Issue link: https://www.epageflip.net/i/397780
ByEmilySchmall The Associated Press DALLAS The Texas nurse who contracted Ebola while caring for a dying Liberian man repeatedly visited his room from the day he was admitted to the intensive care unit until the day be- fore he died, medical re- cords show. Nurse Nina Pham and other health care work- ers wore protective gear, including gowns, gloves, masks and face shields — and sometimes full-body suits — when caring for Thomas Eric Duncan, but the 26-year-old Pham be- came the first person to contract the disease within the United States. Reviewofprocedures Federal health officials on Monday urged the nation's hospitals to "think Ebola" and launched a review of procedures for treating in- fected patients, while the World Health Organization called the outbreak "the most severe, acute health emergency seen in modern times." Pham's family told WFAA-TV in Dallas on Monday that she was the health care worker with Ebola. A rector at her fam- ily's church, Hung Le, told The Associated Press that Pham's mother told him Pham has the virus. The Texas Christian Uni- versity nursing school grad- uate was monitoring her own temperature and went to the hospital Friday night as soon as she discovered she was running a low fe- ver. She is in isolation and in stable condition, health officials said. Public-health authorities have since intensified their monitoring of other Dallas hospital workers who cared for Duncan. Centers for Disease Con- trol and Prevention Director Tom Frieden said he would not be surprised if another hospital worker who cared for Duncan becomes ill be- cause Ebola patients be- come more contagious as the disease progresses. Pham's name appears fre- quently throughout the hundreds of pages of doc- uments in Duncan's med- ical records, provided to The Associated Press by his family. They show she was in his room Oct. 13, the day before he died. Progress reports note he had loose, watery stool and nurses had difficulty insert- ing a needle at one point. Pham's notes also describe nurses going in and out of Duncan's room wearing protective gear to treat him and to mop the floor with bleach. She also notes how she and other nurses were en- suring Duncan's "privacy and comfort," and provid- ing "emotional support." Breach of protocol Frieden has said a breach of protocol led to the nurse's infection, but officials are not sure what went wrong. Pham has not been able to point to any specific breach. The CDC now is moni- toring all hospital workers who treated Duncan and planned to "double down" on training and outreach on how to safely treat Eb- ola patients, Frieden said. Health officials have re- lied on a "self-monitor- ing" system when it comes to U.S. health care workers who care for isolated Ebola patients and wear recom- mended protective equip- ment. They expect workers to report any potential expo- sures to the virus and watch themselves for symptoms. Besides the workers, health officials continue to track 48 people who were in contact before Duncan was admitted to the hos- pital and placed in isola- tion. They are monitoring one person the nurse was in contact with while she was in an infectious state. None has exhibited symptoms, Frieden said. Containment concerns The case involving Pham raised questions about as- surances by American health officials that the disease will be contained and that any U.S. hospital should be able to treat it. Dr. Anthony Fauci, di- rector of the National In- stitute of Allergy and In- fectious Diseases was asked on ABC's "Good Morning America" if federal health authorities should consider requiring that Ebola pa- tients be sent only to highly specialized "containment" hospitals. "That is something that should be seriously consid- ered," Fauci said. Duncan, who arrived in the U.S. from Liberia Sept. 20, first sought med- ical care for fever and ab- dominal pain Sept. 25. He told a nurse he had traveled from Africa, but he was sent home. He returned Sept. 28 and was placed in isolation because of suspected Ebola. Among the things the CDC will investigate is how the workers took off protec- tive gear, because removing it incorrectly can lead to contamination. Investiga- tors will also look at dialy- sis and intubation — the in- sertion of a breathing tube in a patient's airway. Both procedures have the poten- tial to spread the virus. Fauci said on CNN that the CDC is examining pro- cedures like dialysis to see if they "heighten greatly" the risk of health care workers contracting