1 10 229 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound I knew I'd be doing epi, which is pretty much it. I thought that that meant doing contact tracing and case management. I thought that would be the whole thing, because in a normal--"normal," air quotes--Ebola outbreak, it's twenty, fifty people. That's what the database, the Epi Info database, was set up for, was to do contact tracing so that you can find people who may have been exposed and you can stop the spread of disease. I thought that's what I was going to be doing. I knew there was a hospital, and I think they told us that our office would be at the hospital, but I thought a hospital that had a few Ebola patients. It also had TB patients and a peds [pediatrics] ward and surgery and, you know, everything else, because this was the big district hospital. There was nothing. It was just Ebola. There were some TB patients who were still there because they lived there, because they got direct-observe therapy there. They were the only patients at the whole hospital. When I first got there, for the first few days, I think there were still a few people in the men's and women's ward. Then one of the nurses from the women's ward, she'd been sick. I think I'd been there for just a couple of days. I didn't know her, and this was to be--because my perception of Kenema is that there's no one in any of the wards. But in the first few days, there were. There was a physician who got sick while I was there. He had not treated Ebola patients, but he'd not protected himself. He got sick, and he passed away. There was another nurse I didn't know from the female ward. I think I got to Kenema on Thursday, and I think it was Saturday at night or early in the morning. She'd been sick and a couple other people had been caring for her in the women's ward. She just didn't go home, but she wasn't a patient. She was still working, but sick, and they were helping care for her. Finally, they convinced her that she should go over to the Ebola ward and get tested. She literally collapsed and died on the walk over. It was just these little fires pop up. So, now there's more people. Now the entire women's ward was potentially infected, and the other nurses were infected. Those first few days, we would walk through the women's and men's ward. It was a cut-through. You'd walk through there to get to the hot zone, the Ebola ward. Then one morning we came and there were these beds stacked up that wouldn't allow anybody to walk through. Then you see the decontamination and then the next thing you know, it's a ghost town. There's no one in there. There's no one in the men's ward. Walk the very circuitous route around, try to avoid that at all costs. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Purfield Kenema Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound Which was a busy day for us when it came out because the press knew about it. We spent a lot of time talking to the press and, of course, a lot of it is you've got to be kidding me, these numbers are not--and we said, look--the number that caught their eye was the now-infamous 1.4 million. So they said, you've got to be kidding and, of course, they get people's comments about CDC have drunk at the well of craziness, Meltzer is not to be trusted. All those type of things. We said, yeah, but there's also the part says what happens if you have a response, and in fact it turned out, which we couldn't know, we were forecasting five and half, six months ahead which is one of the longest forecasts out there at the time, and it turned out when you took our estimates 8of what would happen with the response, we were within 23% of what actually happened. Of course we couldn't know that, but we said we're pretty sure that if you do these interventions properly to the degree that we put in the model, you will stop it. In fact, I was asked point blank by leadership, do we think, in Liberia particularly, it will be over by Christmas? I said, no, I don't think you can bet on that but I think if you move fast and you do it correctly as best you can, and hit that target of 70% of the cases either in Ebola treatment units or at home with proper isolation and safe burial we needed, if you get to the point about 70% of all cases are in one of those two categories, by Christmas you will have not finished but really under control, which is what happened. And we actually have done some post-Ebola epidemic analysis to suggest that we came pretty close to the 70%. So the accuracy is something you determine afterwards. You can't guarantee accuracy upfront. You'll be foolish to do so. But you do get a sense as you publish and people are asking, they're focused on what seems to be the spectacular, they don't always focus on the details. Leadership didn't. In fact, in that paper there was one other graph that was really important which showed the cost of delay. For every month in delay you'd have three, three and a half times increase in number of cases at peak. The important thing about that graph was when we originally did the first draft of the paper, that graph was not in there. That was done at the express request of CDC leadership because they wanted that piece of information to help explain to other people, Congress, the media, why we needed to go in big, but also why we needed to go in fast which is what that graph showed. So there you have a perfect example of leadership saying, okay, you're giving me