The White House

Office of the Press Secretary

Press Briefing by Press Secretary Josh Earnest, 10/16/2014

James S. Brady Press Briefing Room 

1:08 P.M. EDT

MR. EARNEST:  Good afternoon, everybody.  Nice to see you all.  Apologize for the delayed start today. 

Jim, do you want to get us started with questions?

Q    Sure.  Thank you.  Congrats on the Royals.

MR. EARNEST:  Thank you.  We're pretty excited about them.  I think Sam Mellinger, who is the sports columnist at the Kansas City Star, I think said it best that for a long time we spent most of the year talking about how the Royals haven't been in the playoffs in 29 years; it’s now true that the Royals haven't lost a playoff game in 29 years.  (Laughter.)  So, well said.  So, anyway.

Q    So can you fill us in on what the President has been doing today or will be doing today regarding Ebola?  It seems like -- he cancelled -- he’s been talking about not wanting to create a panic, yet for the second day in a row he cancelled his other activities.  And I wondered if that doesn’t by itself kind of contribute to that sense that something is really amiss.

MR. EARNEST:  Well, I think what it contributes to is the sense of urgency that the President and members of his administration feel about dealing with the situation.  You’ll recall, Jim, that yesterday the President did convene a meeting with members of his Cabinet and other members of his senior staff who are responsible for the response to this particular Ebola diagnosis, and to the broader Ebola outbreak that has occurred in West Africa. 

Today the President will meet with some members of that team here at the White House to continue these discussions and to follow up on some of the actions that the President directed out of that meeting. 

To be clear, what the President directed out of that meeting is a commitment on the part of the federal government to ensure that we're doing everything necessary to detect, isolate and treat Ebola patients when they materialize at health care facilities in this country, and that we do that in a way that protects health care workers and the broader American public.  That is a core priority.  At the same time, the President wants to ensure that those efforts do not distract from the very important work that's being done in West Africa.

Our experts tell us that the only way to completely eliminate risk from the Ebola virus to the American public is to stop this outbreak at its source.  And that's why CDC officials have been on the ground in West Africa for seven months now dealing with this specific Ebola outbreak.  And it's why last month the President announced a significant commitment of resources from the Department of Defense to lend their logistical expertise to improve the flow of personnel and supplies that are being used to mitigate the outbreak in the region.

So that was the topic of extensive discussion in yesterday’s meeting.  I'm confident it will the topic of discussion in the follow-up meeting that the President will convene later today.  In addition to that, the President will also convene a series of phone calls.  He'll call a number of members of Congress to talk about the ongoing response efforts and discuss a role for Congress to play in that ongoing effort.  He'll also convene a call with health care workers from the CDC to talk about that agency’s response to the situation. 

The President will also make a couple of additional calls to foreign leaders.  You’ll recall that over the last 24 hours the President has placed a telephone call to Prime Minister Abe of Japan and convened a secure video teleconference with the Prime Minister of the U.K., David Cameron, the President of France, the Prime Minister of Italy, and I believe the German Chancellor, Angela Merkel, participated as well.  In those conversations, the President reiterated the need for leaders in the international community to step forward with contributions to the effort to stem the outbreak in West Africa.  And the President will be placing a couple more calls along those lines to different world leaders to discuss the same issue.  I do anticipate that we'll have readouts of those phone calls later today.

Q    But reports on that response to provide logistical support in West Africa -- reports today that the President might sign an executive order directing the National Guard to be deployed in Liberia -- can you elaborate on that?

MR. EARNEST:  I'm not in a position to elaborate on that.  I will point out the Department of Defense has indicated that to carry out the mission that the President has ordered in West Africa will require about 4,000 -- or up to 4,000 Department of Defense personnel in West Africa.  So in terms of the composition of that force, I'd refer you to the Department of Defense.  I would anticipate that they’ll be able to share some more details with you about the composition of that force in the next day or two.

Q    But would that require a presidential executive order that would extend to the National Guard?

MR. EARNEST:  For the mechanics of deploying that force I'd refer you to the Department of Defense.  I, frankly, am not sure if a specific presidential executive order is required to do that.  It may be, but the Department of Defense will know for sure.

Q    Also, you pointed out, the President has been drawing attention to the outbreak in West Africa and how serious it is there.  I'm wondering whether, because of that and in response to some comments from members of Congress, is the administration reconsidering the idea of a temporary travel ban from the afflicted region?

MR. EARNEST:  At this point, Jim, that's not something that we're considering.  And this is something that’s been raised a couple of times, and so let me give you a little bit more insight into the thinking about that. 

Currently, when individuals do travel from West Africa to the United States they are screened prior to departure in West Africa.  They are screened again once they enter this country, and they are subjected to heightened screening if they have traveled in these three West African countries in the last three weeks or so.  That is an indication that we are taking the necessary steps to protect the American public.  That is our core priority.  And that is why the President has directed that these heightened screening measures be put in place at the airports where 94 percent of travelers from western Africa arrive in this country.

Now, if we were to put in place a travel ban or a visa ban, it would provide a direct incentive for individuals seeking to travel to the United States to go underground and to seek to evade this screening and to not be candid about their travel history in order to enter the country.  And that means it would be much harder for us to keep tabs on these individuals and make sure that they get the screening that's needed to protect them and to protect, more importantly, the American public.

So we want to keep those lines of transportation open so that those individuals who seek to enter this country -- and again, it's a relatively small number, about 150 a day, that enter this country -- we want to make sure that those individuals are subjected to the heightened screening measures that the President put in place a week or two ago.

