The Rachel Maddow Show, Transcript 10/14/14

Guests:
Amy Hagstrom Miller, Nancy Northup, Anthony Fauci
Transcript:

RACHEL MADDOW, MSNBC ANCHOR: Good evening, Chris. Thank you.

HAYES: You bet.

MADDOW: And thanks to you at home for joining us this hour. We`ve got a
big show tonight. Dr. Anthony Fauci is here, the nation`s top expert on
infectious disease is going to be with us tonight for the interview. Here
from the National Institutes of Health. I`m very much looking forward to
that conversation.

But we need to start tonight with some breaking news from the United States
Supreme Court. Late tonight, just within the last couple of hours, the
U.S. Supreme Court has handed down a pretty significant ruling on abortion
rights.

The U.S. Supreme Court tonight reversed a Lower Court ruling that earlier
this month had shut down all but the last handful of abortion clinics in
the state of Texas. Tonight, because of this intervention from the Supreme
Court, the dozen clinics that were basically shuttered overnight earlier
this month, legally those clinics should be able to reopen effective
immediately.

Whether or not they can literally reopen, whether they`re in a position to
reopen after having been shut down recently, that remains to be seen. But
legally, at least, they are now officially un-shutdown.

This all stems from a sweeping piece of anti-abortion legislation that was
passed by the Republican-controlled Texas state legislature last year,
despite a marathon filibuster effort by a state senator named Wendy Davis.
The law did eventually pass. It was signed into law by Republican Governor
Rick Perry of Texas. Parts of it have been tied up in the courts and have
been over legally since then.

But two weeks ago, a federal Appeals Court did rule that the entire Texas
law could take effect. And when that Appeals Court made that ruling two
weeks ago, that shut down nearly 80 percent of the clinics that provide
abortions in Texas. Before this law took effect, there had been more than
40 clinics in Texas that provide abortions. After the Appeals Court let
the full law go into effect two weeks ago, all but eight clinics in the
state shut down. From 40 clinics plus to eight.

There are 5.4 million women of reproductive age in the state 06 Texas. In
the year 2011, which is the last year for which we have data, it`s thought
that more than 70,000 women in Texas had an abortion that year. But,
again, the number of places they can do that, because of these court
rulings, had gone from more than 40 down to eight.

That ruling left no clinics open south or west of the city of San Antonio.
There was not a single clinic in the entirety of the Rio Grande Valley.

In response to that ruling from the Appeals Court, last week the Center for
Reproductive Rights filed an emergency petition with the Supreme Court
asking that the Supreme Court take immediate action to basically put this
whole thing on hold. Allow those clinics to reopen.

At issue here is part of the abortion law that was passed in Texas which
forced abortion clinics to make multi-million dollar renovations,
basically. Upgrades to their facilities. It was very obviously intended
to shut those clinics down. That particular part of the law has been put
on hold once again tonight by the Supreme Court.

The Supreme Court also decided to give two clinics a reprieve from another
part of the law that forced doctors to have admitting privileges at local
hospitals. In part, because they are the only clinics in their respective,
vast and remote corners of the state of Texas.

I should tell you that one of the clinics who got that specific reprieve
from the Supreme Court tonight is the clinic that we visited a few months
ago in McAllen, Texas. This is the clinic in the Rio Grande Valley. It
had been the only remaining clinic that did abortions in that whole huge
part of Texas before this Texas law shut them down. As of tonight,
legally, they will be able to reopen.

That clinic`s owner, Amy Hagstrom Miller, is going to be joining us to tell
us her reaction to this ruling in just a moment.

Ever since this law was passed last year against that marathon filibuster
effort from State Senator Wendy Davis who is now running for governor, it
has been expected that this Texas law would end up at the Supreme Court.
Well, tonight, the court has made a significant ruling, shutting down some
of the most important parts of that law and letting clinics reopen.

It was a split 6-3 decision, divided along somewhat familiar lines. The
dissenting judges from this decision were Justices Scalia and Thomas and
Alito. They were indicating that they were perfectly comfortable with
keeping the law in effect. Ultimately, in terms of whether or not this is
the final word, it`s not clear that it is. The case will now go back to
the lower court to the Fifth Circuit for a full hearing in that court.
That`s not expected before the end of the year, at the earliest.

But in the meantime, clinics tonight are reopening in Texas and that
draconian anti-abortion law will remain on hold.

Joining us now on the phone is Amy Hagstrom Miller. She is the founder and
CEO of Whole Woman`s Health which owns five Texas clinics including that
one that we visited a few months ago in McAllen, in the Rio Grande Valley.
Four of her clinics were forced to close by the Texas law. Tonight Supreme
Court action may allow Amy Hagstrom Miller to reopen her facilities.

Amy Hagstrom Miller, thanks very much for joining us tonight. I appreciate
you being here.

