMES” …. contagion doesn’t have anything to do with it.

  69. Long: What happens if people don’t come back? (referring to monitored travelers)

  70. Are Republicans and their constituents really that stupid? Is this travel ban issue really so hard to figure out?

    • Maybe Dems should be discussing plans for quarantine? It seems extremely likely that Ebola aside, someday we’re going to need plans for quarantines in this country.

      • Believe it or not, Bush actually had quarantine restrictions in place. Whether they would have been adequate is another issue. At any rate, Obama eliminated them in 2012.

        • I don’t have an issue with quarantines if someone has been in a hot zone. I do agree with them that a travel ban will be counterproductive because of the reasons he stated.

          • I agree with you. Obama eliminated the ability to quarantine because the airlines complained that it was too expensive. So much for public health….

  71. Ellmers: Was Pham exposed in the ER?
    Hospital: No, they were ICU nurses but they were exposed within first three days.

  72. Ellmers: I asked for travel restrictions. How many strains of ebola are there.
    Friedan: there are 5 but only one strain here.

  73. Ellmers: why is this strain more contagious?
    Friedan: We’re looking into it
    Ellmers: Concern, concern, concern
    Friedan: The patient was spewing virus through every orifice. He was majorly contagious.

  74. Borio(FDA): We are looking for a new diagnostic test. We will expedite.
    Ellmers: I just don’t believe you about tracking. We need to have travel restrictions.

  75. Scalise: We need a travel ban until you geeks can prove Americans are absolutely safe
    Friedan: We don’t rule out anything.
    Scalise: Have you had conversations with the WH about a travel ban.
    Friedan: We talked about travel. I can’t speak for the WH.

    Scalise, going for the jugular.

  76. Scalise doesn’t understand limited role of CDC.

    This section may be worth reviewing later. But it’s just political posturing as far as I can see. He’s ignoring the porous borders argument.

  77. Scalise: What about protocols? Samaritan’s Purse says they warned the CDC that your protocols were lax.
    Friedan: We saw that but we don’t know if that event actually occurred.

  78. Scalise just being rude and unproductive.

  79. DeGette:(Thank god). Which protected gear were the nurses wearing the first three days.
    Hospital points out.

  80. DeGette: Summarizing. We can train nurses better. We can more robust protective gear. CDC could be on the ground earlier.
    Friedan: Agree on training and gear. We consult immediately. We can’t be everywhere.

    • That “everywhere” argument is bogus. Right now we’re talking about 3 or 4 hospitals and only 1 at a time had a 1st case.

      I really think that people who have experienced this (coordinated by CDC) have to supervise getting hospitals up to speed for each 1st case.

      • I think the point he’s making is that the CDC doesn’t just treat ebola. There’s only so many places they can be at one time.

        • That’s why I say people from other hospitals but, under a CDC contract or something. We can’t stop pandemics if hick hospitals have to make it up as they go along. Someone from Nebraska or Emery hospitals should have got down there in the first hours. the CDC should be authorized to coordinate that.

  81. DeGette: Please keep committee updated.

  82. Murphy: He wants an apology. People lie. Protocols may not be followed. Protective gear inadequate.
    He wants travel ban. Mandatory quarantine for Americans who have treated patients in Africa.
    Then the same stuff as Degette.
    Remove statutory language, more funding.
    Better diagnostics.
    Transport stuff
    Stop ebola in africa

    So, in essence, DeGette and Murphy are more or less on the same page except for the travel ban.

    • How about Travel Ban (enforced however possible) AND quarantine?

      Also, did I just hear that Nurse Amber had a fever when she got on the plane but, actual symptoms developed while she was on the plane?

      What the F* does that mean?

      OMG. Those tiny airplane toilets and how many people using them after her?

      • I didn’t hear that she developed symptoms while on the plane except for the elevated temperature.
        Like Friedan said, a travel ban will probably not be effective because the borders of the three most affected countries are very porous. So, it would be relatively easy for someone who has to come here for whatever reason to skirt the restriction by taking a different route out of africa. And if that happens and it’s not noted on the passport where the passenger is from, there’s no way to know to monitor them when they arrive here. So, I agree that a travel ban at this point will probably be counterproductive and is being used as a political issue. It won’t stop the infection from getting here if someone is determined to do it. It only makes the Democrats look callous, lax and unconcerned.
        Have we learned nothing about the way the Republican mind works?

      • I keep thinking about the people on the plane with her. Does the CDC demand that people on the plane quarantine themselves? Who can take three weeks off work, school, etc.

        Do mom’s continue to care for their children? Can families afford three-week quarantines?

        That nurse was irresponsible for traveling. She should have been quarantined. But wait, let’s remember Nurse Nancy Snyderman. Fema camps, here we come?

        • I think I asked these questions when Duncan first got sick in Dallas. If congress and the states want to do anything productive, they could pass a law making it mandatory that employers pay their quarantined workers, provide internet access for them to perform their work from home, and guarantee their jobs, without stigma or discrimination, when they are able to return to work. That right there might help prevent infections.

          • Good idea, and in the long run, it would be cheaper. Hospitals (at least the ones where I live) cannot afford to deal with Ebola. Keep people quarantined/stop the spread.

          • Exactly

  83. I’m done. So are they.
    I think they missed an opportunity to discuss the very limited treatment options in the pipeline.

  84. Not helpful to curtail flights? Uganda and Kenya and maybe some other East African countries have banned flights to–from Ebolastan.
    If they get zero cases of this particular ebola outbreak, then their decision to ban flights will have proven correct.

    What would screening achieve. I know that if I had “prebola” , I would lie like hell to get into a country where I would get good treatment. Just like Mr. Duncan lied like hell to get back into America.

    • Hopefully India and China will have the sense to ban travel to or from Ebolastan, including travel of Indian/Chinese expats for the duration of the epidemic. Picture ebola running amok in the slums and villages of India.

    • I am really surprised at the number of people who are falling for the travel ban argument.
      Remember “cut and run”? If you say something over and over again, it starts to stick. But just because it is sticking doesn’t mean it’s rational.
      It’s not rational.
      Friedan gave very good reasons why a travel ban is a dumb idea. Was no one paying attention or has fear of ebola taken hold?
      There is not going to be an epidemic in this country. We are not West Africa. What we have here is a gigantic screw up by a hospital in Texas. Now that we know what we’re dealing with, i.e. private for profit health care and lax staff training, we can deal with new cases more efficiently and safely.
      Jeez, I’m pounding a brick wall with my head aren’t I?

      • No. I get it. But, it’s the politics. If you can get something by agreeing to the travel ban, then do it. But, make sure you’re getting something useful.

        I am way more worried about logistics of quarantine. I think we’ll have people hiding (is that cut and run?) from that — and the fear of losing all possessions. Is there a way to contain contagious disease while not stripping families of all possessions?

        Ebola is not spreading and won’t. But, someday something will.

        • I’m with Friedan et all on this that a travel ban will be useless at best and possibly increase cases at worse.

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