Now, separately -- and I've mentioned this before -- it's also important for us to keep this line of transportation open because commercial transportation is critical to ensuring that supplies and equipment can get to the region.  And what that means -- if we acknowledge what the experts tell us, that the only way we can completely eliminate risk of the Ebola virus to the American public is stopping the outbreak at its source, we need to make sure that we're surging supplies and equipment and personnel to the region, not putting in place a travel ban that would only restrict the movement of those materials that are critical to the effort to stem the outbreak at the source.

Q    Nobody is talking about banning going into; it’s coming out of the region that's the issue. 

MR. EARNEST:  But essentially, if you're a commercial air carrier -- I know nothing about the commercial airline industry -- but ostensibly, you're not going to fly a bunch of planes to West Africa and then fly them out of there while they’re empty.  So as a practical matter, putting in place that travel ban would make it harder for the international community to respond to this incident and to mobilize the personnel and equipment that's necessary to stop this outbreak at the source.  And again, the reason that we're focused on stopping this outbreak at the source is not just because it is the humanitarian thing to do, it's also the right thing to do to protect the American people.


Q    Josh, with schools being closed in some states because of this, is there a concern at the White House that people are overreacting to the threat of Ebola?  And would you concede that the White House’s efforts to sort of avoid a panic are not working?

MR. EARNEST:  Well, Jeff, what I would say in terms of the steps that individuals are taking to protect themselves and their communities, I would encourage them to be cognizant of the medical advice of experts.  What the experts tell us is that the likelihood of an Ebola outbreak in the United States is exceedingly low.  The reason -- there are a couple of reasons for that.

The first is, we know very clearly how the Ebola virus is transmitted.  It’s not transmitted through the air; it’s not like the flu.  It’s not transmitted through water that you might drink in the United States or food that you might eat in the United States.  It’s only transmitted when individuals come into close contact with the bodily fluids of an individual that is already exhibiting symptoms of Ebola.

That is why, tragically, we have seen a couple of health care workers, who were trying to meet the medical needs of an Ebola patient in Dallas, who obviously did have to come in close contact with that individual, and tragically they did contract the Ebola virus.  But the risk that they faced was obviously very different than the risk that the average American faces.  So that’s the first thing.

The second thing is, people should be confident in the ability of our medical infrastructure to deal with Ebola cases as they arise.  As I mentioned at the beginning of this briefing, the President did direct his team to ensure that we’re doing all that’s necessary to detect, isolate and treat Ebola patients in the United States, and that we do that in a way that protects both health care workers and the broader American public.

I’d point out that there are already a number of cases of Ebola patients that have been treated in the United States.  There were a couple of -- I guess a total of four or five humanitarian aid workers who did contract the Ebola virus while they were treating Ebola patients in West Africa who were transported to medical facilities in the United States at Emory University Hospital in Atlanta and at a medical facility at the Nebraska Medical Center.  These facilities demonstrated an ability to treat those patients.  Some of the patients who received treatment there have already recovered and been released.  The President has had the opportunity to meet a couple of them.  And those patients were treated in a way that protected the public in those communities and protected the health care workers who rendered them lifesaving aid.  So we do have a track record of being able to handle cases like this, and that should inspire some confidence across the American public as well.

Q    Do you think people are overreacting when they’re closing schools?

MR. EARNEST:  Well, again, I would encourage those individuals who are responsible for making decisions about protecting their communities to rely on the medical advice from experts about the prudent steps that they can and should take to protect their communities.

Q    Has the White House been monitoring the stock market drop, and do you think Ebola is related to that or is helping to spur that?

MR. EARNEST:  Jeff, I can tell you that there are a lot of things that are monitored at the White House, including the financial markets not just in this country but also around the world.  I’m not in a position to play market analyst today.  I recognize that there other people that have appointed themselves as individuals who have keen insight into the kinds of things that are driving the market.  But that’s not something I’m going to speculate on from here.

Q    Is there any concern about the market drops elsewhere in the world?

MR. EARNEST:  Well, we’ve talked -- again, I’m not in a position to talk about specific markets, but I do think that there are indications that broader economies in countries around the world, including economies that are closely linked to the United States, have seen some weakening in recent months.  That’s something that we are concerned about.

At the same time, it underscores the strength of the American economy, that even in the face of some declines that we’re seeing in other markets, or in other economies, the U.S. economy continues to gain strength.  And that is true based on almost any measure.  Whether it’s the job market, whether it’s an evaluation of economic growth, even consumer confidence indicates that the U.S. economy is demonstrating the kind of resilience that right now is the envy of the world. 

The vast majority of the credit for that resilience goes to American workers [who] through their grit and determination have helped this economy recover from the worst economic downturn since the Great Depression.  Certainly our entrepreneurs, our small business owners, and our innovators deserve a lot of credit for what they’ve done to drive our economy forward.  But --

Q    But are you reaching out to those other economies, Josh?

MR. EARNEST:  But what’s important is that people understand that the difficult decisions and the policies that this administration put in place in the depths of that economic crisis have also supported this broader recovery.  And a lot of those policies were the subject of quite a bit of controversy and criticism from the President’s political opponents.  But the fact of the matter is the approach that this President implemented for this country has served the country and our citizens extremely well, particularly when you consider how that stands in contrast to the policies that were put in place in other countries and the results that were experienced by other countries.

In terms of our outreach, the President, as I pointed out, has been in touch with leaders of other countries quite a bit in the last few weeks, and he’ll continue to be.  I also would anticipate that these kinds of conversations will be taking place in the context of the G20 meeting in which the President will participate next month.