something useful but there's something still missing. Can you do this? Sure, we can do this. Originally, the request is can you talk about every day in delay and we said no. Given the quality of data we can't break this epidemic down into per day, it's just too difficult, but we can give you in terms of every month of delay and they said, okay, that's enough. And it was used, I know for a fact, in intimate discussions at the very highest level regarding the need to move fast and it did help influence. So as much as people focused on the 1.4 million, what was more important, said, yeah, okay you scared us enough, what can we do about it? And the most important part of the model was yes, the publication September 26th, 2014 showed, yes, this isn't just fear mongering, here's the problem but here is the solution. Which was as I say difficult explaining to people because it's not a simple one-sentence explanation. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Meltzer MMWR Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound TUMPEY: I had been working for two weeks with a partner in New York City, and that Monday, Bryan and I flew up to New York City, and the following day we did a training with five thousand healthcare workers at the Javits Center and actually demonstrated this guidance. That the entire timeframe was just such a whirlwind because we started talking about the event at the [Jacob K.] Javits [Convention] Center on Sunday, October 5th. How this all came about was there was an organization called Partnership for Quality Care, and basically what they are is they're a nonprofit group that works with hospital associations and healthcare unions to educate healthcare workers on a variety of different things--everything from flu vaccination during the flu season to major events like around Ebola to the emergence of antibiotic resistance, etcetera. This particular organization, they had contacted Dr. Frieden. Dr. Frieden had spoken at some event for them a couple months prior. The organization came back to Dr. Frieden and said, we'd like to do something around Ebola. Actually, the center director [of what is now CDC's Center for Preparedness and Response] at the time was [Dr.] Sonja Rasmussen. It got passed to Sonja Rasmussen, and Sonja called me and said, "I'm not sure what to do with this request. Can you join a phone call on a Sunday night with me?" This group of people got on the call from New York, and they laid out this plan of, "We would like to do this big training in New York City. We have enough space for 5,400 people." At the time, the nurses had not been diagnosed. This was the first couple days of October. They weren't really sure that they were going to get five thousand people. But what ultimately happened in those couple of days after we said yes to it was that the nurses got sick, and all of a sudden this event became extremely important. Because--one was, we were on the hook to pull off this event and we were on the hook to demonstrate our new updated guidance. So the guidance had to be out and done and ready for literally primetime. How this all happened was, I knew in order to pull this off, I needed a couple people to be with me. There's one individual who's been a spokesperson for the agency for years, his name is [Dr.] Arjun Srinivasan. He is just an amazing individual. He connects really well with people, he's a great teacher, he can take really complex information and make it very plain language, and people just love him. I knew I needed him. I knew I also needed someone who was going to demonstrate the personal protective equipment. But we also wanted to do it with somebody locally. Given that Bryan Christensen was so involved in the updated guidance--he was literally, as I said, testing the PPE and making sure that the steps made sense--it made sense for him to be the one to go with us. And so we started calling contacts in New York City and ended up finding a nurse from Mount Sinai [Hospital] who was going to come and be the counterpart to Bryan. And then the fourth person who was part of our team to go was a media expert named Melissa Brower who'd worked with me for several years and knew us. Her role on this was to manage potentially the amount of media that would be there. Okay, so back up. Second nurse gets sick on a Wednesday, guidance was done on a Friday. We work all weekend testing the guidance, refining the guidance. Monday morning, it's time for me to go to New York City, and the guidance is not out the door yet. The plan was--originally, the hope was that the guidance would be released sometime midday that day. This is Monday, October 20th, 2014. Bryan and I fly up first, and we get out of the plane, and we have a huge bag of all the personal protective equipment. We brought extra supplies because we were going to have to demonstrate this we don't know how many times, and we don't know how many times we were going to have to practice in advance. We literally have this massive bag that probably I could fit into. He's pulling all of our luggage off of baggage claim, and we get into a New York City cab. We're sitting in the back, and at the time the New York City cabs had these little, tiny TV screens, and they were running news that said the CDC is coming to New York City and they're going to train five thousand healthcare workers tomorrow on Ebola. [laughs] We're literally watching the preview of what we're about to do as we're driving