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CDC Director: U.S. Hospitals Should Use 'Index Of Suspicion' With Ebola


Now more about efforts to control the Ebola outbreak. Doctor Thomas Frieden is director of the Centers for Disease Control and Prevention. Yesterday after his briefing of President Obama, the president announced that there will be increased screening of passengers at airports in both West Africa and the United States. Doctor Frieden, welcome to the program.

THOMAS FRIEDEN: Thanks very much for having me.

SIEGEL: We spoke in late August when you were in Liberia, and in that interview you said this about the Ebola outbreak - unfortunately, we are definitely not at the peak. It's going to get worse before it gets better.

Do you think we've now reached the peak, or will it still get worse before it gets better?

FRIEDEN: It's too soon to say where we are in the outbreak, but what's clear is the situation is very fluid, and it's very heterogeneous. So we're seeing big changes even from one day to the next within each country. Each of the three countries has a very different pattern, and even different areas within each country have different patterns.

SIEGEL: The three countries that you're speaking of - Liberia, Sierra Leone and Guinea, I assume.

FRIEDEN: Absolutely. Guinea has far, far fewer cases. In Liberia we may be seeing some signs of hope, but whether that is a reflection of less complete reporting or real progress will take time to tell.

SIEGEL: Let's focus on Liberia for second. Our reporter, Jason Beaubien, there has described rather slow progress of building a pretty small hospital facility for healthcare workers. We've heard about also supplies sitting on the dock in Monrovia - supplies that haven't been delivered and end up being diverted onto the black market. Is the effort to contain Ebola in Liberia keeping pace with its spread?

FRIEDEN: We wish everything were faster, but there is definite improvement in Liberia. You've seen real improvements in the care for people who have died - dead body management. And that's reducing exposures. And we may well be seeing changes in behavior. People get that Ebola is a terrible thing. And so limiting the number of people who care for someone who is sick, changing burial practices - these things actually can have big impacts on reducing the epidemic.

SIEGEL: Let's talk about airport screening. Would everyone entering the U.S. from West Africa have his or her temperature taken both before boarding the plane and then when getting off the plane? And given the commonness of connecting flights, would all West Africans or people from Liberia, Sierra Leone and Guinea ultimately be screened?

FRIEDEN: We are already doing screening in the three countries. In fact, every single person getting on a plane is observed and has their temperature taken with an FDA-approved thermometer that's accurate. Now, that process, over the last couple of months, has identified about 77 people who were pulled off and didn't get on their flights. And as far as we know, none of them actually had Ebola, but it's keeping people who are sick off the flights. And that's important to reduce risk.

SIEGEL: But that - those numbers seem to confirm what we've heard about airport screening during the SARS outbreak - both screening done in Australia and done in China - that you actually find remarkably few people who are infectious with the disease you're looking for when you do airport screening. Is that fair?

FRIEDEN: Yes, well, you know, we're going to look at all things that might keep Americans safer because that's our number-one priority. So we're looking at all of the options, and we will implement something that reduces the risk to Americans and also ensures that if people coming back do get sick, they're as promptly cared for and isolated as possible.

SIEGEL: And this would also happen as people arrive in the United States at American airports - is that the plan?

FRIEDEN: That's what we're looking at now.

SIEGEL: There's been a lot of coverage of the case of Thomas Eric Duncan, the Liberian man who is hospitalized with Ebola in Dallas, including reporting of some fumbled information about his having recently been in West Africa when he first went to the hospital. Are our hospitals today more alert to the possibility of an Ebola patient entering the building than they were two weeks ago?

FRIEDEN: We're getting 20 times as many inquiries today as we were two weeks ago at CDC. Only the one patient in Dallas has been confirmed to have Ebola, but we want doctors and hospitals and emergency departments to have an index of suspicion so that if there's any possibility that the person may have been in West Africa in the last 21 days and they have a fever, they're immediately isolated, assessed and, if appropriate, tested.

SIEGEL: And just to one final point - on airport screening, how soon will the new regime begin? How soon will we see changes at American airports?

FRIEDEN: I'm confident that you'll hear about it this week.

SIEGEL: This week you would assume that we'll hear about it, or see it at the airport?

FRIEDEN: When we tell you about it this week, we'll tell you when we'll start.

SIEGEL: OK, Doctor Frieden. Thank you very much for talking with us.

FRIEDEN: Thank you very much, Robert.

SIEGEL: That's Doctor Thomas Frieden, who is director of the Centers for Disease Control and Prevention. Transcript provided by NPR, Copyright NPR.

Robert Siegel
Prior to his retirement, Robert Siegel was the senior host of NPR's award-winning evening newsmagazine All Things Considered. With 40 years of experience working in radio news, Siegel hosted the country's most-listened-to, afternoon-drive-time news radio program and reported on stories and happenings all over the globe, and reported from a variety of locations across Europe, the Middle East, North Africa, and Asia. He signed off in his final broadcast of All Things Considered on January 5, 2018.