AMY HAGSTROM MILLER, WHOLE WOMAN`S HEALTH FOUNDER AND CEO: Oh, absolutely.
It`s nice to – to talk with you when something good happened.

MADDOW: Well, I was going to – I mean, obviously, this is good news for
you, for people who support abortion rights in the state of Texas.

First of all, did I – did I summarize it accurately? I`m still sort of
starting to absorb this ruling and what`s your reaction?

HAGSTROM MILLER: Well, my reaction is I`m very delighted. I`m just – I
can`t believe that we got both Kennedy and Roberts to rule in our favor. I
think that`s a huge precedent for us. It`s delightful to be able to say
yes to the women who have been calling us in the Rio Grande Valley instead
of having to turn them away as we`ve had to do for the last two weeks.

And so we are already calling, trying to set up a physician to come down
and be able to serve women in that community as soon as we can. And we`re
also doing our best to keep our Fort Worth office open as well and taking a
look at reopening the Austin clinic as well.

MADDOW: So when you said that you`ve been turning women away, since the
Federal Appeals Court a couple of weeks ago issues that ruling that shut
down so many clinics, including your own, including that clinic in McAllen,
which shows the only clinic serving that whole huge part of the state, did
you have women still coming to the clinic still trying to be there for
their appointments, still trying to get abortions at your clinic, and you
had to turn them away?

HAGSTROM MILLER: Absolutely, Rachel. Over the last two weeks, we had
quite a few women. I mean, the – the day after the injunction got
overturned, we had every single patient show up the next day anyway.
Mainly because it`s not a community where we can call everybody by home.
Every schedule on appointment. And so my staff found themselves there the
whole day with those women doing, you know, ultrasounds and counseling and
talking with them and doing our best to raise money for some of them who
were able to, to travel north to get services.

But there were quite a few women who just looked at us and said, I can`t
travel north, and I`m going to have to take matters into my own hands. And
so those will be some of the first people we reach out to, to see if we can
help them.

MADDOW: Amy Hagstrom Miller, founder and CEO of Whole Woman`s Health, now
facing a vastly different legal landscape than she was facing it close of
business even today.

Amy, thanks very much for being with us. Keep us posted on what happens
next.

HAGSTROM MILLER: Thank you, Rachel.

MADDOW: Thanks.

All right. Joining us now for more on this is Nancy Norfolk who`s
president of the Center for Reproductive Rights, which is the group that
filed the appeal with the Supreme Court.

Nancy, when we talked about you having asking asked the Supreme Court to
intervene, sort of on an emergency basis in this case, I did not think you
were going to get what you want. You clearly have received the ruling that
you were looking for.

Is this –

NANCY NORTHUP, CENTER FOR REPRODUCTIVE RIGHTS PRESIDENT: Yes.

MADDOW: Is this what you wanted to happen? Is this half the way there?
Is this everything?

NORTHUP: It`s exactly what we wanted from the Supreme Court right now.
It`s extraordinary the action that they took tonight. Extraordinary in the
sense that it`s not usual for the Supreme Court to step in at this point in
a lawsuit. And it`s extraordinary for what it means to the women in Texas.
To have 13 clinics be able to reopen while this case goes forward. That`s
just huge. We are delighted.

MADDOW: It is a – it is not the final ruling. Obviously, this goes back
to that Appeals Court which will – it`s a very conservative court, not as
conservative it used to be before the presidency of Barack Obama, but it`s
still pretty, pretty conservative.

In the meantime, though, we see what Amy Hagstrom Miller, the immediate
effect that those 13 clinics that shut down two weeks ago reopened at least
all of them that can. But what does it mean to you legally that you did
get Justice Kennedy? You did get Justice Roberts? You did get a bigger
split than you would expect. It wasn`t 5-4, it was 6-3.

Does that say anything to you about this issue substantively going forward
in the courts?

NORTHUP: Well, you never want to make a substantive, you know, inference
from what the court does. But clearly, six members of this court thought
it was important to take this unusual step and to reverse the decision by
the Fifth Circuit which was closing those clinics and allow the injunction
at the district court.

We wanted trial. We had a full trial and the district found, this is a
sham law, there`s not a basis for this law and that it`s designed to shut
down the clinics. And the court put back into place, you know, the
injunctions that that judge had found. So that is a very good sign.

A year ago, when, unfortunately, half the clinics in Texas are still closed
in the wake of that law. And when we were up in the Supreme Court a year
ago, in the same kind of posture, we were not able to get the clinics
reopened. And that was in a 5-4 ruling from the court. We`re looking at
6-3 today. It`s a better day.

MADDOW: So the parts of the law, just to be clear. There used to be –
before this law.

NORTHUP: Yes.

MADDOW: There were 40 something clinics that did abortions in the state of
Texas.

NORTHUP: That`s right.