in the cab to the location. We decided, thankfully, that we were going to go to the Javits Center Monday afternoon/evening, and we were just going to make sure everything was in place. If you've never been to the Javits Center before, it's several New York City blocks long and wide. We end up getting dropped off at the opposite end, and we walk for what felt like days, and I literally thought oh, this is not the place where we're having this event. Suddenly, we finally end up in the right location at the Javits Center, and I realize the size of this room and the enormity of the event that we're about to do. Although I tried to keep very calm for Bryan and tried to keep very calm for all of the organizers that were there, I was extremely nervous about how this was going to go. I wanted to make sure that in particular--the way the setup was going to happen, about two days out from the event, the governor decided he was coming and the mayor decided they were coming. They have bumped CDC down the agenda because the governor has to kick it off and the mayor has to kick it off. Arjun now has a shorter timeframe to basically give his presentation. The plan was to bring Bryan and our nurse from Mount Sinai out to demonstrate the personal protective equipment right after that. This is Monday night, the night before, we start practicing. We end up--not kidding--we practiced for four hours on every little step of the PPE, making sure everything went right, redoing every little hand movement, every little gesture, every point that was going to come out of Bryan's mouth, because he was going to narrate the entire sequence. Every single thing we had to get exactly right. I was more thinking because of the amount of people in there, and at the time it wasn't until the following day that I realized exactly how many media were going to be there. By this point when we're going through everything, everybody else is still down in Atlanta and the guidance has yet to come out. This is Monday night and our event kicks off first thing in the morning on Tuesday morning. It ends up that the press conference that Dr. Frieden does is something like seven o'clock or something that night, and the guidance officially--my team was working on it. They didn't get it officially posted until sometime after midnight that evening. Q: What took it so long? TUMPEY: They were just making sure--again, we didn't want to put it up and have to pull anything back. They literally went through line-by-line-by-line-by-line. Made sure there was no error in the editing process, made sure there was no error in putting up the website. We were so cautious because at that point the amount of negative media we had been getting around the guidance, we had to do this right. We absolutely had to do this right. Finally, I get a text, press conference is a go. I'm listening to the press conference as Bryan and the nurse from Mount Sinai are practicing, and they continue to practice on the stage and on the side, etcetera, for quite a while. Finally, we call it a night and decide to go back to the hotel. But we didn't really get to rest because we had other things we needed to work through. We were scheduled after the Javits event to immediately go to--there's a company called Medscape, and Medscape is the largest provider of online continuing medical education for medical doctors in the country. They were also going to tape the exact same sequence for us and get it out to all of their members on the website. We wanted to get this out in several locations. So we spent that evening working through the script and working through all of the other components that we needed to have for Tuesday. One of my team members calls me, we're finally going to sleep, she's finally on her way out of CDC and it's a couple minutes before midnight, and she says that the website's going to go up any minute and the press conference went well and at this point it was all up to us in New York City for the next morning. Arjun had to stay back for the press conference. He ends up not getting to New York City until nearly midnight, and he's so nervous about the event, he barely sleeps that night. We're up and at 'em first thing in the morning and the four of us are very nervous because we knew the amount of attention on the agency and attention on this small group of the four of us, and we're sitting having coffee and muffins and my cell phone starts ringing. It's an individual who is very senior in communications at the Department of Health and Human Services, which is our department over CDC, and he's asking me all these questions to make sure, do I really know what I'm doing? [laughs] Is this going to go okay? What are we going to do? He's hitting me with scenarios and hitting me with walking through what communications people would call the tick-tock--the timeline of everything that's going to happen. Then talking about what's going to happen afterwards, there was supposed to be a press event afterwards, and what are we going to say, and what if we get these questions, and all of that sort of thing. This is like, we've barely woken up and the phones are ringing making sure that this was a good idea. [laughs] Q: May I interject quickly? TUMPEY: Yes. Q: What's a scenario that he would present you with and it's like, you have to be prepared for? TUMPEY: We didn't know--we had received such bad media attention the several days prior to this, including people who had been