Hantavirus transmission requires prolonged close contact (approximately 6 feet for 15 minutes) with symptomatic individuals through bodily fluid exposure, and the 42-day quarantine period represents the maximum incubation period for the Andes variant, which does not spread easily between people.
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Hantavirus presser from hospital treating American patientsAdded:
of regents and on behalf of uh our 50,000 students and over 16,000 employees uh welcome you uh to this facility and of course to our state uh to get to the most important question of the day and I want to get this exactly right. Last night, uh, the United States, uh, Health and Human Services Department supported the Department of State in the safe, uh, repatriation of United States citizens, uh, from the Handas. They are now here with us here in Nebraska and are being cared for in the National Quarantine Unit and the National Bioontainment Unit. To extend our welcome to you uh, here in Nebraska, I'd like to introduce the governor of our state, my friend and colleague, uh, Jim Pan.
Well, good morning everybody. For those of you that are new, welcome to Nebraska. I can't uh start but be to begin by expressing my incredible appreciation for the countless professionals, both federal, state, and local, who have uh burnt the midnight oil and worked extensively uh in the last days to have a safe transfer of the American passengers from the Canary Islands to their arrival in the great state of Nebraska here in Omaha. It's been a highly coordinated effort, many agencies, uh, one that, uh, has gone incredibly smoothly. Uh, it's due to outstanding communication and coordination of everyone involved. And, uh, I simply want to acknowledge and be grateful for their incredible hard work.
Um, the passengers who are here at UNMC are going to receive nothing but worldclass care. It's a guarantee. You can take it to the bank. Uh this is not the first time Nebraska has been called upon to provide the facilities and care that's required critical medical situations like this arise. As governor of the extraordinary state of Nebraska, it makes me proud to know that these capabilities exist in our state and that we can provide the assistant assistance when it's needed. And I know all of my fellow Nebraskans are as well. as I could speak directly to the passengers who are now calling Nebraska and UNMC home for the coming days. We're glad that you're here and we're going to ensure that you have the best worldclass care possible. We know it's been very difficult for you in an arduous journey, one that will keep you away from your friends and your loved ones a little while longer. But you can be assured the medical staff at UNMC are highly trained and compassionate, extraordinarily compassionate caregivers. And whatever they are, uh, and we can do make your stay as comfortable as possible, we will do. Um, we have walked hand inand with our federal partners from, uh, the White House to Secretary Kennedy to the CDC and all of their great teams. I am satisfied and Nebraskans can be that the rest of American can be satisfied that there is a strong plan in place and to ensure the folks are secure for their initial assessment and we are working diligently to ensure no one leaves this security in an unsecured way at an inappropriate time. No one who poses a risk to public health is walking out the front door of the streets of Omaha or beyond. Again, I simply want to say uh thank you again, Dr. Gold, to you and your team and all of our federal partners and uh state and local agencies that have all had a hand in facilitating and making an impact on getting Americans back home. Thank you.
>> Uh thank you, Governor. And uh it is now a pleasure to provide uh some more information specifically on the operations and the condition of the passengers. I'd like to introduce Admiral Brian Christine. Uh Admiral Christine is the assistant secretary for health of the United States Department of Health and Human Services. Admiral.
Well, good morning. Thank you all for being here. Thank you especially to our partners at the administration for strategic preparedness and response.
Thank you to Nebraska Medicine and thank you to the University of Nebraska Medical Center. Thank you all for your leadership and your readiness in this response. At the Department of Health and Human Services, our approach is grounded in science.
It's grounded in coordination and it's grounded in transparency. This is a whole of government effort across federal, state and local partners who are all working together to ensure the safety of the American people. And let me be clear, let me be crystal clear.
The risk of hunter virus to the general public remains very very low. The Andes variant of this virus does not spread easily and it requires prolonged close contact with someone who is already symptomatic. Even so, we have taken this situation very seriously from the very start. We've taken it seriously across HHS and particularly through the Centers for Disease Control and Prevention. And I'm proud to see many of my US public health service officers have been actively engaged in the response. The CDC rapidly activated its emergency operations center. It deployed medical teams to assess passengers and coordinated closely with international partners. They have notified state health departments. They have initiated monitoring of potentially exposed individuals and they have issued clinical guidance through the health alert network. They have also brought together national partners through coordination calls. They've developed tools and resources to support public health decisionmaking and and they have ensured that both clinicians and the public have clear timely information.
Transparency has been and is the order of the day. And now with the safe arrival of these US citizens here in Nebraska, CDC teams are working side by side with Asper, with UNMC, and with state and local officials to conduct assessments and provide ongoing monitoring and care. This this is what strong public health system looks like.