Ebola. He sug- gested that in cases where the patient has deteriorated to the point where he or she cannot be saved, such high- risk procedures should not be done. DISEASE He al th o ffic ia ls u rg e hospitals to 'think Ebola' BRANDONWADE—THEASSOCIATEDPRESS Protect Environmental workers move disposal barrels to a staging area outside the apartment of a health care worker who treated Ebola patient Thomas Eric Duncan and tested positive for the disease in Dallas. By Suzan Fraser The Associated Press ANKARA, TURKEY NATO allies Turkey and the United States differed Monday on where they stand on the use of a key air base, with Turkish offi- cials denying reports from the United States that there was a new agree- ment on its use for opera- tions against Islamic State militants. The impasse suggests that major differences re- mainbetweenthetwosides. Turkey has said it won't join thefightagainsttheextrem- ists unless theU.S.-ledcoali- tion also goes after the Syr- iangovernmentofPresident Bashar Assad, including es- tablishing a no-fly zone and abufferzonealongtheTurk- ish border. The United States has been pressing Turkey to play a larger role against the Islamic militants, who have taken control of large swaths of Syria and Iraq, including territory on Tur- key's border, and sent ref- ugees fleeing into Turkey. U.S. officials said again Monday that Turkey would let U.S. and coalition forces use its bases, including In- cirlik air base, which is within 100 miles of the Syr- ian border, for operations against the Islamic State militants in Syria and Iraq. However, emerging Monday from a Cabinet meeting, Turkey's deputy prime minister, Bulent Arinc, said that "apart from the existing cooper- ation in combatting terror- ism, there is no new situ- ation concerning Incirlik air base." The deputy premier added that Turkey had proposed the use of some of its bases to train and equip moderate opposi- tion forces fighting the Is- lamic State group in Iraq and Syria, but said the sides had not yet come to any agreement. Turkish Prime Minister Ahmet Davutoglu, in com- ments published Sunday, said Incirlik was already being used for reconnais- sance purposes in Iraq and said its use for wider op- erations would depend on whether Turkey's demands for a no-fly zone and a safe zone in Syria are met. "There are activities that we are already under- taking jointly from Incir- lik, concerning Iraq," Da- vutoglu told the Milliyet newspaper. "But as a base for a more extensive oper- ation ... we have already made our position clear: There has to be a no-fly zone and a safe haven must be declared." Arinc said the two coun- tries would hold "deeper" talks in the coming days on Turkey's cooperation in the U.S.-led coalition, including its demands for a no-fly zone and a safe ha- ven in Syria. On the ground Monday, the battle continued to rage on Turkey's border as Islamic State fighters car- ried out at least three sui- cide bombings in the Syr- ian border town of Kobani, allowing the group to make a small push into the strate- gic town, activists said. WAR ON TERRORISM Turkey: No deal with US on using air base LEFTERIS PITARAKIS — THE ASSOCIATED PRESS Syrian Kurd Kiymet Ergun, 56, standing in Mursitpinar on the outskirts of Suruc, at the Turkey-Syria border, watches while thick smoke rises following an airstrike by the US-led coalition in Kobani, Syria as fighting continued between Syrian Kurds and the militants of Islamic State group on Monday. By Sylvia Hui The Associated Press HONG KONG A mob of masked men opposed to Hong Kong's pro-democ- racy demonstrators led an apparently coordinated as- sault on the protest zone in the heart of the city's fi- nancial district Monday, tearing down barricades and clashing with police. The chaotic scenes came after police carried out a dawn operation to reopen some key roads blocked by protesters for more than 15 days. Police said they will continue to chip away at the occupied zone to relieve traffic, and warned that anyone who challenges them could be arrested. Monday's confronta- tions highlighted the grow- ing tension between stu- dent-led protesters and au- thorities — as well as other residents aggravated by the disruptions. The pro- testers, who had enjoyed widespread support when the movement began, are fighting to keep up mo- mentum as the political crisis entered a third week. Demonstrators have flooded several thorough- fares in central Hong Kong since Sept. 28 in a civil dis- obedience movement to oppose restrictions on the first-ever direct election