fans of the agency. Like Sanjay Gupta, for example, who had come to the agency several times. He had deployed, he knows people in the agency well, we were very good friends with his producer. He had even started doing negative media. We didn't know if people were going--this is five thousand people. Are they going to be okay and be happy and listen, or are they going to riot? Are they going to throw something at us? Is Arjun going to come off the stage and be rushed by people? What is the scenario? I think it was just such a--I mean, the government doesn't do events with five thousand people. In the middle of a major outbreak with fifty-two media outlets there. Fifty-two reporters and media outlets, live. And the whole thing was going to be live-streamed, etcetera. It was just something that had not really been done before, so I think everybody just wanted to talk through the "what-ifs." We get to the event. We walk in from the back. It literally looked like--you can see the pictures on Getty Images and other places of this massive room with a ton of people and these large screens. All of a sudden we realized, oh my gosh, we're really going to do this. We moved backstage, and there was the governor and there was the mayor and they were all very gracious that CDC was there to present to them. Arjun goes up, and I've never seen Arjun so nervous and it made me nervous because at this point in my time in working with Arjun, we had done major documentaries, we had done major events together, he's always kept his cool. But the fact that he was about to stand up in front of all of these people, he was very nervous. As soon as he went up and started talking, I started pacing because I was nervous. Was it going okay? Was it going too slow? Was everything fine? [laughs] Just the normal anxiety of the person who's trying to coordinate all of it. I will say the dynamic in the room was as if you could have heard a pin drop. Here's five thousand people and they are hanging on every single words Arjun said. He was going almost, I thought, too slow and methodical in how he was saying it, but in hindsight, all of these individuals--they were scared. These were individuals who were really concerned. They don't know anything about--what is Ebola? What do I need to do? What do I need to do to protect myself? What do I absolutely need to know about this disease and what do I need to do if all of a sudden this shows up in my healthcare facility? I was so amazed--I kept peeking out of the back curtain, and I was so amazed looking at the looks on people's faces that they were just hanging on everything he was saying, writing notes, and just fully attentive. Then comes the point of demonstrating the personal protective equipment. As soon as Bryan and the nurse from Mount Sinai start to come out, it was as if you could feel the dynamic in the room start to change. Halfway back in the room, there was a media platform that the fifty-two reporters and media outlets were on. As soon as they started coming out to the side and started to come onto the stage, the fifty-two media outlets jumped off the platform and started running to the stage. This entire thing is being live cast. Thank goodness, the AV [audio/video] folks flip the switch and put a logo up so you can't see fifty-two media outlets running to the stage. The organizers are asking people, calm down, calm down, okay, we need the reporters to calm down. Everybody's going to be able to get a picture, calm down. [laughs] And as everybody calms down, they start to begin their whole sequence of we're going to demonstrate now how to put on personal protective equipment and take it off. They start going through the whole thing, and I think it wasn't until they were finally in the sequence where they were taking off the final pieces of personal protective equipment that I finally took a moment to breathe. I grabbed Melissa Brower, who is my media person next to me, and I said, "We did it." I literally couldn't believe that we had, in the craziness of that October, that in a few-week time period we had said "yes" to doing this. [We had] gone through the whole situation of the two nurses being sick in Dallas and all of the media around that. That we had rewritten government guidance, gotten it cleared, agreed to do something that most people would not have said yes for the government to do, flew up there, and pulled this off live. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Tumpey Presentation Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound MAMORA: We all got to have a meet-and-greet, that day of training. We spent six hours in PPE [personal protective equipment], taking it off, putting it on. Our donning-doffing, that's what we called it. Over and over and over and over, and drill drill drill drill. We were like, okay. The people that were comfortable were like, oh yeah, we're comfortable, this is good, just follow the protocol. Great. Some people weren't able to physically do it, or they panicked underneath the hoods. So they bowed out. But there was a good number of us, I think there was around twenty-four, twenty-six members at the time, after that training.<o:p></o:p> Q: All of you nurses?