Thursday, October 16, 2014

A truly transforming and important day here at NIH. First I testified before the House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations chaired by Mr. Timothy Murphy (R-PA). Tom Frieden testified with me as did Luciana Borio of FDA, Robin Robinson of BARDA, and someone from Customs and Border Protection. Tom got hammered somewhat by the committee and was not strong and firm in his answers. He continues unfortunately to give a poor public appearance suggesting that he is not in control of the situation. He has shown the same slow deliberative response in the media which is costing him dearly since it is making him out to be less than he really is, which in my opinion is quite good. However, the most important event of the day was the fact that at 11:54 PM today, Thursday, October 16, 2014, Dallas nurse and now patient was transferred by air evacuation from Dallas to the NIH Clinical Center to be taking care of by us in the Special Clinical Studies Unit (SCSU). I had stopped off at Accura automobile showroom on Wisconsin Avenue where Diane Baker, Francis Collins's wife, was hosting a Friends correctly; you are not at risk of infection.”. I was horrified to hear this. Now comes the revelation. Cliff Lane and I stop off at Chris Grady’s office on 1st floor of the Clinical Center, now late at night and I tell Chris the story about the CDC person. While Cliff and I are talking, Chris pulls up the CDC website and to my amazement she reads what its guidelines are for PPE. It is exactly what said she was wearing including the fact that it resulted in open skin. And so the CDC recommendations are much less stringent than the MSF and the NIH PPEs. In other words, the CDC guideliens are in fact inadequate and was following them when she likely got infected. I got goosebumps. I was incorrectly assuming that the CDC guidelines were like the NIH strict PPEs. In fact they are not. That night I e-mail Tom Frieden to call me and I explain the situation and he says that his people tell him that if you follow the guidelines even with that PPE protocol, the experience in Africa says that you are protected unless you break protocol. He then says that we really cannot tell exactly how and when got infected. We could not distinguish between the first 2 days and the days after they went to more stringent protocols. I went ballistic over the phone. I begged him to please not listen to his staff. I told him frankly as a friend and as someone who care about him that his staff “had no fucking idea of what they were talking about since none of them who are advising him have ever taken care of a patient, or if they have it was 10 years ago”. I pleaderd with him not to say that the nurses must have had a breach of protocol and to realize that the CDC protocol was entirely inadequate for a tertiary hospital intensive care setting which is where got infected. I told him that common sense tells you that open skin is much more dangerous than full PPE and that it is essential to change the CDC recommended PPE to insist on no open skin. He agreed somewhat reluctantly and said he would have to check with his staff. I told him that I love him, but I really do not give a shit what his staff says, he must change the protocol. In fact, within the next couple of days with help from me and Cliff and others, the CDC did change the protocol.