Q    You mentioned that the President will be reaching out to members of Congress today.  Who is he going to be calling, and what is he going to ask them to do?  You said that members of Congress have a role that they can play.  What is that role?

MR. EARNEST:  Jennifer, at this point I don’t believe the President has placed those calls, but he is planning to do so later this afternoon.  If we have more information about those calls that we can release at that point, we’ll let you know.

Q    But more broadly, what does the White House see Congress’s role as?

MR. EARNEST:  Well, certainly, Congress obviously controls the purse strings, and so it’s important for us to make sure that members of Congress who have an interest in this issue and have an interest in the kinds of policies that will contribute to this response are aware of the strategy that we’re pursuing and are onboard with it.  We certainly want to give those members of Congress an opportunity to offer up their advice.  If they have some suggestions for some policies that we can put in place that might benefit this response, then we’re certainly going to consider those as well.

But again, I don’t want to get too far ahead out of these conversations that haven't occurred yet.  But if there’s more information that we can share about them I’ll let you know.


Q    Thank you, Josh.  Have there been conversations about designating particular hospitals that are the place for Ebola patients or people who are experiencing Ebola symptoms to go to?  And does the White House think that might make sense?

MR. EARNEST:  Well, I’ll say a couple of things about that.  A designation like that would be the responsibility of the CDC.  They obviously are the point of contact for hospitals all across the country.  Right now -- well, what you have obviously seen in the last couple of days is that the patients in Dallas have been transferred to those facilities.  One in Emory that has a track record of treating Ebola patients.  Another patient was transferred just today to NIH.  That is a facility that’s obviously run by the federal government and a facility that had previously treated a patient that was suspected of being exposed to the Ebola virus. 

So this is a question that CDC is examining right now.  And in terms of a broader policy decision like that, I’d refer you to CDC.

Q    Does the White House have a view on it, on the preparedness of American hospitals for a possible outbreak?

MR. EARNEST:  Well, we continue to believe that the risk of a widespread outbreak in the United States is exceedingly low.  That said, the CDC has taken very seriously their responsibility, at the direction of the President of the United States, to communicated in a detailed fashion with hospitals all across the country about what precautions and what measures they should put in place in advance in the unlikely event, just based on the odds, that they have to care for an Ebola patient.

Again, what we want to make sure that we’re doing -- and this, again, at the direction of the President of the United States -- that all of the elements of his government are focused on detecting, isolating and treating Ebola patients in a way that protects both health care workers and the American public.  And there are a variety of ways that that can be done.  But what the CDC is focusing on right now is making sure that the best possible advice about protocols are being communicated to medical professionals all across the country.

Mr. Zeleny, welcome to the Briefing Room, sir.

Q    Mr. Earnest, thank you very much.  At the House hearing that's underway right now, the subcommittee chairman, Mr. Murphy, from Pennsylvania, he said the reason that the travel ban has not been put in place, it’s because the administration wants to protect fledgling -- the fledgling democracies.  Is that the reason for this?  

MR. EARNEST:  It’s not.  The reason that the travel ban, in the view of this administration, is not appropriate right now is because it’s not in the best interest of the safety of the American public.  Again, people who are traveling from those three countries to the United States right now are subjected to intensive screening both on the ground in those three countries, but also upon arrival here in the United States of America. 

If we were to put in place a travel ban, it essentially would drive those individuals underground, and it would make it easier for them to evade detection.  They wouldn’t be screened at the airport before they left, and it would be harder to ensure that they were being screened when they arrived in this country.

Q    How would it drive them underground, though, if they're flying across the ocean?  How would it drive them underground?  (Laughter.)

MR. EARNEST:  Well, I don't mean literally underground.  (Laughter.)  I mean, that they would be below the radar of the transportation system, that they would now have an incentive to be less than candid about their travel history.  If knowing that they could not travel to the United States by saying that they’d been in Liberia, individuals are much less likely -- if they're planning to travel to the United States -- to disclose the fact that they’ve been in Liberia.

Right now -- again, they're subjected to screening measures on the ground in Liberia and are subjected to screening measures when they arrive in airports here in the United States of America.  Those screening measures are critical to the safety of the American public, and we want to make sure that individuals who are traveling to the United States are monitored as they make their way through the system and screened appropriately.

Q    But can't you understand the question about this that Americans may have?  This summer a brief travel ban was put into place flying into some airports in the Middle East on the hypothetical fear of an airstrike.  And this is an actual case of Ebola.  Can't you at least understand the questions that Americans have about this?

MR. EARNEST:  I can understand the questions.  That's why it’s important for people to have the facts.  It’s important for people to understand how Ebola is transmitted and how it’s not.  It’s not transmitted through the air.  It’s not transmitted through the food and water here in the United States.  It’s only transmitted when an individual comes into close contact with the bodily fluids of an individual that already has Ebola. 

And what people need to have the facts about is the facts that there are screening measures that are in place to ensure that individuals who are traveling from West Africa don't currently exhibit symptoms of Ebola when they try to enter the country.  That's much harder for us to do if we put in place a travel ban, because people will attempt to circumvent that ban and it will make it harder for us to ensure they get the screening we believe is necessary.

Q    Final thing here.  From the very beginning of this administration, the President has always said he can be President from any place.  He has the equipment to do this job any place.  Why cancel for a second day in a row?  It seems like optics if he can do it from any place.

MR. EARNEST:  Jeff, what we are focused on is evaluating the situations on a case-by-case basis.  And there have been circumstances where there has been pressing governmental business where the President has decided to move forward with his travel because he felt like he could perform his responsibilities to deal with that emerging situation, while at the same time dealing with the things that were already on his schedule.

