Ebola: CBS's Heather Bosch Dr. Brahm Segal, MD
Good morning everyone let's go live now to New York should they receive BS's other Russians to anybody shelf above above the latest in the the ball to scare. In New York City Heather isn't really a scare Telus which can tell us. While we understand that epic expense they're in our partners are people out he was at it yet they ain't. CDC at any team can at that however the double check that I don't sit. I think you know we are handling everything with an abundance of hostage but the doctor Hewitt in West Africa. Had been treating Ebola patient. When he came back. Eight side. Back in without order we put our ultimate take it temperature up or I'm everyday and watch our intent. Yes well both of our time you woke up it was ill. Activist temperature it was harder street at the diarrhea immediately all how the and so even ambulance an imported into the hospital here. I had a better especially rain they were wearing protective ear. They rushed it into what I currently she knew match here in Bellevue hospital it's only one at eight are well in the eight at a special like early you know. With people who are grain or any all the issues. Okay now how many people did he come in contact with close contact before he got sick before he went to the hospital. That is great practice he get that aren't great and should grant that he'd been hanging out all of them at that form team as a or are in addition the they are they'll applaud you said. Health of people that we breaking all of his spat. Just to see. If other people may have been exposed theaters it did take the well. He I have right image act its act the Bible all that he is not at risk but nevertheless they're checking that out anyway all right. That's another place where we expect health officials the heat are in the people how what unpacked it happened this guy. But again they Brett you know he kept the ball but let your ancient art Leach went without went symptomatic. When you know New Yorkers are a resilient group we've known that now. Is there any indication that people are worried about this the average guy on the street I mean like staying off the subway maybe after during the the doctor rode the subway. You know we get you get them out here are some people who are a little bit actually learned about it get what happened Alice McGee dot other but they don't you know. It seem to be handled very well and ever new York and the benefit of what he what happens to Al. Duncan became so great Willie L. And nurses there's saying it baby we're not treat properly handle it (%expletive) like that. Here they've had yet I'd I'd wake when he set up. There will be protocols. And people understand that he would Eric gay people who have caught Ebola treating other cheating agents that are exits Jerry. Hillary thank you for your time this morning. Eddie. That CBS is another bosh live from New York. And where we are very pleased to have in studio this morning doctor brand Siegel. Chief of infectious disease at Roswell park cancer institute and we'll take your questions to for doctor Siegel and or text line at 30930. Also at news radio 930 and Twitter and our FaceBook page is well doctor Siegel thanks so much for coming and we appreciate it pleasure nice to see you can. Any surprise TO that Ebola has come to New York City. Not specifically a surprise that there would be an additional case so. When I was in your studio last week here in the affected West African areas that were. About 9000. Total cases west that it in that affect West Africa countries. Over the past week it's now the total cumulative number of of cases is close to 101000. So as the epidemic increases in West Africa are going to be people. Health care workers like this position where couldn't go there and and try to help out and that is absolutely crucial. I it is it is crucial not just for humanitarian reasons but also to protect ourselves in the United States because. Cases will be imported. With that being said. We would expect to see isolated sporadic cases. Health care workers or others were coming back. Back to the United States who might have people. Okay. Again the actual. Risk of a single health care worker using appropriate precautions to get Ebola. Is is very low but there are a lot of people there so we can expect on a sporadic. Individual level that there will be a case. That there will be sporadic cases in the future. No we know that in most cases in West Africa serious cases of mobile nine out of ten victims. Die. Now the doctors and lose doctor Spencer from New York City. Members of groups like Doctors Without Borders and other agencies would go to help treatable victims I mean they have to know how serious this is. So whether on the way back to this country what precautions. What they have taken or should they have taken before coming back. OK very good question so the fatality rate of Ebola it in this most recent outbreak isn't. If it is at nine out of ten it's closer to five out of ten about 50%. Under conditions. In West Africa and obviously can't. Match the level of of of icu care that that we have in the United States still very very serious when you have a 50%. Mortality and people who reprieve previously healthy that's a very big deal. What is happening going forward is that the CDC and there are multiple into room. Guidelines are being put out and revisions. Starting early next week they're gonna have even more or stepped up approach to follow travelers which would which would have included this position. That position New York City did exactly the right thing he reported things immediately when they occurred but there's gonna be a more structured. Plan to. Follow up with travelers who come back United States and people affected areas. On a daily basis so not only is it an issue that they're instructed to monitor your temperature they will be in contact with public health. Officials on a daily basis through 21 days. We're getting questions that are coming in this morning people are wondering why he was allowed to wander around why is he was allowed to go bowling and taken a subway train and you know things like that. You know things are now in such flux with these guidelines. He as far as I know did not. He was fully aware direct risk. And was compliant with what he was told to do. I think going forward there might be that there will not be quarantined for asymptomatic. People who who packed travel. People are endemic areas but for people like this position that obvious close exposure to Ebola patients. There might be what it's called what the CDC is calling control movement or somewhat restricted movement. Where there is these hook these people not be quarantined but they might say you know. Don't go on long trips don't go and cruise