MADDOW: After the law went into effect that shut down about half of them,
went down to about 20 then these final provisions of the law that went into
effect were allowed to go into effect two weeks ago. That shut down all of
but seven or eight. It is that final portion that has now been reversed.

NORTHUP: That`s right. So there are now those 13 clinics that can reopen.
They`re going to be able to be in practice during the time of the Appeals
Court that. And that`s a good thing because in just the days in which they
were closed, a lot of damage was done.

MADDOW: Nancy Northup, president of the Center for Reproductive Rights,
keep us posted. Thank you for your time tonight.

NORTHUP: We will.

MADDOW: Appreciate it.

All right. We`ve got lots more ahead tonight, including what a world war -
- pre-World War II era airplane can teach us about combating Ebola.

Plus, we`ve got the nation`s top expert on infectious diseases here, Dr.
Anthony Fauci.

Plus, I have to tell you, we have one of my favorite stories in a long time
that involves a fancy hotel spying on a secret train station. Yes, stay
with us.

(COMMERCIAL BREAK)

MADDOW: About 30 miles north of Salt Lake City, Utah, there`s a big U.S.
military installation called Hill Air Force Base. Hill Air Force Base is
indeed in a lovely and very mountainous part of northern Utah. But that is
not how it got its name. Hill Air Force Base is actually names after a guy
named Hill.

Ployer Peter Hill, a U.S. Army test pilot who died in really dramatic
circumstances while flying test flights in a new plane that the army was
considering buying at the time. In the 1930s, the Army Air Corps wanted a
big new bomber to add to its fleet. And Boeing designed one to try to get
that contract. Boeing was almost kaput as a company at that point. They
basically bet the whole future of their company on trying to win this Army
Air Corps contract.

And what they built was a whole new approach to military aircraft. Instead
of two engines, it had four. It was huge. Its wing span was more than a
hundred feet wide. It could fly faster than previous bombers. It could
fly further than previous bombers. It could hold tons more bombs than the
army had ever been able to put in a plane like this before.

But on October 30th, 1935, that plane, the Boeing experimental test model
number 299, the 299 had an ace test pilot named Ployer Peter Hill at the
controls. It was being evaluated by the army to see if they were going to
invest in this huge, amazing new plane that could do so much more than any
other bomber ever had before.

And in that test, the plane crashed. Took off, it got its nose up way too
high. Basically went straight up then it cart wheeled over on to one side,
came down on one wing, exploded into flames.

Ployer Peter Hill, the chief of flight testing in the U.S. Army Air Corps.
He was piloting that plane. He was killed instantly. The Army awarded the
initial contract for their new bomber to a competing aircraft from a
different company. The Army assigned a board of officers to figure out
what happened in this deadly crash to find out what was wrong with their
super promising plane that they`d been so excited before it crashed in this
test flight.

Turned out there was nothing wrong with the plane. It was human error. A
thing was locked at take off that was supposed to be unlocked at takeoff
and that was enough to make it go straight up before it came straight down.
That was enough to crash the model 299.

A doctor and writer named Atul Gawande wrote about this for the “New
Yorker” magazine a few years ago because that diagnosis of that plane
crash, that diagnosis that this incredibly good, incredibly experienced,
incredibly expert pilot was responsible for that crash. It wasn`t the
plane`s – fault. It was the pilot`s fault. That diagnosis led to a
really important cure.

Convinced that this Boeing bomber was still the right plane for the U.S.
military, after that crash, a group of test pilots got together. The plane
had crashed, the contract had been given to another company, but they still
wanted that plane and they wanted to try to figure out a way that the army
could still use this Boeing plane. And what they came up with was
deceptively simple.

It was a checklist, a point-by-point pilot`s checklist for taxiing in that
plane, taking off in that plane, flying that plane and landing that plane.

So, yes, this Boeing model 299 was more complicated than other planes had
been before that point. But if you didn`t just depend on the expert pilot
memorizing everything and doing everything perfect every time in this
complicated plane, if, instead, you broke it down and you wrote everything
down that needed doing and you made someone in the cockpit overtly check
off every step in the cockpit, every time those things needed to be done.

Well, then, maybe it was flyable. Maybe the Army Air Corps could have this
plane with all of this capability that they wanted so bad.

Well, that plane went on to be the B-17 bomber, which was, frankly, a
really big help in bombing the snot out of the Nazis in World War II, thank
you very much. And yes, the B-17 and its prototypes, they were more
complicated than planes had been before. But with this pilot`s checklist
innovation, pilots flying after Ployer Peter Hill went on to fly that
Boeing plane nearly two million miles without having another accident.

And to this day, one of the things pilots carry around in those giant,
oversized boxy suit cases they always have with them in the cockpit is
their cockpit checklist. And it seems like a dumb thing, but even when you
are an expert. Even when you`re highly trained and you`ve done it a
million times, and you know what to do, it turns out the simple fact of
having someone check with you overtly that you have taken every step you
need to take, it can make all the difference.