Today, the President and his team made the judgment that it was necessary for him to not travel so that he could remain here at the White House and be focused on ensuring that we have the kind of government response to this situation that's up to the standards that he has set for his administration that he believes the American people deserve.


Q    It seems what you're concerned about is an outbreak of fear in this country.  And would it not go a long way to have the President address the nation in some sort of primetime address to go through some of these common-sense misconceptions that people have about Ebola to put some of these fears to rest?

MR. EARNEST:  That's not something that we're considering right now.  But, Jim, I think this is a place where the American public are depending on faithful public servants like yourself who communicate with them on a daily basis, that when they see your face on CNN with that CNN logo there, they can count on the fact that they are getting accurate information about the world, and accurate information about the threats that's facing them and their families and their communities. 

And that's why I spend a lot of time trying to make sure that you understand because you're a trusted messenger to those individuals.  And so if they can turn on their television, and they can hear from you that they're not going to catch Ebola through the air, that they're not going to catch Ebola by drinking the water in the United States or eating food in the United States, that is going to help reassure people. 

But again, the anxiety that people feel about this is understandable.  We're talking about a deadly disease that is wreaking havoc in three countries in West Africa.  That is a very tragic situation.  But because of the medical infrastructure that's in place in this country, because of the way that we know the Ebola virus is transmitted, people can take some solace in understanding that the risk of a widespread Ebola outbreak in the United States is exceedingly low.

Q    Let me ask you about the second patient who was able to get on the plane.  Apparently she contacted the CDC and was not told by the CDC not to get on that plane.  I assume you're aware of that.  What’s the administration’s reaction to that?  Is that another misstep?

MR. EARNEST:  I think the reaction is something that Dr. Frieden, the Director of the CDC, himself said, which is that that should not have occurred.  And Dr. Frieden rightfully accepted the CDC’s responsibility for that error.

Q    And --

MR. EARNEST:  Well, this I guess would be an opportunity for me to also reiterate that while that should not have occurred, the risk to other passengers we also believe is quite low.  According to those who were on the plane, this particular health care worker is someone who was not exhibiting symptoms of Ebola.  So again, the only way that Ebola is transmitted is through the close contact with the bodily fluids of an individual that already does have the symptoms of Ebola.  So we are -- we have been in touch or are attempting to be in touch with all the passengers who were on that plane to help them understand the risk that they face.  But it’s important for everybody to understand that the risk that they face is quite low.

Q    And you mentioned the importance of getting the message correct and getting the information correct, it’s also important to get the response correct. 

MR. EARNEST:  Absolutely.

Q    And Bruce Braley, who is a congressman -- a Democratic congressman running for the Senate in Iowa, said at that hearing that my colleague Mr. Zeleny mentioned, that he’s greatly concerned that the administration did not act fast enough in responding in Texas.  That's a Senate candidate who is in a very tight race with the balance of power in the Senate on the line saying that your administration did not act fast enough.  Fair criticism?

MR. EARNEST:  Well, Mr. Braley is somebody that has a reputation for being willing to speak truth to power, whether they're in the same party as him or not.  I think this is another indication that he’s willing to do that.

Q    So he’s right in that sense?

MR. EARNEST:  I think Dr. Frieden himself has acknowledged that there have been some shortcomings in the federal government’s response to this situation.  I acknowledged as much yesterday in the briefing, as well.  I think --

Q    You keep going back and saying Dr. Frieden has acknowledged.  Does the White House --

MR. EARNEST:  I guess I say that because he said that.

Q    Okay, but does the White House acknowledge that this response --

MR. EARNEST:  I did that yesterday, Jim, and it continues to be true today.  And what I would encourage people to do is to continue to evaluate the response by looking at what the administration has done to respond to those shortcomings; that the President talked yesterday about how the Centers for Disease Control standing up a SWAT team of experts that can more quickly respond to hospitals that have diagnosed an Ebola patient, that these experts can be on the ground within 24 hours to be there with the health care workers at the hospital to make sure that this patient is getting the kind of medical assistance they need, while at the same time the health and safety of the workers in the hospital and the general population of the community is protected.  That is a reaction to the shortcoming that Dr. Frieden has acknowledged in this response.

What you’ve also seen from the CDC is improved guidance to the health care workers at the facility in Dallas about the protocols they should put in place to protect themselves when they're treating Ebola patients.  There are lessons learned that are being gleaned from that event.  And as there is strengthened guidance for the CDC to communicate to health care professionals across the country, they will do that.  And I would anticipate they would do that soon.

The other thing that you have seen the CDC do is more actively monitor the health status of health care workers from the Dallas facility that we know treated the index patient.  They are doing this in response to the fact that one and now two health care workers has contracted the Ebola virus while treating that patient.  The CDC has appropriately responded by ramping up their monitoring of other health care workers who are, frankly, now at more risk than was previously thought.

And again, that does -- as some critics have already pointed out, including Mr. Braley -- that there have been some shortcomings in our response.  I think this also indicates a commitment on the part of this government at the direction of the President of the United States to the kind of tenacious response that will ensure the safety and welfare of the American public.


Q    There have been a number of statements by Dr. Frieden that suggest that they wish they had done things differently; that he wished there had been a rapid response team in place or a SWAT team, as you call it, earlier.  He said that the nurse, indeed, should not have traveled; that there is a need to enhance the training and protocols; that they have not yet been able to specify what the breach was that caused these infections.  And now we understand that the CDC guidelines that have been criticized as too lax are being beefed up to be more in line with Doctors Without Borders.  So I just want to go back to your statement, which is, “People should be confident in the ability of our [medical] infrastructure.”  Given those statements, has the administration response been more reactive than proactive?