Experienced professional, seamless coordination, and a shared commitment to protecting the American people. We will continue to follow the science. We will stay vigilant. and we will keep the public informed every step of the way.
As I said, transparency is the order of the day. Thank you. Thank you for being here. God bless you. God bless the state of Nebraska and God bless our republic.
Thank you.
Uh thank you so much uh for those words. Uh and now uh it is my uh pleasure to uh introduce Mr. John Knox who's the principal deputy assistant secretary administration for strategic preparedness and response in the US department of health and human services and he will give us an update on planning and as we move forward.
Thank you Dr. Gold and thank you everyone for being here today. As mentioned I'm John Knox. I'm the principal deputy assistant secretary for the administration for strategic preparedness and response. I'll start by noting that what you're all seeing here today uh is a true partnership uh and a demonstration between public and private partnerships. As all of you are aware, last night with the coordination of multiple federal agencies and in partnership with state officials, HHS supported the Department of State in a safe repatriation of 18 US citizens from the MV Hondas.
This is a coordinated whole of government effort to safely return Americans home while protecting public health.
Passengers were transported via Department of State plane from the Canary Islands to Nebraska with appropriate medical capabilities on board. HHS has worked with the State Department from the start for a seamless transfer back into the United States.
Upon arrival, they were transferred here to the University of Nebraska Medical Center. UNMC was selected as the US entry point due to its extensive expertise in handling special pathogens and it's the only national quarantine unit in the country. It is one of Asper's 13 regional emerging special pathogen centers uh also known as respecs that are within the n national special pathogens system.
Asper has established this system over the years to prepare for high consequence infectious disease outbreaks uh with trained personnel ready to safely manage situations like this.
Asper's mission is to protect the health security of Americans and this response reflects the strength of national of the national preparedness system. As mentioned by others here this morning, over the next several days, passengers will undergo an initial health assessment and receive guidance on next steps from the CDC experts and other partners. This event reflects our ability to coordinate across federal, state, and local partners when the health of any American is on the line.
So, at this point, I'm going to turn it back to Dr. Gold to continue. Thank you.
>> Thank you, sir.
Well, thank you, Secretary Knox. Uh, we have several people here as of course you can see uh just to introduce them quickly, we have Brendan Jackson. Dr. Jackson uh is from the Centers of Disease Control and acting director of the division of high consequence pathogens and pathology. We have Captain Michael Gardner also from Asperers, the regional administrator region 7 of the mission field operations.
We have uh Matthew Ferrer who's a DVM and is a HHS counselor. We have Dr. Michael Wadman here from the University of Medical Center and Nebraska Medicine and is a director of the National Quarantine Unit. We have Dr. Angela Hwlet uh who's the medical director of the Nebraska Bioontainment Unit. We have Dr. Deli Davies uh who's the interim chancellor of the University of Nebraska Medical Center. Dr. Michael Ash, who's the chief executive officer of Nebraska Medicine. Uh, and by the way, uh, thank you for hosting us. And we have Dr. Ashley Newire, the director of public health, uh, for the state of Nebraska.
And before I take your questions, I just want to say that UNMC and Nebraska Medicine are are very honored to have this responsibility uh, to repatriate these American citizens. There is no place in the country uh that they could be better cared for uh more safely uh and and more effectively.
Uh as the governor said, it is the people of the state of Nebraska. And indeed here in this microcosm, it is the people of UNMC and of Nebraska medicine that really make a difference to truly uh lead the world. than today as you're all gathered here. Uh there is no other place in the country where they could be more safely uh and more humanistically uh cared for. We have a very simple rule here and having served as the chancellor of the med center for more than a decade of my life. If we treat our patients the way we treat family members and loved ones, we're going to be okay. And uh and that's the rule. So with that, we're very willing to take your questions.
There are microphones uh that we will pass around if you do have a question.
uh I will uh recognize you and uh there are some folks who are carrying the microphones just to be sure uh that everybody can hear your question and if there's a specific individual that you want to address it to that's fine or we can just have volunteers. Uh so uh >> thank you. Hi Waverly Monroe with uh KETV. Just wanted to talk a little bit about um AP confirmed overnight that there was a person who was experiencing symptoms but may have not been tested positive for haunt virus. Um can you talk a little bit more about that? And is that person at the national quarantine unit or is that person at the Nebraska bioontainment unit?
>> Yeah, that's right. And so part of the decision was to make sure that they've preserved space within the the bioontainment unit here to make sure there's adequate care for anyone who might need it among the other passengers. Uh other patients were sorry passengers were flown to uh Atlanta for further assessment and and care there.