It can make the difference between you just being an expert and you being
the kind of expert who performs basically flawlessly in an environment that
cannot tolerate mistakes. And the reason that story of the B-17 bomber and
Ployer Peter Hill has become something that doctors write about in popular
magazines is because that idea, that deceptively simple idea of the pilot`s
checklist, that`s the same basic idea that led to checklists being used by
doctors.

There`s now a famous study from Johns Hopkins Hospital about a decade ago
in which intensive care unit nurses at Johns Hopkins were told to follow a
checklist. Fill out a checklist every time doctors put in a central line
catheter, which is a big catheter that goes into the neck. And nurses were
told to use the checklist to make sure that doctors followed all the steps
they needed to follow to keep the patient from getting an infection when
they were getting a line inserted in their neck.

And, you know, this kind of stuff, I wouldn`t want to do it. But to a
doctor, it`s not rocket science. It`s stuff that they needed to do wasn`t
the toughest thing they do but at Johns Hopkins they nevertheless decided
to put all the steps on a checklist.

Number one, wash hands with soap, check. Number two, clean the patient`s
skin with antiseptic, check. Number three, put sterile drapes over the
patient`s whole body, check. And so on. And so on. And then look at
this, look at what the checklist did.

The unit that made this change monitored the results in their patients for
a year after they started this checklist system. Quote, “The results were
so dramatic that they weren`t sure whether to believe them. The 10-day
line infection rate went from 11 percent to zero.”

So then they followed their patients for 15 more months. Only two line
infections occurred during the entire period. They calculated that in this
one hospital, just this checklist had prevented 43 infections and eight
deaths. And it had saved $2 million in costs just in that one hospital.

Just putting what they already knew they should do on a written checklist
as a way of making sure they actually did it. Just like flying the B-17.
Right? In both cases, the people whose behavior is being improved
perfected by the checklist. There are already really high-performing,
highly trained people in military pilots, test pilots, intensive care
doctors working on one of the best hospitals in the country, probably one
of the best hospitals in the world.

These are not idiots, right? These people are at the top of their game.
And what they`re getting better at by using the system is not the hardest
thing about their jobs. Washing your hands is not something you need years
of medical school to learn to do, right? But that is the kind of stuff
that it turns out it can easily go wrong.

It doesn`t mean that you`re an idiot. You might be the most intensely
trained expert person in the world in your field. But that kind of stuff
can go wrong.

We`re human. And so there needs to be ways, systemic ways, of stopping
those kinds of small and simple but potentially fatal errors.

A checklist works, turns out. Genius.

Authorities now say they still do not how a critical care nurse helping
with the treatment of Ebola patient Thomas Eric Duncan ended up herself
getting infected with the virus that killed Thomas Eric Duncan.

The hospital in Dallas had him in isolation. Its employees, presumably
including this now infected nurse, they were all issued and were all
wearing protective gear that you`re supposed to wear when you`re in contact
with someone who`s symptomatic with Ebola. But somewhere along the way,
something went wrong.

The Centers for Disease Control says they are confident in their advice to
help facilities in terms of how to suit up and how to protect yourself.
Medically, it does not seem like there`s reason to doubt the advice that
they have been giving, the protocols they had been prescribing. It turns
out what we need is more assurance that when it comes to treating,
incredibly infectious patients, every time and every instance, every time
you put your gear on and take your gear off, every single patient
interaction, everything has to be done right.

So will that be cockpit style checklists for health workers dealing with
potential Ebola patients or Ebola patients? And would that be the buddy
system to make sure health workers are able to get their gear on right and
their gear off right every single time? What`s the trick going to be?
What`s the system going to be that essentially gets perfection out of
people who are already highly trained and highly motivated to get it right?

As we deal with our first cases of Ebola in this country, avoiding an
outbreak is not rocket science. But from the people who do come into
contact with America`s first Ebola patients, it`s going to take, basically,
perfect behavior from those individuals. It`s not enough that they are
experts, that they are highly trained, highly educated or even at the top
of their fields. There is no margin of error.

How do we get that?

The CDC today held a nationwide training conference call for health workers
on how to deal with potential Ebola cases. They`re revising and ramping up
their advice for U.S. hospitals after the still unexplained failure in
Dallas led to the first woman, this health worker contracting the virus in
this country. They`re reminding health workers around the country now that
as a country, we can`t just count on specialty biocontainment units
handling all the new cases. They`re reminding us that after all it really
could turn up anywhere.

(BEGIN VIDEO CLIP)

DR. THOMAS FRIEDEN, CDC DIRECTOR: Every hospital in the country needs to
be ready to diagnose Ebola. That means that every doctor, every nurse,
every staff person in an emergency department who care for someone with
fever or other signs of infection needs to ask where have you been in the
past month. Where have you been in the past 21 days. Have you been to
Liberia, Sierra Leone or Guinea.