MR. EARNEST:  Well, Chris, I think I can evaluate that statement in a number of ways.  The first is, the federal government, principally through the CDC, but also working with USAID, has been focused on responding to the Ebola outbreak in West Africa since March.  That is when this outbreak was first reported, and that's --

Q    Doesn't that make it all the more concerning that these things have happened?

MR. EARNEST:  Well, I think what it indicates is that the administration has been very forward-leaning in confronting this significant challenge.

At the same time, we’ve also seen medical facilities in both Georgia and Nebraska respond mobilizing expertise and equipment and resources to treat patients.  There are a number of patients who, again, contracted Ebola in West Africa while they were rendering or trying to render medical assistance to individuals that were afflicted with this disease in West Africa. 

Those individuals were evacuated to the United States because of the confidence that we have in the medical infrastructure in the United States to both treat these individuals, but also to ensure that while they were receiving treatment these individuals would not spread the disease to others in America.  That was successfully completed on a number of occasions at Emory Hospital.  The hospital in Nebraska has done the same. 

That is an indication that the medical infrastructure is in place in this country to handle Ebola patients, both to treat them and help them recover, but to do that in a way that it doesn't pose a significant threat to health care workers or members of the community. 

But what you're pointing out are some shortcomings in that response.  And again, I think the way that people should evaluate that is to determine what the reaction to that has been.  And from standing up SWAT teams to offering additional guidance, the CDC and other members of this administration have been tenacious about updating our response to meet the evolving circumstances on the ground.  And that should give confidence to the American public, because it continues to be true that the likelihood of a widespread outbreak of Ebola in the United States is exceedingly low.

Q    Well, can you get more specific on that?  Because part of preparedness is knowing what you're going to face, which is why the World Health Organization has put out projections for West Africa to which America and other countries have responded. But has the President been given or asked for specifics about the projections for infections in the United States?

MR. EARNEST:  I don't know the answer to that, Chris.  I know that this is something that the CDC has looked at.  Again, I don't know what the specifics are of those projections, if they exist.  But --

Q    But would they be important to understanding what we have to have in place to deal with it?

MR. EARNEST:  Well, let me answer that question a couple different ways.  Again, projections are less important because the risk of a widespread outbreak of Ebola in the United States is exceedingly low.  We don't anticipate that that's going to happen.  What we do anticipate is certainly possible, maybe even likely, is that some additional cases of Ebola will occur.  It is possible -- again, maybe even likely -- that there will be additional health care workers from this hospital in Dallas who treated Mr. Duncan who may have contracted the virus.  So that's why we are actively monitoring the health of other health care workers that came in contact with him.

It certainly is possible that other individuals will travel to this country that don't exhibit symptoms in transit, but after they arrive may have the virus.  And we will make sure that we have the kind of response that's needed to, as the President directed yesterday, to detect, isolate and treat those individuals in a way that protects the American public and protects health care workers who are rendering that medical assistance.

Q    And yet, Josh, a nurse at Texas Presbyterian said this morning that if she contracted the disease she wouldn't want to go to that hospital.  She didn’t feel confident.  If she, who loves her job, doesn’t feel confident in going to her own hospital, should the average American feel confident about the treatment they would get at their local hospital?  This is supposedly one of the best hospitals in Texas.

MR. EARNEST:  Well, Chris, let me just restate this again.  The risk that faces the average American from catching Ebola is exceedingly low.  The fact of the matter is, the individuals who have been diagnosed with Ebola at this facility were health care workers who were responsible for trying to meet the medical needs of this specific Ebola patient.  These individuals put themselves in harm’s way to try to render medical assistance to that individual.  That is a heroic thing.  And the fact that they have contracted Ebola is tragic, but we are committed to ensuring that they get expert medical attention and medical treatment.  That's why these patients have been transferred to the facilities where they are currently getting treatment.  And our thoughts and prayers are with them as they fight this disease. 

Q    Well, my question really was to assess the local preparedness of hospitals across the country.

MR. EARNEST:  Right, and I think that goes hand in hand with assessing the level of risk.  And the level of risk of a widespread outbreak in the United States is exceedingly low.  In terms of preparedness, what we want to do is we want to make sure that the CDC, at the direction of the President of the United States, is offering the best guidance that is available to hospitals across the country as it relates to protocols and other measures they should have in place so that they can treat an Ebola patient if one shows up at their facility.

But, again, the likelihood of that happening is low.  And the efforts by the CDC to update their guidance and communicate it clearly to medical professionals across the country is ongoing.


Q    Josh, I want to follow up on the flight ban.  I know before you said, look, there’s already restrictions in place.  But a very wise person this morning said, “I think substantive actions have to be taken, [and they] it may involve flight restrictions, [they] it may involve moving all patients to specific hospitals…I think that would demonstrate a level of seriousness in response to this that is merited.”  You wouldn't disagree with Jay Carney, would you?

MR. EARNEST:  Well, I think Jay raises some good points. And I think, again, that is why you have seen this administration, in response to some of the shortcomings that have been identified, ramp up our response to make sure that we are closing those gaps.

Q    But he said “a level of seriousness.”  Doesn’t that suggest maybe that this administration has to get more serious about these restrictions?

MR. EARNEST:  Ed, I think that the President, based on his response and the response of his team, indicates that we're deadly serious about this.  We're dealing with a deadly disease, and what you are seeing is the kind of tenacious response that the American people are counting on.  And there have been some shortcomings that have been identified.  There have also been responses to those shortcomings to try to close those gaps, to make sure that health care workers are getting the updated guidance, that we're standing up SWAT teams that can respond quickly if other Ebola cases are diagnosed.  And we are responding by making sure that we are doing more to actively monitor those health care workers that we now know are at greater risk than was previously thought.