<o:p></o:p> MAMORA: All of us nurses. We got to meet the infectious disease physicians, we call them the G5 now. [laughs] Because there's five. We got to meet them that day. Just a meet-and-greet, sort of like, hey, we might get this patient, we might not, we're just preparing. It was still that kind of preparing thing, but of course in the media, you're like, oh, yeah. You'd also hear, they're preparing to fly someone out, they might not. They might. It's still up in the air during that time. We weren't really expecting to work within the week, or even two weeks. We were just being ready, right? They were just being ready.<o:p></o:p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Mamora Preparation Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound [T]here was a lot of fear in Dallas about that case, and about potentially exposed people, and fear of an outbreak of Ebola, or transmissions that could occur. And there were a lot of ways that we saw that fear as we were doing our work. Just one example. For the public health workers who were helping with contact tracing--and mind you, these are people who are not caring for an Ebola patient, and who are not having contact with Ebola--some of them had kids. There were requests from the schools to not send their children to school. I don't know that I can explain it well. I think there was a lot of pressure from parents who were uncomfortable with anyone who worked in the Ebola--or with contact with anyone who could be working in the Ebola response, even if they weren't having contact with Ebola. That atmosphere slowly became very apparent. This was, I think, very unusual. I think this was probably unique to Ebola. There was a lot of fear of the disease itself, which is understandable: a very serious disease wherein a lot of people die who get it. So that was something I think that I--I don't know what to say other than that I was surprised. And maybe I shouldn't have been in hindsight. But I wasn't expecting things like that, and certainly not to hear from the local public health workers that we were working with that they were being asked to not send their children to school for what ended up being a response that was lasting quite a long time. This went on for--I don't know when that ask may have changed. But I was surprised to hear [that]. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Kuhar Fear Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound Q: Right. For some reason, I have--let's see--October 8th in my head as the date when the index patient passed away. I don't know if that's accurate.<o:p></o:p> KUHAR: Oh, yes. We didn't talk about that at all. That was a horrible day. That was--it was quieter. I got a call that morning, early, that--I can't remember the time. I think I had actually been dozing and woken up with a call that he had died. And was surprised. In general, our impression was that he was getting better, which was just wonderful. So we had gotten the call that he had died, and there was a general air--not just with the field team, but even from the physicians who were in the hospital who were caring for him, they were a little bit surprised. We weren't expecting it. He had gone from being pseudo-stable to all of a sudden, having some parameters that make it--like indicating that he was not doing well and getting sicker, to actually dying very quickly, I think over the period of an hour or two from what they told us when we had arrived. It was--that was--just very--it was very sad. It was very disheartening. It was so much, and not just work, but many of our team members had gotten to know his family through daily interactions with the contact tracing, having them take their temperatures, making sure they were okay. There was some very personal interactions with his loved ones that had developed between a lot of our staff and them. I think it hit--his death resulted in a lot of heartache with the field team. It was terrible. Obviously, we had a lot of questions about what had happened and talked with the physicians, but ultimately, we had to keep doing our job. We continued with the--really, at that point, it was just the contact tracing efforts. For the most part, the unit was getting closed down because they now didn't have patients. They didn't have a patient with Ebola to care for, for three days, in there. Until the first nurse had gotten sick.<o:p></o:p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Kuhar Response Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound <div> VILLAR: [L]ater that month--we had the case in Dallas. We had [Thomas Eric] Duncan in Dallas, who was eventually admitted to the hospital, and then some nurses getting infected. I think we were making lots of great progress in West Africa and we had the president's support, and all the partners' support. Then Dallas happened, and that was tough. That was really intense, and we had to get people on the ground quickly. We had to try to message appropriately, which was tough. Texas is a complicated state, as are usually most states, but in particular in Texas. You have a city government, and county government, and state government. Working with the multiple levels of government and working obviously with the hospital, and trying to make sure that all of the providers were safe. Nurses to custodians, and everybody in the hospital, making sure people had proper protection. Making sure that our guidelines were updated. Making sure that we had staff to support Texas on the ground. It was a very, very complicated time and very, very busy. I mentioned before, I spent my entire weekend getting ready for the president--well, after that I spent all of my weekends dealing with the response both domestically and globally. I'll never forget all the meeting and calls, and then we had to ramp up the number of staff involved, and it went from the extremes of--I don't even know--updating our guidance for PPE [personal protective equipment] in hospitals to the very basic things of making sure that our staff at CDC who were working in an EOC [Emergency Operations Center] were being fed because they were working so hard and so many hours and weren't taking time to eat lunch or dinner, or breakfast for that matter. Many of them not seeing their families for days on end--those deployed, obviously, but those also working here who were going home for three or four hours at night to sleep, then coming back to work. It was a pretty intense time.