for the semiautonomous Chi- nese city's leader, promised by Beijing for 2017. They want authorities to drop a plan to use a pro-Beijing committee to screen candi- dates, and demand the res- ignation of Chief Executive Leung Chun-ying, the city's deeply unpopular Beijing- backed leader. Authorities have repeat- edly urged protesters to retreat from the streets, but student leaders have vowed to keep up the dis- ruptions until the govern- ment responds to their de- mands. Protesters were building huge new barriers out of bamboo and garbage cans Monday after about two dozen men wearing sur- gical masks to hide their faces tore at the metal bar- ricades that demonstrators had earlier put in place. CHINA Hong Kong protesters boost street barricades By Nicole Winfield The Associated Press VATICAN CITY Gay rights groups hailed a "seis- mic shift" by the Catho- lic Church toward gays on Monday after bishops said homosexuals had gifts to of- fer the church and that their partnerships, while morally problematic, provided ho- mosexuals with "precious" support. In a preliminary report half-way through a Vatican meeting on family life, the bishops also said the church must recognize the "posi- tive" aspects of civil unions and even Catholics who co- habitate, with the aim of bringing them to a lifelong commitment in a church wedding. The report summarized the closed-door debate that Pope Francis initiated to discuss a host of hot-button family issues such as mar- riage, divorce, homosexual- ity and birth control. No de- cisions were announced, but the tone of the report was one of almost-revolutionary acceptance rather than con- demnation, and it will guide discussions until a final doc- ument is issued Saturday. "For the LGBT Catholics in the United States and around the world, this new document is a light in the darkness — a dramatic new tone from a church hierar- chy that has long denied the very existence of com- mitted and loving gay and lesbian partnerships," said Chad Griffin, president of Human Rights Campaign, the biggest LGBT rights or- ganization in the U.S. Conservative groups de- nounced the report as her- esy and a "betrayal" that will only serve to confuse Catholics. In an indication of the chasm that is appar- ently underway within the church leadership itself, Francis decided late Fri- day to add six progressives from four continents to the synod leadership to help prepare the final document after several conservatives were elected to leadership positions. None of Fran- cis' appointees were Afri- cans, who are traditionally among the most conserva- tive on family issues. Bishops clearly took into account the views of the pope, whose "Who am I to judge?" comment about gays signaled a new tone of wel- come for the church. Their report also reflected the views of ordinary Catholics who, in responses to Vatican questionnaires in the run-up to the synod, rejected church teaching on birth control and homosexuality as out- dated and irrelevant. The bishops said gays had "gifts and qualities" to offer and asked rhetorically if the church was ready to provide them a welcom- ing place, "accepting and valuing their sexual orien- tation without compromis- ing Catholic doctrine on the family and matrimony." For a 2,000-year-old in- stitution that teaches that gay sex is "intrinsically dis- ordered," even posing the question was significant. "This is a stunning change in the way the Cath- olic church speaks of gay people," said the Rev. James Martin, a Jesuit author. "The Synod is clearly lis- tening to the complex, real- life experiences of Catholics around the world, and seek- ing to address them with mercy, as Jesus did." The bishops repeated that gay marriage was off the table. But it acknowl- edged that gay partnerships had merit. "Without denying the moral problems connected to homosexual unions, it has to be noted that there are cases in which mutual aid to the point of sacrifice constitutes a precious sup- port in the life of the part- ners," they said. Francis DeBernardo, ex- ecutive director of New Ways Ministry, a Catholic gay rights group said that though the report repeats doctrine about gay mar- riage, "the move toward accepting and valuing the gifts of gay and lesbian peo- ple is a major step forward." RELIGION Ca th ol ic b is hop s in ' se is mi c' o pe ni ng t ow ar d ga ys GREGORIO BORGIA — THE ASSOCIATED PRESS Pope Francis attends a morning session of a two-week synod on family issues at the Vatican on Monday. 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