ship. Don't go on not on a flight across the country things of that nature. And these decisions I think will be made on that sort of an individual basis in consultation with the state. Public health and CDC to paint those. Not in place now they think they're coming. Well I saw them on the CDC website. And I hear a I didn't see them a few days ago so I think that these. Who with with each case that occurs. There's a huge economic impact. And a huge public health investment when you start and and the huge. Just fear factor. So you could imagine if you have an Ebola and some with the Ebola exposure coming back from let's say Liberia. And aid travel quite a bit to go on York city subways and and seven days later. They develop Ebola like symptoms you're now in a situation where there's the air and huge amount of contact tracing and anxiety. So my sense is if if based on their exposure. If they work with the public health authorities not quarantined let me be. We strict some of their movement within about 21 day incubation period. That might make sense and and again these are in flocks are not sure that it's fully implemented. But I see it on the CDC website as of this morning. In our studio this morning is doctor brand Siegal Dei chief of infectious disease at Roswell Park Cancer Institute. We are taking your questions to. At 3930 on the text line and it news radio 930 and Twitter also our FaceBook page as well for doctor Siegel as there is eight. First case of Ebola in New York State it's in New York City doctor Siegel and this and bring us up to you of the Doctor Who came back from West Africa. Clearance screenings at JFK airport he went through this new airport screening. On October 17. But to didn't. So nothing showed up yet I mean it doesn't mean at the screening was. Was you know deficient in anyway right it's. That's it there's an incubation period for Ebola so he didn't have fever symptoms then but it. He got developed it and a week or so laughter. Our itself. So he got after the screening and Bennett was you know until yesterday that he's just started feeling bad I mean even the day before it is pricing he ran three miles. Now no there there and the incubation period. Can be as longest 21 days it usually isn't. But it can be as long does that. So he became ill as I understand it within about a week of his return from. From Guinea. So no that that was actually. As as would be expected. So that's a limitation. Airport screening in the attic can't predict the future. Susan mentioned a few minutes ago though one of our listeners and wanted to ask you why this doctor was allowed to meander all over Manhattan and Brooklyn. And after testing positive for the virus should he have been told. To limit his traveling and maybe stand some kind of even limited isolation. So he. In terms of the big policy. In terms of how of whether there should be sound. Rules about. Restricted movement or what the CDC is now calling controlled movement. That may be happening in the future and in retrospect that does seem reasonable so if you are. Coming up but again we we have to frame this in a big way we absolutely need to have health care workers. Going to West Africa to try to contain via the epidemic that's for humanitarian reasons and for our own safety. It's not going to be practical when these health care workers come back to say. Two imposed quarantine which is basically confinement in your house nor is it indicated from an infectious disease standpoint. Whether they'll be some middle of the road approach where someone who has an intensive people exposure like this position. Whether our health officials will will. Whether they'll be laws or guidelines that say you know you should be restricting your movement. In some way I mean going for a walk around the block is perfectly fine but. Going on on subways or airplane during that three week window maybe to restrict that makes sense is he'll be done on a case by case basis. We'll just have to see. Right another question it's coming and they keep stressing that you have to exchange bodily fluids with an infected person in order to catch it so. If if that is the case than most people don't have anything to worry about right with him. That is exactly the case. And we could think about it again a little bit more broadly if we ask yourselves. What is the pattern of transmission of the virus that is easily transmit it. For casual contact or cough or sneeze so we have great examples for that the flu. Think of the H1N1. A which is a flu epidemic in 2009 how rapidly spread. And think of the exact opposite. In terms of the Ebola outbreak can be of this sport easily transmissible. Why would it be confined to three West African countries I would also say that it remember the imported case to Nigeria. Which then spread to twenty others but then was completely contained so that now Nigeria. Is classified by WHO has basically free. Of people this kind of pattern. Indicates from an epidemiological standpoint that you really do need. Bodily fluid exposures such as occurred with health care workers. Or with. Certain ceremonies. To. Certain a burial ceremonies and Africa which involve close contact or maybe intensive. Household contacts this this pattern which has been observed since suppose first describe forty years ago. Is exactly the pattern we're seeing with the current outbreak it just submit it just much more widespread than previous episode. Okay will a second part of the question from his listeners. And how is it that this doctor and why did these nurses from Texas probably exchange bodily fluids with their patients like. I guess the term exchange of body volley bodily fluids it's it's a one way exchange so. That the the patient is happening guy. It in the case of Texas mr. Duncan and the the transmission occurred when he was extremely ill. In the hospital so. We could imagine what this and Ebola patient looked like who is very ill in an intensive care unit it may be an event later they may require dialysis. They're bleeding there's Hugh there's a huge amount of dire we have by Lisa crew. And the infection control precautions were far from my deal. Interest stating that his family members. When he was sent home he was not ill he was had fever right at fever muscle aches that sort of thing they did not contract people. The ball that really was transmit health care workers at the time that he was most ill. And where there's it if you can imagine the greatest opportunity for spread about bodily fluid. Okay we've got more with doctor Siegel he will be with us until about 8:30 this morning news sent graciously given up this time to answer some questions from you. And I text line we're getting lots of and 30930. Doctor brand Segal chief of infectious disease at Roswell Park Cancer Institute.