(END VIDEO CLIP)

MADDOW: The number of cases of Ebola that have been treated or in the
process of being treated in the United States stands at seven. Of those
seven patients, three have recovered, three are still in treatment and one
has died.

Those are our numbers here, in terms of how successfully we have dealt with
this disease inside our border thus far. But look at this. These are the
numbers at the – look at this. These are the numbers at the epicenter of
the Ebola outbreak. We knew Ebola was spreading rapidly in Guinea and
Liberia and Sierra Leone. We know hundreds of people have died in each
country, thousands more have been diagnosed with the disease.

But knowing those numbers is different from seeing them plotted out like
this. Right? With this spike in the progression of Ebola in those three
countries over this relatively short period of time. I mean, any time you
see a graph shoot up like this, unless the thing you`re measuring is a good
thing, which in this case it is not, you are looking at a really scary
trend.

Look at the numbers in Liberia. Today the official in charge of the World
Health Organization`s Ebola Response warned that a couple of months from
now we could see 10,000 new cases of Ebola diagnosed each week worldwide.
That is a tenfold increase over the current rate of new cases per week
right now. It`s bad now. It`s a thousand new cases a week now. WHO said
today that within two month it is on track to be 10 times as bad as it is
now.

In Washington today President Obama met with military leaders from 21
different countries. The topic was supposed to be the coordinated global
military strategy in the Middle East against the Islamic state terrorist,
ISIS or ISIL. But the president also at this meeting today took a moment
to speak pretty candidly about Ebola.

(BEGIN VIDEO CLIP)

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: The world as a whole is not
doing enough. There are a number of countries that have capacity, that
have not yet stepped up. Those that have stepped up, all of us are going
to have to do more because unless we contain this at the source, this is
going to continue to pose a threat to individual countries at a time when
there`s no place that`s more than a couple of air flights away.

(END VIDEO CLIP)

MADDOW: Those that have stepped up, all of us, are going to have to do
more.

The U.S. government is stepping up in some specific ways here, in addition
to that nationwide training call with health workers today, the CDC
announced a new program today to get their experts on the ground anywhere
in the country immediately as soon as there is a new Ebola diagnosis.

(BEGIN VIDEO CLIP)

FRIEDEN: The second thing that we will be doing starting today is
establishing a CDC Ebola response team. For any hospital anywhere in the
country has a confirmed case of Ebola, we will put a team on the ground
within hours with some of the world`s leading experts in how to take care
of and protect health care workers from Ebola infection.

(END VIDEO CLIP)

MADDOW: Today, we anxiously awaited word all day long from one of those
local hospitals dealing with one of these potential cases. This afternoon,
the University of Kansas Hospital and Kansas City was going to announce
publicly whether one of their patients had tested positive for Ebola.

This was different than a lot of the scares and false alarms we`ve been
seeing recently when it comes to Ebola because this patient in Kansas had
actually been in West Africa. He had worked as a medical officer on a ship
that had been stationed off the West Coast of Africa. He entered this
hospital in Kansas City with a high fever and with various other symptoms
that could be associated with Ebola.

So there was a lot of worry about what the Kansas hospital was going to say
today. But this afternoon, they announced that his initial test for Ebola
came back negative. This is not the final result for that patient, but it
is a good sign, obviously, for him that the initial test did not show that
he was infected.

A desperately needed piece of good news today against the backdrop of those
huge and alarming new international numbers. And also a ton of fear about
what we are facing even here in the United States. And on that subject, on
what we are facing here. In addition to all the steps for CDC and the
National Institutes of Health are taking, in addition to everything that`s
happening medically to address Ebola there`s also of course a real need to
communicate with us, right?

To communicate effectively with the American public about this new disease
we`ve never thought very much about before and that we are now confronting
as a country. Of course, we do have a position in our government for that
exact purpose. That`s what to be what the surgeon general does.
Communicate to the American public about complicated and potentially scary
medical things and language the American public can understand.

That`s what the surgeon general is supposed to do, we currently don`t have
a surgeon general. It was almost a year ago President Obama nominated
Vivek Murthy to be the next surgeon general. The Senate never voted on his
nomination. There`s never been a vote on him at all. That`s because the
National Rifle Association decided they didn`t like him. NRA announced
that they would score the Senate vote to confirm Vivek Murthy. And that
was it. That was enough to send senators running.

The NRA intimidated the U.S. Senate into not even voting on whether they
would confirm President Obama`s surgeon general nominee so we haven`t had a
surgeon general for more than a year now.

That void in practical terms has been filled capably by Doctors Tom
Frieden, the head of the CDC, and by Anthony Fauci, the director of the
National Institute of Allergies and infectious diseases, the NIH. Those
two men have filled that public role essentially which entails reassuring
the public and keeping us informed about what`s going on.