>> So that person is not here.
>> Correct.
>> Okay. Thank you.
So again just to be very clear on that point uh we want to maintain optimal space in our bioontainment facilities on the small chance that it becomes necessary to use that space given the individuals who are transported.
>> If you don't mind I just love to add that we're going to expect to see people have symptoms that's just you know if you think in any given week or month how many times do you experience some level of nasal congestion or upset stomach or something? We're being very very liberal in how we're framing symptoms and monitoring for symptoms here. And so that's how the system is working. It doesn't necessarily mean just because someone has symptoms that they're going to end up having this illness.
>> Yeah.
>> Go ahead since you have the mic.
>> Hi Diane Gallagher, CNN. Could you clarify first then how many of the p the passengers who were on the plane from the cruise are here and how many have been moved to another facility in the country.
>> Yeah go ahead I can just address that briefly. So of the 18 16 are 16 passengers are here and two are in Atlanta >> and the bioontainment unit we have the one who had the mildly positive uh PCR test. Can you explain a little bit more about mildly positive? Uh I I initially thought that we were not testing people who were not symptomatic. I know they said this person was not symptomatic.
Can you go into a little bit more about what it means to be mildly positive?
>> Sure. And and I'd welcome my colleagues from the University of Nebraska to weigh in on as well, but I I'll note that uh so this passenger this was this test was not collected in the United States. The specimen was collected uh back I believe in uh one one of the islands. it was taken on the ship. Uh there were two specimens. One was positive uh and the other one was was negative. You know, with with these PCR tests, it's not uh necessar like even though there's a sort of exact cutoff, there's sort of a range and where they can fall. And so for that reason, we want to just want to make sure there's further testing to evaluate that uh at this point more. And are the two individuals who stayed here, one of whom is in the bioontainment unit, did they have prolonged contact with each other and that's why they're both here or what was the I guess the idea behind moving the 16 to other parts of the country?
>> Sorry. So so 16 uh people are are here uh and >> and that's for all the reasons that was mentioned. Can you repeat again what your your question was related to that?
I guess then the two who were moved, what was the reasoning behind moving them beside was it just space or were they traveling together? Are we keeping people together since this is a prolonged contact uh transmission?
>> Got it. It may be helpful for you all to explain the difference between the sections within University of Nebraska Medical Center as well.
>> Sure. Um I'm Mike Wadman. I'm an emergency physician and the medical director of the of the quarantine unit.
Um we welcomed 15 um passengers to the quarantine unit early this morning. Um one uh passenger did go to the bioontainment unit and I'll let Dr. Hillet address that patient. The 15 that were welcomed here um were in good shape. They were in good spirits. They definitely uh were tired and needed some rest. So we did a quick assessment. We brought him into the unit. Very smooth and successful safe transfer. a lot of coordination between our teams here and I'd like to thank our nurses and techs in the bioontainment unit as well as all the administrative support that we have for this and also our federal, state and local partners. It's a definitely a well-coordinated activity and really proud to be a part of that team. Once they're in the unit, we've been doing symptom monitoring as well as uh temperature checks. Everyone here is asymptomatic and and aphibile and do not have a temperature at this time. They're all resting now and we'll do further assessments later in the day once they've had a chance to sleep. But that's where we're at with it now. But all asymptomatic, all very grateful to be here and we're just waiting for them to rest up and then we'll do the further assessment. But to be clear, as far as uh Nebraska medicine, we have 15 patients in quarantine and we've got one patient in the bioontainment unit.
>> You maybe just explain the difference between the two two a bit more if that's helpful.
>> Sure. So in in the and I'm Angela Hlet.
I'm the infectious disease physician and I'm the medical director of the Nebraska bioontainment unit. And so with our two facilities, our quarantine unit is designed for well individuals who need to be monitored. Um it is not a patient care space. Um it is much more like a hotel than um than a patient care space.
We don't have the typical things that you'd see in a hospital room. Um it's a much more comfortable environment actually um with um uh with some things that to help keep people comfortable like exercise equipment and it's a larger space um you know TVs and things like that. The bioontainment unit is a patient care space and that's our our unit which is also located on this campus and that's where we provide um uh hospital-based care to people who need it. And those patients could range from um being, you know, relatively well and stable to critically ill, requiring multiple procedures and multiple interventions. And so we do have one individual um who, as you know, was were was uh taken to the bioontainment unit early early this morning. And um I'm happy to report that we uh assessed that individual. Um they are doing well.
actually they are currently do not have any symptoms um and have a good appetite although they're very uh they're very tired um understandably but it's been a really long journey for these folks and so again everything appears to be going very smoothly I'm really proud of how our team responded and um and how how we all kind of came together to um to execute this very complicated um you know transfer of multiple different individuals into these different units >> so I might just underscore that it was it's a contingency mergency planning reason. They want to make sure that if other of the people that are sort of in the more residential side of that need potential medical care, there is space available. And so by moving other people who may have symptoms uh to another location, it makes sure there's there's that space to care for them.