<o:p></o:p> Q: How did you help to remedy that situation?<o:p></o:p> VILLAR: There were lots of different things that we did. We worked very closely with the CDC Foundation to buy some healthy food [laughter] for the EOC. Because it's really easy for people to pick up a candy bar. That kind of stuff. I remember walking through in the month of October and all you saw was Halloween candy everywhere. So we did that. We worked closely with the [CDC] Foundation, and that was even a tough sell at the time because the response was so critical, and what was happening in West Africa and here was so critical, that to be working with the Foundation and to be thinking that they would spend some of their donor money on food to feed people who were getting a paycheck and working for the federal government--that was not something people could really even get their heads around, but it was necessary in the end. We took up collections. We bought crates of apples, and we did all kinds of--I baked banana bread. I mean, whatever we could do to keep people going. It was a crazy time.<o:p></o:p> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Villar Response Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound KNUST: [A]t that point and I wanted to have a few days off while I had some family visiting. Just as they were coming into town, one of the members of the epi team got a call from Dallas, and he sent an email with a little quick summary about this patient. I emailed him back very quickly, and I said, make sure to get in touch with this person, this person, this person, just to let them know, and make sure that they're getting enough education and guidance on what to do and that they're covering all the bases that need to be covered. Because to me, even from that first little brief description about the patient, I thought this looks like an Ebola case. This looks like it could be real.<o:p></o:p> That week, I was watching things very closely and I was spending time with my family, but ready to go back to the EOC. I didn't wind up going to Dallas, which at the time I felt incredibly guilty about, but they assured me that they had plenty of people that were doing everything that they could and that I needed to take a break. So I took that time, and then when I came back, things were going well in Dallas, at the time. And then the first nurse became infected.<o:p></o:p> Actually, one of the little sidebar things was that the whole situation with her dog, [laughs] we had heard that she had a dog. We very quickly started to put together a response plan for what to do with this dog, just in case--it was while she was being tested, before she even was confirmed. Sure enough, the dog had to undergo an observation period.<o:p></o:p> Just as that was slowing down a little bit, we found out about the second Dallas nurse. That day, I decided to sit out on the EOC main floor because there was so much going on. It was like--there weren't any meetings. It was just people running around and talking to each other. It was incredibly chaotic. I was out on the main floor, and Dr. Frieden came by. First of all, he was standing there, and he looked over at me and made eye contact with me, and smiled, and said, "Hi, Barbara." At first, I thought, oh no, he knows my name! [laughter] And then I saw his eyes, and he was smiling. But I could see in his eyes, he was really thinking very hard about what was going to happen next. And just a few days later, he was testifying [before Congress].<o:p></o:p> That night, I was on an airplane flying to Ohio. So I was involved in the response that was in Ohio. We had Chris [Christopher R.] Braden, Matt [Mateusz P.] Karwowski, Colin [A.] Basler, and Carolyn McCarty there, and Kristen Nordlund on the team. It was a great team. We did not have a shard of Ebola virus anywhere in the whole state of Ohio, but we still had a very good outbreak response for it. [laughs] It was very intense, though, because the second Dallas nurse, of course, had been on two airplanes, and it was decided that both airplanes were going to be treated as if she had had symptomatic Ebola while she was on the airplanes. That was a very intense investigation. Then there was also a very intense investigation of everywhere that she had been in the town in Ohio. A lot of community concern--people were thinking that the contact of a contact was a risk of having Ebola. A lot of discrimination was happening as well, as a result. Discrimination against the known contacts and discrimination against people who even knew them.<o:p></o:p> Q: Can you give some examples of that?