But honestly, that`s not supposed to be their job. And they`re very busy
guys. I mean, instead of having someone communicating to the country what
the people who are fixing the problem are doing, turns out, the people who
are actually fixing the problem are also now having to be responsible
themselves for communicating to the country what they`re doing. Because we
don`t have anybody else to do that communications work right now because we
have no surgeon general during the Ebola crisis.

Thank you, Congress. Yet another reason to be thankful for our current
Congress.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

OBAMA: The world as a whole is not doing enough. There are a number of
countries that have capacity that have not yet stepped up. Those that have
stepped up, all of us are going to have to do more.

(END VIDEO CLIP)

MADDOW: On the day that the World Health Organization upped its estimate
of new Ebola infections from roughly 1,000 new infections a week now to
10,000 new infections a week with sometime within the next two months.

What we need to do right now is talk to an expert about how we should feel
about these things and how our nation is responding. So I`m very pleased
to say that joining us now for the interview is Dr. Anthony Fauci. And
he`s director of the National Institute of Allergy and Infectious Diseases
at the NIH.

Dr. Fauci, it`s a pleasure to see you. Thanks very much for being here.

DR. ANTHONY FAUCI, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
DIRECTOR, NIH: Good to be with you.

MADDOW: Can you shed some lights for us on why that estimate leapt tenfold
today? Obviously the spike in numbers, seeing those graphs go up in terms
of new infections in Liberia, Sierra, Leone and Guinea has been scary
enough already in real time. Why did the forecast just go up by tenfold
today?

FAUCI: Well, it`s spreading in a way that we call exponential or almost
exponential which means it isn`t just the linear increase that as you get
more and more people who are getting infected and not getting into the kind
of isolation and able to contact trace, they`re infected a lot more people
than if you had a system where as soon as someone was identified as being
infected, he would them in isolation and treat them. Hopefully they do
well.

Obviously 50 percent or more of them die. But when you get someone who`s
infected and there is no place to go, they go out into the community and
they infect several other people, so instead of the curve just going up
this way, it goes up like that the way you just showed on that slide.

MADDOW: So in terms of – I mean, the – not just the experience in Sierra
Leone and Guinea and Liberia, which is so tragic, but in terms of the risk
to the globe, in terms of the locust of this epidemic and getting that
under control, is that basically the idea of what U.S. military forces and
logistical help is doing there? Trying to upscale the number of places
that people can go so that they stop infecting people in the community once
they know they`re symptomatic?

FAUCI: That`s exactly the point, Rachel. The military is involved right
now in the logistics and the engineering to get set up those 17 by 100 bed
– hospital bed units. Now that`s a big leap to what we have right now and
that`s going to be very helpful. But as you just showed that piece, where
the president is speaking, there is no one country that can actually do
that alone because if you have 17 times a hundred, that`s, you know, close
to 2,000 beds.

When the expansion is like that, we`re going to need multiple countries
coming in and stepping to the place. Organizations NGOs. So it`s not
going to be one person or one group or one country that`s going to be doing
it. And that`s the concern we have because as the epidemic itself in the
speed of its expansion outstrips the speed and quantity of the resources
that you put in, you`re always playing catch-up ball.

The only way to turn this around is to actually catch up so that the effort
and the – and the resources and the bed and the health workers that are
there to work actually are commensurate with what the challenge is there.
Right now they are not. It`s all catch-up ball.

MADDOW: In terms of the U.S. contribution to that and U.S. leadership on
that, obviously, we`re doing this out of self-interest but also out of
responsibility for global leadership because this affects everybody and
puts everybody at risk.

FAUCI: Right.

MADDOW: Today there was an interesting development when an American
billionaire, the guy who founded Facebook, decided to give $25 million as a
personal donation to the CDC foundation to try to help contribute to that
effort. On the one hand, that makes me happy for him. I`m glad that he
has those resources and that`s where he wants to put them. It does call to
question to me whether or not as a government, as a – as a polity, as a
country, whether we are resourcing adequately what we`re doing.

Whether this is the sort of thing where we ought to be saying Katie, bar
the door, the budget needs to get really big really fast.

FAUCI: Right. Well, that`s a good point, Rachel. The issue is whenever
you`re behind trying to catch up, you can never day we`re doing enough. I
mean, no one is doing enough. We`re doing a lot. And I think if we get
the global community involved, that that`s going to be something that`s
going to be, you know, compounding the amount that you`re doing. And
that`s what we really need to do.

Right now getting the military there was really an important thing because
we really do need the command and control, the logistics, the engineering
and the ability to get those beds up. So hopefully when that really gets
going at full blast, that we`re going to start seeing a major impact that
we can but as again, I have to emphasize we can`t do it alone. It`s got to
be a lot of components coming in.

MADDOW: Can I ask you just one last domestic question, Doctor, about the
health worker who is infected in Dallas? Is it clear to you that we are
ever going to know exactly how she became infected? Can that be – forgive
the term, but can that be post-mortemed enough in terms of the way she
interacted with potentially infectious waste?