>> Right. And then those are the preliminary conversations planning that we had in terms of bringing in a number of individuals for quarantine is when those patients develop symptoms or test positive, what is the contingency plan?
because bioontainment capacity would not be able to accommodate 16 you know persons who would turn positive and and turn into inpatients. So those conversations look at patients that may be identified early and travel to other bioontainment centers across the country which is what happened in this case or you know if we have quarantine patients here and they have symptoms positive testing where those would be decanted to if they were stable or would go to our bioontainment unit. All those uh contingency plans are in place and the example of the two passengers traveling on on to to Emery is an example of that.
So, two things. Uh, Camila Bernell with NBC News. How long do you anticipate people to stay here and do they have a choice to leave or are they being told you have to stay here for a particular amount of time? And then in terms of the two passengers that are in Atlanta, same question. How long are they anticipating to have to stay in this facility in Atlanta? And also that the one in Atlanta has symptoms. Is the second person a partner? Just more clarity on why there is that separation between the patients in Atlanta and the patients here.
>> It's a great question about the the plan in terms of where things will happen.
So, right now, the folks, the passengers that are all in the uh sort of assessment phase, uh they they're going to be here for at least a few days while we do assessments and then coordination from what happens next. They certainly have the option uh to stay here for the entire 42-day period if that's just the saf safest and most effective option for them. There's going to be an individualized decision plan for them to determine if it makes more sense for them to complete their 42-day monitoring period at home. But there's going to be a couple of things that go into to to that decision. First and foremost, do they remain symptom free? But then also, do they have all the structures and support to be able to be continue that period at home? making sure that that they can uh be able to uh isolate in a in a separate part of of of structure from anybody else. Make sure that they can contact their health department, get tested if necessary, if they develop symptoms or if they need a higher level of medical care that that's available to them. So, there's a range of structures that need to be in place uh before anyone would be transferred to their their home and that would be done in in close coordination with the health department in the states that would be receiving them.
>> Ultimately though, will it be their decision? Yes, we want to do this in the most in the least restrictive way possible that is still safe that protects the health and safety of both the passengers and their communities.
>> And then in terms of the patients in Atlanta, >> I just wanted to make a a brief comment.
Um so I Ashley Newmire, director of public health for Nebraska. Um our partnership with the federal part with our federal partners has been tremendous as it has been with Nebraska Medicine and UNMC. Um but I do want to uh just reiterate as uh the governor made a comment here earlier that um we are here also to make sure that there's a structure in place um to make sure that no one poses a public health threat. Um I do um you know as we are as the team is assessing and monitoring the individuals um we understand that there is we want they've been through an unimaginable experience already. Um and we we know there's that human element but we also um want to make sure that there is a structure in place. Um safety is number one across the board here. Um but I'm we are here to make sure that um there is no public health risk. So >> yeah, and we've been reassured that in event that one of these uh individuals who is asymptomatic uh chooses to finish their period of observation elsewhere in their home or or elsewhere wherever that may be that they will be escorted uh under the very appropriate circumstances uh from end point to starting point. Dr. >> Yes, sir.
>> I just want to reiterate what what Ashley was saying. What you're seeing is a coordination from Washington to the state to the local levels with the governor with here at UNMC. This is what true public health care looks like. It's important for the administration. It's certainly important for Secretary Kennedy that we work together, that there are no silos or walls between us.
This is how public health should work.
This is how it is working. And I think this is a perfect example of how we are coordinating, how we are speaking, how we are interfacing and doing things together for the good of the nation, certainly the good of the people of Nebraska and the good of the individuals who've been repatriated here.
>> And then the patients in Atlanta, are they quarantining there as well? Is there a reason other than space as to why they're there? Any explanation as to the separation?
>> Nothing more to add. the they're going to there would be evaluation of symptoms there and then next steps would be similar to what happens here >> and they're quarantining as well >> they're in in yeah under med under medical evaluation right now similar >> hi Kaylee Skyler with Fox News back here if one of the patients who's currently located here in Nebraska were to test positive would they remain here and is it always a sixish week quarantine or can it vary >> sorry I was just going I'll start off by saying that is why we've maintained space in the bioontainment unit uh in event that becomes necessary uh and uh how it a lot would depend upon uh if that was the only individual or if there were multiple individuals that would get us to capacity of the BCU and if that occurred uh we would work with our federal partners very closely uh and make sure that they were transported to another facility that had the capability you want to add >> sorry I was just going to add on the the 42-day monitor ing period. The reason for that is that's sort of that's the maximum incubation period that's been seen for the Andes virus. So the incubation period is the time from when someone was exposed to when they develop symptoms. That's really at the very very long end. Much most people who are who end up infected with this virus will develop symptoms much sooner than that.