<o:p></o:p> KNUST: For example, there were some children who were--the children of a friend of hers. And they were asked not to attend school. And the friend of hers was completely healthy. The children were completely healthy. But people were just so afraid. The bridal shop where she had worked--or not worked, where she had gone to look at different bridesmaid gowns because she had a wedding coming up, the shop closed its doors. They did a complete cleaning of the shop. The shop still wound up going out of business just a few months later because people were afraid. I'm sure that that's just an example of--I'm sure that there were a lot of other examples in Dallas, as well, of just--people had a lot of fear about it. It was really great working with the county and the state health departments there in Ohio, though. Especially the folks of the county really knew their people well. I think that they were very well-connected, and they did a great job of working to reduce the hysteria and focus on what was really important. They really stood up very well and performed, delivered very, very well. It was really rewarding to work with them.<o:p></o:p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Knust Response Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound MORGAN: I can use his name because of course by now he's written a book and he's all over the news and he's a great guy and a great family. Dr. Kent Brantly had been a family practitioner OB/GYN [obstetrician/gynecologist] over in Liberia and sort of watching Ebola smolder in the surrounding areas, and then watching it come closer and closer to where they were in Liberia and eventually seeing quite a few patients in Liberia, lots of patients in what would be really desperate situations for anybody who's only used to Western or American high-resource medical centers. We're talking about cinder block building and tents and wards where patients were on cot to cot to cot basically. I think they put together the most reasonable protocols they could with the equipment they had to take care of patients over there, but then when he got sick, he and Nancy Writebol were both ill and they worked for two organizations that were willing and able to fly them out of there. Through those phone calls with Dr. Ribner and the hospital and things like that, we agreed to take them.<o:p></o:p> One of our big concerns, my big concern personally, was I didn't know how much they had heard about what was going on over here. Sort of famously, people were up in arms, as I mentioned earlier, "how dare you bring that to Atlanta, why would you bring that to Atlanta and potentially expose an entire city to something for which there is no cure?" Because they didn't realize we had this unit and we felt very safe and all these things were already in place. But because I was worried that Dr. Brantly would be afraid himself, that he was being brought in but were we going to be afraid of him, are we going to be resentful of being put in this position? The first thing I did when we set up that room was we had a big whiteboard in the room and I put the names of the care providers that were going to be taking care of him and I said, "Welcome home, we are glad you're here." Because I really wanted him to feel like we were there willing and able to make him better. I didn't even know what that was going to take yet but I wanted him to know that there was no hesitation on our part despite what anything might be going on in the news. Of course, as it turns out, Dr. Brantly had not heard anything about what was going on in the news. It was a very good thing. And he got there and we were there to receive him and I was in the room. He walked out of that ambulance in his own--they had basically placed him in personal protective equipment to contain anything that he might have on him in the ambulance and in the flight over, and he walked in the room and we went about the business of getting him doffed basically, getting all that stuff off of him. And while he was lucid and speaking to us and we were able to have conversations about his medical history and everything else we do for patients when they first come in, as it turns out, over the next couple of weeks we realized he didn't remember that. He didn't really remember coming in. I think he and our other patients were actually more ill than they had realized themselves. If you think back to the last time you had the flu, that first day can be sort of just a blur, and I think that's exactly where they were, sort of in that stage where they were ill and not thinking completely clearly. But yeah, he was just such a nice human being.<o:p></o:p> Q: Even at first?<o:p></o:p> MORGAN: Even at first. Even at first, yeah. Not for a second--I think especially knowing he was a medical missionary--you know, I grew up in the South, I grew up in a religious family but I'm not very religious myself. In the South, you get used to sort of being condemned to death or eternal damnation on a regular basis. It's just what Southerners do to each other. One of the first questions you get asked if you live in a small town or a rural area or even some urban places I'm sure is, where do you go to church? If you don't have a suitable answer to that question, then people will assume you're going to Hell, which is okay. [laughs] But I was a little concerned that Dr. Brantly would also--you know, patients can put you in awkward positions unintentionally because they need to pray, they want you to pray with them, and that's fine and I'm