Q    You say “deadly serious,” and the President -- we don't know how long the meeting was budgeted for yesterday -- maybe you can tell us -- but it went on it appeared for well over two hours.  Some people in the meeting suggest that the President was quite angry that a second health care worker, after he had been told this was unlikely to happen, that he was demanding answers from people.  Do you think that's a fair characterization?  How could this happen again is the way it was described.

MR. EARNEST:  I think the President was very focused on getting answers to some very basic and direct questions about what happened in Dallas and what steps are being taken to correct those shortcomings that have cropped up.  Again, the President, as I described yesterday, believes that some aspects of this response have fallen short of his expectations.  He’s got high expectations for the performance of his government when it comes to ensuring that we're protecting the safety and wellbeing of the American public.

That's why you have seen so much tenacity in making sure that this response is responding to evolving circumstances on the ground.

Q    Given what you're saying, the seriousness of it, then why hasn’t a particular agency been held responsible?  Is there a particular person who’s going to be held accountable?  We've seen this with other stories -- we messed up, somebody dropped the ball, we fumbled -- and a person is not held accountable.  Who is responsible for these shortcomings you're talking about?

MR. EARNEST:  Well, you have seen at least in a couple of instances Dr. Frieden take responsibility for the CDC not performing up to expectations.  At the same time, the CDC has been focused on this situation since March.  They’ve been offering expert assistance to countries in West Africa to try to stem this outbreak.  You have seen the CDC ramp up the kind of assistance that they can marshal so that a SWAT team can be deployed within hours of an Ebola diagnosis.  You’ve seen the CDC draw on their expertise to give clearer and better guidance about the protocols that health care professionals in Dallas and across the country should follow when treating an Ebola patient.

So, again, as we’ve said in a lot of these situations, it's important for people to evaluate the response.  And I think what you're seeing is the kind of tenacious response that the President expects.  There’s a lot more work to be done.

Q    A couple quick follows on other subjects.  Bowe Bergdahl -- we haven't heard about him in a long time.  This administration promised months ago there was going to be a full investigation of whether the law was broken in terms of notifying Congress and whatnot.  I understand the investigation is still in the hands of the Army right now, but is this White House pressing for answers?  Is this going to be released before the election on a timetable soon?

MR. EARNEST:  Ed, I believe that the -- I haven't talked about Bowe Bergdahl in a while either, but my recollection is that this Department of Defense review that is currently underway is focused on determining how exactly Mr. Bergdahl fell -- Sergeant Bergdahl fell into the hands of the enemy.  And it's my understanding that that review is still underway.  So I would refer you to the Department of Defense.

Q    But also a review of why -- about the prisoner swap.  Correct?  Isn't it also about the 30-day notification for Congress?

MR. EARNEST:  I can check on that.  I know that there are a number of members of Congress who have been very interested in that issue.  The fact of the matter is the President determined  that this was clearly in the national interest.  The Secretary of Defense certified that this transaction could take place in a way that mitigated the risk to the American people.  And it secured the release of an American soldier, and the President believes that that was the right move. 

I don't know if there is any ongoing review of that specific aspect of this situation, because the President still believes that was the right thing to do.  And living up -- as the Commander-in-Chief, he felt it was important to make sure that this administration and this government were living up to the principle that we don't leave anybody behind.

Q    Last one.  Any update on when we might get some figures on how much it cost taxpayers for the President to fundraise?

MR. EARNEST:  I don't have any specific stats on that, but we'll work with you on that.


Q    I wanted to follow up on Chris’s question earlier. Each of those instances that she laid out -- the start of her question about the various shortcomings that have come up in the response to Ebola -- at each of those times, what the public was hearing from the White House and from the CDC was that there were these strict protocols in place and there was no cause for concern.  And now you're in a position of saying, well, we've now implemented X, Y and Z in response to those shortcomings and everybody should feel confident in the process now as it is. 

How is that -- why should people believe you now?  Are you concerned about an erosion in public trust based on what you said previously and what you're saying now and what’s happened in between?  And how much of that is a challenge for you guys going forward?  Is there a way where you can get on the other side of that?

MR. EARNEST:  Well, I think -- let me give you just one example about how the CDC has approached this specific issue as it relates to the protocols for using personal protection equipment.  One thing that the CDC did was they actually deployed a couple of nurses from the hospital at Emory that has successfully treated a couple of Ebola patients in their hospital and sent them to this facility in Dallas to do some peer-to-peer training about the proper use of personal protection equipment.  So that is an indication where we’re taking best practices from one medical facility that had had success in safely treating an Ebola patient, and transferring those best practices to other hospitals.

I think, again, what Tom Frieden, the Director of the CDC, acknowledged is that the CDC should have acted sooner to make sure that those kinds of experts were on the ground in a more timely fashion to ensure that the proper protocols were in place and that they were being properly implemented.

I think it is fair for the American public to take some confidence in the fact that we have taken the best practices from a facility that has successfully undertaken this effort and are applying that best practice to at least one other hospital and communicating that best practice to hospitals all across the country.

Q    Just to be clear -- the President is fully confident in the system that’s in place now, given those changes that have been made?

MR. EARNEST:  The President continues to be confident in the advice that we’re getting from our medical and scientific experts about what is necessary to treat Ebola patients in a way that protects health care workers and protects the American public.  In fact, the President has directed that every member of his team, including at the CDC, are doing everything that they can to ensure that Ebola patients are properly detected, isolated and treated, and all that in a way that’s consistent with protecting the American public and health care works who are responsible for meeting their medical needs.