So that's a conservative time frame and that's the number we're using. I'll note this is a much longer incubation period than we see for a lot of other viruses, but typical for haunted viruses.
Uh Ian Lee with CBS News. You mentioned this incubation period uh being so long.
We know that there are some Americans who already traveled back to the United States or in their communities. How can you guarantee that they don't have the virus and can you guarantee that when people leave here that they will not be carrying the virus?
Would you like me to take that question?
Certainly.
There's been contact made with all of those passengers who who returned. The state health departments have been monitoring them on a daily basis including symptoms and temp temperature checks. Uh they have plans in place to make sure that they can isolate effectively in their home should they develop symptoms. If they are developing symptoms, they have ways to get tested safely uh and to make sure that they're not going to spread it to others. Again, what based on what we know about this virus and this again I want to emphasize this is not a brand new virus. This is a virus even though it's new to many of us. It it is a virus that has been known for uh decades um now and there's been outbreaks that have been dealt with in other countries and even here in the United States. This is not the first time we've had Andes virus in the United States before. The data that we have now all suggests that that transmission that spread between people happens when people are symptomatic. And so I think that gives us when when they have symptoms. And so that gives us um one layer of added protection to know when the risk is going to be greatest and how we can best protect the health and safety of the passenger and the American public.
>> Can you give us more details about those other Americans? What kind of procedures are they undergoing? Are they in quarantine as well? What kind what medical treatment are they receiving?
>> So they're um they're not receiving medical treatment when they are not symptomatic. um and it would only be for evaluation or testing and or if symptoms progressed and they would were required if it would turned out to be positive or they needed care for something else. Uh they again they're following the the recommendations that we have in our overall guidance for this uh daily monitoring um and uh and contingency planning. And when it comes to testing, there was one person who's asymptomatic and they tested positive. With this testing, can you test everyone and just see if they have the virus? Uh and this person who has symptoms, have they been tested? are they confirmed positive with the virus?
>> So when it comes to testing um I actually will defer to my colleagues at University of Nebraska um to to discuss their their plans on testing the traditional um way of managing hivirus testing has been that you you really focus on testing people who are are uh symptomatic who are having symptoms. Uh that's are the current stance right now but clearly we're going to keep re-evaluating this as we learn more about this virus and I'll turn it over to my colleague here. I mean, we're in the process of evaluating all of the individuals and as was mentioned, we're giving them a little bit of a rest period now just given their ordeal. Um, and then we are going to go back and jointly with our federal partners um ask questions about their exposure and get a lot more information from that individual and then we will make individualized decisions on testing um based on on those conversations. um the individual in the bioontainment unit uh will be tested and that's only because that individual did have this kind of equivocal positive test previously um not in the United States and so we will be testing that individual um but the individuals in the quarantine unit that will be a conversation and a lot of conversations between us um and and that those individuals that are in in the unit now.
>> Yeah. And just to add to that, in partnership with the Nebraska Public Health Lab and the university, we've developed and validated the necessary testing. So that can all be done here and done quickly and it's a PCR test.
If if I can follow on what you were just saying about the individual in the bioontainment unit, has that person uh developed or shown any symptoms since they've been here? And do we know if there is any evidence that this could be transmitted by someone who is asymptomatic? I know that's not typically what happens, but is there evidence that that could happen?
So, first question, uh are the individual uh is doing well and not having any symptoms at this time? Um but again, just arrived a few hours ago and so that will be an ongoing assessment.
Um and we will continue to ask those questions and and ensure that uh that they remain asymptomatic. Um and second question was about transmitting without symptoms. Um so there are a lot of unknowns here. Um but as was mentioned earlier it it seems that with this with haunt virus um the specific Andes virus that this can be transmitted person to person but it typically does require very close contact and typically when those individuals are symptomatic. Now again recognizing that like I said although this is you know there are some unknowns and this is not a not a new virus. This is not the scenario that we encountered with COVID where we had a brand new brand new virus. So there is some information uh known about Annie's virus and and we feel fortunate to at least have that. Um but again these this will be an ongoing assessment. There are a lot of moving parts right now but we'll do our best to take care of the individuals both in the quarantine unit and in the bioontainment unit and make sure they receive the best care. And go ahead.