certainly able to do that but I'm not--that's just not a thing that's real comfortable when you're trying to do your job. I didn't know what he was going to be like, and then his whole family got here. I mean, this man has a big family, his wife has a big family, they are wonderful, wonderful people, but there was a lot of mention of God's working His--you know, this is all in God's plan. So I just had to poke at Dr. Brantly. He's just a great guy. He's got a great sense of humor and so he would never swear or never even have a cross word. When his lovely wife, Amber, would want to be talking to him but he was busy doing something else, I'd say, "And Amber says get off the damn phone." And he'd look at me like, she did not. I know, but we just have to poke you a little bit. [laughter] He turned out to be a genuinely kind human being who I think intuitively understood that while he was a physician and is a physician, in his role here he was trying to be a compliant and easy-to-take-care-of patient, and of course he was. It was good. It was good. It was a great experience.<o:p></o:p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Morgan Arrival Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound I came in on a two-month detail. I came in as the support for the first month, for the first three weeks. Then I was a team lead after that. But there were two of us in-country at that point. We had an FETP [Field Epidemiology Training Program] program, the STEP [Surveillance Training for Ebola Preparedness] program, which was the surveillance--oh gosh, I can't even remember these names. It was an Ebola program, basically a very basic field training epi program that was done specifically for Ebola. We had enormous success with that, our STEP program, and we brought in mentors from Portugal, or from Brazil. The Brazilian FETP program sponsored, and one girl was from Argentina, and one girl was from Colombia. Basically, South America's FETP program sponsored Bissau. We worked with TEPHINET [Training Programs in Epidemiology and Public Health Intervention Network], which is a regional co-ag [cooperative agreement] we have in South and Central America. We worked with them to bring these people into country for a ten-week training program. We were able to train sixty people, I think. We had enormous success. These people were trained very well. Our going out into the field, our training exercises, and their projects, what they brought back. We actually identified chikungunya, which they said didn't exist, and we identified that. We actually did have chikungunya in Bissau. And there were a couple other things. We identified some outbreaks that were going on and tried to think about how the country needed to deal with some of those that the country apparently knew were going on, and was ignoring. But it came to light and we're like, how do we deal with these? That was one of the big things.<o:p></o:p> I spent a lot of time, aside from just these, being the technical lead and meeting endlessly in all of these different work group meetings about how we prepare the country, we did this training. And then I did a lot of training. I spent a lot of time with Placido. He was my basic person, so sometimes I would just go sit in his office and be like, what do we need? I did very, very basic training on [Microsoft] Excel. A lot of their surveillance was based on Excel, and they didn't even know what a cell was. A lot of these people were not computer literate at all. They were scared to be computer literate. So I did a lot of training. Then of course, there's people who want to do pivot tables in Excel. It was kind of like, I had to do training for, what is a cell in Excel? And how do you add two cells together, and how do you put a word versus a number? All sorts of stuff like that, all the way to how do you develop pivot tables that we can do some pretty--more advanced analysis than they were able to do before they understood that technology. So, stuff like that.<o:p></o:p> We were trying, and then they wanted some evaluations, so I spent a lot of time working with two of their people. In the time that I was there, Placido actually made an evaluation group. He identified and hired three people that would be in charge of evaluation for the agency as a whole. Which meant we went back and we looked at their strategic plan and some of the plans, and we started selecting evaluation indicators. We went back to IHR, what they had to do with the International Health Regulations, and started looking at, how could the countries start evaluating what they were able to do and not do? And how could we use that data to improve their system? These were the kind of things and the conversations.<o:p></o:p> Because there were only two of us, sometimes only me, in that first kind of sixty-day period, and I actually closed the program. I went in January and I closed it on April 1st. Then I came home, and at that point I was still working at NCEH, and I came home and went back to NCEH. While I was in-country, I was offered a job in global health in the Global Health Security Agenda program, running the Bissau country program. We would, of course, never have a country director, we would never have a program in-country, but it was, how can we work with this country? We've got eight million dollars, seven-point-some million dollars that we can spend.  Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Delea Work Transcript