Q    Josh, from the podium you said there is anxiety in the public; you did acknowledge that.  And you said to Jim that the President would not be coming out and making a statement at this time when it comes to Ebola.  And you also said that the press will be delivering the news to help disseminate the news that it’s not as bad as what people are perceiving.  But beyond that, where is the onus on this administration?  What will this administration do further to help lessen a panic as a vast majority of Americans believe that there is a concern about Ebola?

MR. EARNEST:  Well, again, we’re doing everything we can to make sure that people have the facts.  And you did hear from the President directly yesterday at the conclusion of his meeting talk about those facts.  He talked about the fact that he had met nurses who had treated an Ebola patient.  He talked about the fact that we know very specifically about how Ebola is transmitted, that it’s not transmitted through the air or through the food and water in the United States.

So the President himself has addressed this on a number of occasions as recently as just yesterday.  It’s something that I’ve talked about.  We’ve had senior officials like Secretary Burwell, Director Frieden, and others talk about these kinds of facts.  And we do think that the American people should understand exactly what the risk is, and that a full understanding of the risk will help people understand why this is something they don’t need to be concerned about.  But right now it’s understandable that people are concerned because we’re talking about a deadly disease, and the proper way to meet that concern or to address that concern is to make sure they have a full accounting of the facts.

Q    It’s kind of a tight-wire rope type of situation I guess trying to make sure that public is not in a panic situation but delivering information.  When do you say enough is enough, we have to come out and say give more facts than what you’re giving, or just for the President to come out and do an Oval Office or a Cross Hall speech to the nation at night versus the sound bites that come out before a nighttime event, so that people will fully understand that this is something, as you said, that’s going to be harder for them to get than other diseases?  When do you say when?

MR. EARNEST:  Well, you know, April, there are social media channels that we’re taking full advantage of right now, that there are materials that are being circulated by HHS and even from here at the White House to make sure that people have the necessary facts.  We’ve got medical experts from outside the administration.  Obviously, senior administration officials, as well, are playing a leading role in communicating these facts to the American public. 

If we determine that it’s necessary for the President to give a more high-profile address, then we’ll do that.  But right now, given all of the media scrutiny on this issue, and the ample opportunity that I’ve had at least to talk about this issue and to answer your questions, should help people understand exactly what the risk is. 

And again, I think it is perfectly understandable that people would have some concern.  We’re talking about a deadly disease, and we’ve acknowledged that there have been at least a couple of shortcomings in the response.  But more broadly, what people should take solace in is that they’re not at high risk of getting Ebola.  In fact, the risk of an Ebola outbreak in the United States is exceedingly low.  And what you’re seeing is a health care system in this country and a federal government in this country that have already demonstrated an ability to take in patients from West Africa -- there are American citizens who are performing humanitarian medical work -- to bring them to this country, to treat them, to do it in a way that allows them to recover, but also doesn’t expose the health care workers in the hospital or people in the broader community to a significant risk.

So that experience and that track record should give people some confidence that the administration is mobilizing the kind of tenacious response that they deserve.

Q    And lastly, a very simple question:  What is the mood of this administration right now as you’re challenged with a lot of issues, not only here, but around the world?  What is the mood of this administration, particularly this President?

MR. EARNEST:  I think the mood is determined.  You have a President who is dealing with a lot of pressing issues right now, but the President, as you would expect, and I think is pretty obvious to anybody who’s watching, that the President takes very seriously his responsibilities as the leader of the country and as the Commander-in-Chief.  And the President is working hard and is pushing his team really hard to make sure that, at least in this specific situation, that we’re mobilizing the kind of response that’s up to the standards that the President has set for his administration, and the kinds of high standards that the President has set for serving the American people.


Q    Josh, can you indicate what the coverage will be today, how will we be able to see any of these things the President is working on -- transcripts or other things like that?

MR. EARNEST:  We’re still working through the details on this.  I don’t actually even know what time the meeting is at this point.  But as we lock down some more of these details we’ll be in touch with you about the logistics.

Q    Can we anticipate at least seeing the President today?

MR. EARNEST:  There’s a possibility of that, but again, let us lock down the details and we’ll get back to you.

Q    In the phone calls with members of the Congress, is the President trying to lay the groundwork for a request for additional funds to be dealt with during the lame duck?

MR. EARNEST:  It’s unclear at this point whether or not that will be needed.  But certainly these are the kinds of issues that we want to confer with them on the front end so that if that eventuality arises that it’s not a surprise to either them or us.

Q    So it’s possible.

MR. EARNEST:  It’s possible.  I wouldn’t take it off the table.  But at this point we’re just having conversations with them about what may be needed.

Q    And I just want to double-back on the executive order regarding the National Guard.  Are you saying that you’re not sure if the President needs it?  Or are you saying that you are aware that he has ordered it and it’s just a matter for the Pentagon to carry out that order without anything required from him as far as signing a piece of paper?

MR. EARNEST:  It’s the mechanics with which I am unfamiliar.  The President has laid out very clearly what the mission is.  The Department of Defense has told the President that it will require about 4,000 Department of Defense personnel to execute the mission the President has directed them to execute. 

What I don’t know is the composition of that force and whether reservists or National Guardsmen will be required to augment that force.  And if they are required, I don’t know if the mechanics dictate that an executive order has to be signed by the President, or if that’s something that the Department of Defense can go ahead and act on.