FAUCI: Yes.

MADDOW: Or with that patient to let us know how that happened so we can
stop it from happening at any other health care workers here?

FAUCI: We may not be able to know exactly what this particular individual
came into – how they came into contact with the virus that actually
infected her, unfortunately. But I think a review of how things are
operating there could give some important hints as to what really needs to
be changed.

Clearly it`s not acceptable to have our great health care workers in danger
where they get infected And as Dr. Frieden said on – one of the
interviews that you showed, it is entirely conceivable that there may be
another health care worker that gets infected because if that other person
was working under the same circumstances as this person was doing, they
very well may have been at risk.

So the idea of being very proactive in the training and not just make it
passive like reading Web site or here`s a piece of paper, but to be very
actively drilling to make sure that these people are very talented and very
smart and very good, are actually trained to do it and the idea of getting
that team of CDC people down there to be able to be on site making sure
things get done well I think is a major step forward in how we can
safeguard our health care workers.

But in direct answer to your question, we may not ever know precisely how
this person got infected.

MADDOW: Dr. Anthony Fauci, director of the National Institute of Allergy
and Infectious Diseases at the NIH. Thank you very much for talking with
us about this. I know that this public communications part of it has been
probably a bigger job than you expected. But it`s really, really, helpful
for us. So thank you, sir.

FAUCI: Good to be with you.

MADDOW: Thanks very much.

All right. Much more ahead, including the secret train story that I love
more than life itself. Please stay with us.

(COMMERCIAL BREAK)

MADDOW: September, 2003, President George W. Bush came to New York to
address the U.N. General Assembly. But because the U.N. is in New York
City and because this is just a couple of years after 9/11, the Secret
Service during that trip arranged for President Bush to have an escape
option in case of attack.

The Secret Service, I kid you not, pre-positioned a getaway train
underneath the hotel where George W. Bush was staying in order to whisk the
president away in the event that there was some sort of attack.

A getaway train. There are not that many places in the world where you can
hide a whole train. But that place where they did hide the getaway train
for George W. Bush. That has now become a huge worry in Washington for a
totally different reason.

Amazing story. Coming up.

(COMMERCIAL BREAK)

MADDOW: I know it`s Tuesday, but imagine it`s Friday. You`re off work,
your whole weekend is ahead of you, you have a date. You pick a schmancy
place downtown, conversation is snappy. Entertaining, but not forced.
Everything is going well. You`re already thinking about desert. And then
smoke ball.

What we have for you here is an amazing piece of tape. This is the first
frame of security footage taken outside of a New York City restaurant.
It`s about 6:00 p.m. You can see it`s still light out.

I want you to keep an eye on what happens with this yellow subway grate in
the subway. Watch. OK. Watch the subway grate. See? The circles are
covering up the faces of people eating at the restaurant. What`s coming
out of that little hatch? Hmm, I wonder if that`s a maintenance worker or
something. People eating dinner don`t seem to mind.

Hey. There`s the waiter. Yes, that was a smoke bomb being tossed into a
fancy restaurant. Yes. Can we – can we just watch that part of it again?

Watch the guy with the smoke bomb. You have to love the New Yorker walking
toward the grate as it opens. Doesn`t even blink. He just reroutes around
the grate. Keeps on moving. Guy pops out of the hatch. Yes. The guy
pops out of the hatch, throws the smoke bomb and then goes back down the
hatch.

That yellow hatch is an emergency exit for the subway in case there`s an
evacuation from the station of the tunnels. Apparently it should be
guarded with an alarm. But in this case no. The dude pops out of the
subway hatch, dude tosses the smoke grenade into the restaurant and then
hops back in and disappears.

We have a different angle on it slightly. Just pops out, look there he is.
Pops out, throws the grenade, whoop, back in, disappears. And he really
does disappear. Police say they`re looking for him. White male in his
20s, light wavy hair, wearing an American flag T-shirt. But the dude just
vanished back into the New York City subway system. We don`t know why he
did it. We don`t know if he had some kind of beef with the restaurant if
he was just playing some sort of a prank, if it was a test.

And I mean, there have been some other, you know, maybe it`s a security
breach, maybe it`s performance art moments in New York City over the past
few months. There were the German artists who snuck on to the Brooklyn
Bridge and replaced the flags on top of the bridge, the American flags with
white flags instead.

There was also the dudes base jumping from the New World Trade Center
tower. They taped the whole jump up – I get vertigo just watching it.
But this new one at this Greenwich Village Restaurant this week kind of
makes your stomach turn in a different way. Right?

I mean, what if it was not just a smoke bomb kind of way. Because after
that guy did that weird thing at that restaurant, he popped out of the
subway grate, popped the smoke grenade through it and then went away. The
guy got away scot-free. They haven`t found him.