>> Just to make sure that we reiterate that even here the quarantine center the rooms have negative pressure so that the virus cannot leave the room generally and then the ventilation is separate from the rest of the building goes right out and then it's filtered through high efficiency particulate air filter. So the risk to the general public for those patients who are here even if they were to become symptomatic is very very minimal to to none.
>> Yeah. And just to add on to that also we're doing everything in our power to protect our healthcare workers um who are wearing appropriate protective equipment both in the bioontainment unit and in the national quarantine unit as well.
>> And just for clarification especially you mentioned there were a lot of people who I'm sure hearkarkens back to six years ago who were watching this. What is the definition of very close contact?
What does that mean?
>> I I may let our public health partners answer that a little more definitively. Uh they they're asking the definition of very close contact and what you would consider. And the reason I bring that up is because there are some guidelines that uh just came out on this.
>> Right. So there's there's guidance that you can look to specifically on our website about about close contact and how that defines exposures. Typically, we're talking about exposure to specifically to body bodily fluids and then that could include things like saliva. So if you're sharing eating utensils, um kissing, touching, those type of things. It can also mean just being really really close to that that person for a fairly long period of time.
So we're we're calling that six right now six feet for at least a cumulative number of 15 minutes. I want to be clear, there's nothing magical about six feet. It's not a force field, but it's a rough number that gives us a sense of how close somebody has been. 15 minutes, again, it's a bit arbitrary, but it again gives some sense of how close someone has been. I think that's actually a fairly conservative approach given how we know uh how how the evidence we have so far about how this virus has spread uh in the past.
>> Um I have one clarification question then a few more questions. Um I believe just now um someone said 18 US citizens who were on the plane yesterday. I believe officials were seeing 17. I saw reporting that one person was a British national who was a who's a US resident.
Can we confirm those numbers?
>> Yeah, that is true. The the last person was a British dual national um who decided to come back to the United States.
>> Are they in Nebraska right now or in Atlanta?
>> Uh they are in Nebraska.
>> They're in Nebraska. Okay. And they are um one of the people who are in the quarantine unit, not um in the bio quarantine.
>> Yes.
>> Bioontainment. Okay. Thank you. And then just in terms of how limited the quarantine is, can you talk about what protocols are? are like I'm assuming family members want to visit. Is there room for that? What does that look like?
>> Well, currently uh each uh quarantined individual is in a private room, their own room and there are no you know no direct visitation. They do have access to uh technology. They can you know conduct uh you know phone conversations um you know video uh teleconferencing with family members and friends but there's no intermingling of any of the quarantined individuals. There's no visits uh from anyone outside of the quarantine unit. Um they do see our nursing staff, our techn technicians, our physicians on a daily basis. Um of course in full PPE following the precautions that we have in place to prevent trans transmission of the pathogen. Uh but there's no direct contact with anyone.
>> Um in terms of um the bio quarantine unit, can you just quickly describe is it similar? They're completely isolated.
um what are the differences between you know how many beds there are etc. >> So the Nebraska bioontainment unit is a completely separate entity from the national quarantine unit and it is designed as a patient care unit. Um we have five rooms in the Nebraska bioontainment unit. One of those rooms now is currently being operated as an in-house laboratory, which is actually um an important aspect of our clinical care to make sure that we're able to um to perform our lab work in a timely fashion with a a good uh turnaround time. Um the remainder of the patient room, so we have one individual who's occupying one of the rooms. Um at this point, that's the only patient that we have in in the bioontainment unit. Um but it also similar to the quarantine unit, it's its own separate entity. It is had its own air handling system. We don't share air with any of the rest of the facility. Um it has hepoiltration um out on the roof and so it's a a very different uh facility compared to your routine patient care room in a regular hospital. Everything is negative pressure throughout on a gradient. Um and there's just a lot of environmental uh you know and engineering controls that we have in the unit that makes it just very distinct from a typical patient care unit.
>> And how many people can it hold? So depending on the pathogen and our waste stream, the unit also has autoclaves um which is how we are able to um to decontaminate waste. Uh and so the the actual capacity of the unit is dependent on the pathogen um and what we're dealing with and how much waste we're having to process out. Um so there's I know that's a an interesting answer to your question, but but it actually depends. Um for airborne diseases we typically can take 10 patients with an airborne disease and by that I mean uh you know aven influenza um MS kov something that line um with this type of a disease and the fact that these individuals could become become ill fairly quickly as we've learned you know from what went on on the cruise ship um you know we typically are a two to three bed unit for that scenario. And then sorry just one more question. How often are people in the quarantine unit being tested and what are the symptoms that um you all are looking out for?
>> Well is it as far as the testing that's going to be decided in conjunction with the physician medical direction team and CDC colleagues. Um there's no frequency of testing for asymptomatic individuals that's agreed to at this time. Um, and then in terms of the symptom monitoring, I mean, it's all the things that you would think of in terms of an kind of an influenza-like illness, but it includes, you know, fever, headache, nausea, vomiting, diarrhea, muscle aches, generalized kind of malaise, um also uh more respiratory symptoms, cough, shortness of breath, um dizziness, things that would indicate low blood pressure, um those sorts of things are on the symptom monitoring that we do on a twice a day basis.
You know, a good way to think about it would be uh uh quarantine is sort of like a very well-managed air-handled hotel room and uh the bioontainment unit is like a very well-managed air handled intensive care unit.
>> Uh Jeff Cook, ABC News. Um I'm right here in the front. Um the two patients that went to Atlanta, why did those two patients go to Atlanta specifically, if you haven't already answered that? And um what facility exactly in Atlanta are they at?
>> Please.
>> So the reason they went there is I've discussed previously that it's contingency planning. That means if we're on since there was symptoms involved, they want to make sure that um if they turn out to actually have the the haunt virus that it uh makes sure that the bioontainment unit here that provides medical care uh doesn't take up too much space in case it's needed by the other passengers who are currently here in the um resident more residential section.
>> And what facility exactly in Atlanta?
>> Oh, it it's the I don't know if you want to speak to it might be helpful to talk about the um the Oh, Dr. Mr. Knox, that'd be great. So I'll kind of step back a little bit because this question keeps popping up as to how this system works, why people are in certain places.
Asper designed this system along with uh UNMC um Emory and other hospitals uh which are NEX National Emerging Special Pathogen Treatment and Education Centers.
There's uh three of those across the US.
And this is a system, a national special pathogen system. It's not designed as one hospital does everything. So the national quarantine unit is here at UNMC and it is designed to house a large group of patients or uh passengers from a plane or a ship like what we have now to monitor and assess them. um if they get symptomatic, become sick, they can be moved into the bio into the bio containment system and have a higher level of care. Right now, they're just being monitored and assessed. So, as a system, it works. We have 13 respects which are the regional emerging special pathogen treatment centers across the US so that those patients can be distributed load balanced across the system and and one place like UNMC she said you know we have 10 beds right but depending on the pathogen that can change those beds and right now we have uh 16 people here we have 15 in the quarantine center one in the bioontainment unit and then we have two down in uh uh Emery. So, that being said, why did they go there? Because we knew somebody was symptomatic and we have 16 people that are here. If someone were to get sick or multiples get sick, we don't want to take the time and energy, right, and and lack of care transporting them to a different location. So, this is how the system is built and designed so that we can load distribute across this system. I I think that hopefully should answer the questions.
>> And what facility in Atlanta is it?
What's the name of it?
>> Uh, currently they're at Emory University.
>> Okay. Thank you.
>> Back back over here. Ian Lee, just uh a couple questions. Uh >> oh, >> I'm sorry. There's multiple people talking. Sorry. Go ahead.
>> Is there is there a um bioontainment unit there? And are those two people in a bioontainment unit or just quarantining? Currently at this time, it's my understanding, Matt, do you know? They are currently in a quarantine. So, this is the only quarantine unit in the country right here. So, they would be in a bioontainment unit down there. Okay. It it can still be used as a quarantine unit, >> right? Understand that.
>> But it's a bioontainment similar to what you have here with the filters and and the desitation and all.
>> Yes, that that is correct. And it is because uh that one passenger was symptomatic. So that is the reason they went to the bioontainment unit at Emory.
Uh additionally to build on what Mr. Knox was saying, I mean this is a system uh that exists for exactly this kind of scenario and what you are seeing is the system working. uh the system kind of will absorb uh passengers as needed and this is a very well rehearsed uh system that exists and what you are seeing is that system work exactly as intended >> and is this a couple are they together or in two separate rooms how does that look like >> uh yes so it is a couple um and they are uh I'm I'm not sure of their exact uh situation the plane just landed recently uh in Atlanta and the patient uh the passengers ers were taking to Emory. Um, but because of their situation on the ship, they were traveling together to Emmery >> and just one of them had symptoms.
>> That is correct.
>> And I do have another question. You mentioned the 42 days. If someone recently tested or possibly tested positive, we've seen someone else with symptoms. Do the 42 days start now all over again or when do these 42 days start?