And so yes, it was just pink smoke but what if it had – sort of changes it
from creepy funny to creepy worrying.

Police say they are still looking for that young man who popped out of the
subway grate. They`re welcoming any tips. If you have one, call the New
York City Police.

We`ll keep you posted.

(COMMERCIAL BREAK)

MADDOW: I love this story so much I can hardly stand it. OK. Here goes.

A few weeks before the great stock market crash of 1929 and the beginning
of the Great Depression, this last bit of gilded age amazement ran in “The
New York Times” September 8th, 1929. Look, New Waldorf gets own rail
siding. Quote, “The New Waldorf Astoria Hotel will have a private railway
siding underneath the building. It was learned yesterday. Guests with
private rail cars may have them routed directly into the hotel. Instead of
to the Pennsylvania Avenue or the Grand Central Terminal and they may leave
their private rail cars at a special elevator which will take them directly
to their suites or to the hotel lobby.”

Must have been grand, right? Taking your own private railroad car and
having it drop you off at a private rail station at the $40 million Waldorf
Astoria Hotel. No need to deal with the hoy-palloy at Grand Central. You
can park your rail car downstairs. The bellhop will help you and your
luggage right into the elevator and right into your suite.

May I light your cigar?

Must have been very, very nice. But then it became national security.
What began as a luxury perk for the unimaginably rich became ultimately an
important escape route and a source of privacy for VIPs including U.S.
presidents when they were staying at the Waldorf when they were in New York
City on official business.

And yes, that train track may have been put in more than 80 years ago
before the Great Depression and all that, but that train line is still down
there. And every few decades it gets discovered again. As mysterious
Track 61, the hidden VIP-only train station stuck underneath this fancy
hotel.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Travelers using the station included General John
Perching and General Douglas MacArthur.

But perhaps the most interesting user of Track 61 was President Franklin
Delano Roosevelt. Not only was it convenient for the president, but it
offered a discreet way for him to travel.

DORIS KEARNS GOODWIN, NBC NEWS PRESIDENTIAL HISTORIAN: He and his advisers
went through elaborate precautions to make sure that even though the
country knew he had polio, they did not know that he could not walk on his
own power again.

UNIDENTIFIED MALE: On the night of October 21st, 1944, after a long day
traveling through the boroughs of New York City President Roosevelt gave a
speech at the Waldorf Astoria.

TEDDY ROOSEVELT, U.S. PRESIDENT: We have to back our American words with
American deeds.

UNIDENTIFIED MALE: Afterwards he descended to the basement.

GOODWIN: When that speech was over, what a pleasure for him to be able,
exhausted as he must have been, to actually go below without people having
to see that body being carried back into the train.

(END VIDEO CLIP)

MADDOW: So the “Today” show a few years ago re-discover the secret train
station and the secret train tracks underneath the Waldorf and how they
were (INAUDIBLE) presidents stay at that hotel. Lots of other countries`
presidents do as well particularly during the big U.N. General Assembly
every year.

In 2003, amid hyper security fears when George W. Bush came to New York
that fall for the U.N. General Assembly, they kept a train idling on the
tracks underneath the Waldorf so President Bush would have a getaway if he
needed it that year.

Here`s the Obama administration piled into the Waldorf just last month for
the annual U.N. meeting. They took up two floors of the hotel. Weirdly
that hotel, the Waldorf, is also the regular home, the permanent residence
for whoever is the U.S. ambassador to the United Nations. If you get that
gig, part of the gig, is that you get a big suite at the Waldorf to live
in.

So the Waldorf isn`t exactly a secondary White House but it`s a little
close. It`s essentially the residential outpost of the president and his
administration for when they have business in New York. And because of
that, it was bigger news than it appeared to be at first when news broke
that the Waldorf had just been sold to the Chinese. To a Chinese company
that has ties to the ruling communist party in China.

U.S. State Department officials now say that this is the thing. The State
Department is publicly expressing their concerns that the Chinese
government might use this new purchase to spy on U.S. officials staying at
the Waldorf. Quote, “Officials said Monday they are reviewing the sale and
implied the glittering renovation scheme for the iconic Park Avenue Hotel
might mask a nefarious purpose – espionage.” As in they`re worried that
the Chinese spies will bug the rooms.

The “New York Daily News” points out that the State Department already
warns U.S. diplomats going to China that their hotel rooms in China could
be bugged. Now they`re concerned that the Chinese might bug hotel room
here, including the rooms where the president stays every year and where
America`s ambassador to the U.N. lives all year round.

Press one for the front desk, press two for the room service, and just
please stay on the line for the People`s Republic of China.

I love this story. I have no idea how this ends, but I love this
story.

That does it for us tonight. We will see you again tomorrow.

Now, it`s time for “THE LAST WORD WITH LAWRENCE O`DONNELL”.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY
BE UPDATED.
END


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