So, it would be a different story if the the person is already known to have an infection, if it's a true actual um PCR positive. I'd actually like to defer a bit to our our clinical partners because I think this is something that um is going to require somewhat of an individualized decision-making process to make sure we when we feel confident um that the person would be no longer in infectious. I don't know if there's anything you want to add to that or just leave it there. Well, the day one is typically the last known exposure and so these individuals were brought over um but they also were all in wearing PPE um on the plane on the way over and so I would say and again we we need to go in and assess these individuals. We we did give them a little bit of a rest and so we are going to go and ask a lot more questions about their exposure. Um you know how much contact did they have with these known positive individuals that were on this cruise ship um you know and other things like that. And so once that is more established then I think we'll have a better idea of when day one is because day one was your last known contact with you know someone at risk um or someone who was infected. And so um once we get in there and actually can ask some more questions I think we'll have a much much more kind of clear idea of the 42day period.
>> Yes sir.
>> We've had several people over here. Uh we've had several people already die from this virus. When they're here in the United States getting the treatment, what does that change the survival rate?
Do are they more likely to uh fight and beat this virus now that they're under your care unlike when they were on the ship? Well, as was mentioned, um you know, this the reason that we need these individuals to be close to care, whether that's here in the national quarantine unit or for the individuals that are already out in their home jurisdictions to make sure that they have access to critical care, is because the real management of this disease. Um this is not a disease that has a whole lot of therapeutic options and things.
Everything is experimental when it comes to that. We don't have any FDA approved therapeutic options um for Andes haunt virus. And so because of that, we rely on aggressive supportive care. Um, and by that I can mean everything from IV fluids to oxygen if they need it. Um, to more aggressive things like mechanical intubation, um, you know, uh, even emmo, which is extra corporeal membrane oxygenation, um, that is something that that in when people are in dire straits and really can't oxygenate their blood, um, then sometimes that can be a life-saving measure for people. And so these are though very aggressive measures. Um, we do think that being able to provide those aggressive measures to people can change outcomes and that's the importance of being close to this type of care and to be able to provide that critical care for individuals should they need it.
>> And then finally, just for the general public, can you guarantee that no American will catch this virus from the passengers who returned uh to the United States?
I just want to emphasize that our top priority across all levels of government here and part partners is the health and safety of the of the passengers and their communities. And that's what we're working constantly to address through all the measures that we're putting in place.
>> So there's you can guarantee no American will catch this virus from these returning passengers.
>> There are no guarantees in life. We're putting as many measures in place as possible to ensure that people are safe and healthy and we keep the community safe and healthy as well. Just speaking on behalf of our staff and the capabilities that we have, uh we will guarantee that every single precaution w that can be taken to keep the communities and our staff healthy and of course to keep these passengers healthy will be taken.
>> Um wanted to talk a little bit about the passengers. Waverly KTV here. Uh what are the age ranges of the passengers and how does that factor into the level of care? Are they part of a vulnerable population for this virus? And then also um as they then move home out of Nebraska hopefully uh does care change depending on like what part of the country they're from and what they might have been exposed to based off of where they're living >> just in in general the the age range that we have in the quarantine unit ages ranges from uh late 20s to uh late 70s early 80s in general. Um and and definitely you know pe people who have uh you know coexisting disease core morbidities would be more more vulner vulnerable um in terms of returning to their uh you know home home community.
Um you know it resources that are available there I mean it's it's variable. I think one of the main main benefits of being in this unit is exactly what Dr. He had stated is that it's a great resource for the country and that you are proximate to critical care and a bioontainment unit that can can treat high consequence infectious disease you know the best and the best teams uh the best policies and procedures the best training for these things and also the experience that we've had over the years to be able to provide this care in a safe manner that that track record I think is is uh really really one of the things that sets us apart. So, if if I was exposed to to this and I had the option to stay in a quarantine unit proximate to that that care, I would definitely take that because you're putting yourself in a position if you were to to uh turn positive that you'd be in a position to take advantage of all those things that's going to give you the best chance of survival. And with the people on the older end of the spectrum that you talked about, um, are they considered a vulnerable population or at more risk of having severe complications if they contract the haunt virus?
>> Yeah, generally it's thought that uh people who are older or have those medical coorbidities could potentially be at higher risk of more severe disease or potentially more adverse outcomes um, you know, should they should they get infected. So, I'm getting the message that we uh need to adjourn. I want to thank all of you for being here today.
Rest assured that we will periodically provide some updates. I'm sure all you from the media know how to contact our communications people at any time. And rest assured uh as you've heard said earlier, transparency is the name of the game here. Uh we will be totally transparent and we as we continue to learn more and more about these individuals and what their plans will be. So, thank you for being here and and thank you folks for uh doing this this morning.
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