Q    Related to that, is the President asking all those who are on this team what are his executive order powers to do things to address this particular Ebola issue?  Nurses have asked for him to do things as far as sending -- using his executive power to make some very clear communications about clothing or other procedures in hospitals.  To what degree is the President asking for that information and contemplating using something you’ve talked about a lot this year, his pen, to address some of these shortcomings and improve the federal response?

MR. EARNEST:  Well, out of the meeting yesterday, the President was very clear about directing his team to make sure that we are using all the necessary federal resources and authorities to detect, isolate and treat Ebola patients, and do it in a way that we could protect the American public and the health care workers who are rendering them assistance.

So that is something that, if necessary, the President I’m confident will not hesitate to use.  But at this point, I don’t know if it’s necessary for -- or at least we haven’t come across a situation where it’s necessary for the President to invoke a specific executive order or an executive authority in order to get something done. 

Obviously, a lot of this response is being driven by the executive branch of government.  And that’s why the kind of whole-of-government approach that you’ve seen is one that the President is leading and directing, and will continue to do so, to ensure that we’re meeting the high standards that he has set for his administration. 

Q    On ISIL, since a week ago, from Thursday to today, roughly 150 people have been killed in suicide bombs in Baghdad.  Thirty-six died today in a massive attack.  Does the administration believe this is a signature tactic of ISIL and this is something that has been introduced new into the reality of Baghdad?  And even if it may not be under immediate threat from a full-on assault from ISIL, from the West, it is nevertheless having its daily rhythms and life vastly disrupted by an ISIL tactic that is somewhat new?

MR. EARNEST:  Let me answer your question in a couple different ways.  Let me first start by saying that Deputy National Security Advisor Tony Blinken was in Baghdad and Erbil over the last three days to meet with senior Iraqi officials and U.S. embassy and consulate staff to discuss the latest political and security developments in Iraq and the region.  That presumably, Major, includes the recent spate of bombings that we’ve seen in and around Baghdad.

In his meetings, Mr. Blinken emphasized the United States’ commitment to continued support for the Iraqi government and security forces in safeguarding a unified Iraq in combating our common enemy, ISIL.  Tony’s meetings in Baghdad included discussions with President Masum, Prime Minister Abadi, Council of Representatives Speaker Jabouri, Foreign Minister Jaafari, National Security Advisor Fayyad, and other senior Iraqi officials. 

In Erbil, Mr. Blinken met with the Iraqi Kurdistan region President, the Kurdistan regional government Prime Minister.  And he also received a briefing from U.N. officials on the humanitarian situation in Iraq, including assistance to displaced people and refugees.

Mr. Blinken’s comprehensive discussions in Iraq covered the full range of issues at stake in our cooperation with the Iraqi government and people in the fight against ISIL.  He expressed appreciation for the government of Iraq’s progress in forming an inclusive government and in resolving political differences so that the strongest possible force is brought to bear against ISIL.

Let me also -- as a more direct answer to your question -- note that we strongly condemn the terror attacks across Iraq in recent days that have cost scores of innocent lives.  We’re committed to working with the government of Iraq to end this terrorist scourge and strengthen the capability of its security forces to take the fight to ISIL.  We extend our condolences to the families of the victims and hope for a rapid recovery for those who were injured.

Q    And what would you characterize has been going on in the last 48 to 72 hours in Kobani?  You’re seeing a lot more specifically targeted airstrikes there.  And does the administration now believe what appeared to be something that might be an overrunning of that small village might have been forestalled and possibly ended?

MR. EARNEST:  Well, I’d refer you to the Department of Defense for the latest assessment about what’s happening there.  And it’s a pretty dynamic environment so I don’t want to get out in front of that.  I mean, what you have seen is --

Q    CENTCOM is making it clear that there’s been a very good deal of activity there in the last couple three days.

MR. EARNEST:  Yes, that’s evident.  They are -- CENTCOM has been pretty consistent about putting out information about the airstrikes that are conducted by the United States and our coalition partners in Syria, and they’ve been pretty specific about the fact that the number of airstrikes around Kobani have increased in recent days.

Just last night -- I don’t know if they put this out yet -- but another 14 strikes were conducted around Kobani just yesterday.  And the United States and our coalition partners are continuing to target our air power in the vicinity around Kobani. 

Now, the reason for that is that we are, as we’ve discussed many times, striking ISIL in Syria to try to diminish the group’s ability to project power, to erode their military and economic infrastructure, and to deny them a safe haven.  And what we have seen is we’ve seen that ISIL fighters and materiel and supplies have been marshaled in and around Kobani as they mount this offensive.  What that has created is -- essentially are a set of targets for American airstrikes to occur. 

So as we’re seeking to degrade the ability of ISIL to operate in Syria, taking strikes at clusters of fighters or at pieces of equipment, they’re all now operating -- or at least there are a large number of them in a pretty concentrated area in Syria, and that’s enhanced the environment for military airstrikes.  And that is what accounts for the stepped-up operational tempo in that region of Syria.

Q    This may sound flippant, and I don’t mean it to at all.  The Pentagon has a name for this operation now:  Inherent Resolve.  What does that mean? 

MR. EARNEST:  Well, it’s a name that was given by the Pentagon.  So in terms of --

Q    Are you comfortable with it?  Is the President comfortable with it?  But what does it convey?

MR. EARNEST:  Sure, absolutely.  I think it conveys the commitment of the international community to something that is not going to be a short-term proposition.  The President has been clear that this is going to require a sustained commitment, and that it is critically important to not just the United States but to all of our coalition partners that this kind of extremist organization is not allowed to establish a safe haven in Syria; that that is inherently threatening to countries in the region, and potentially could be threatening to the United States and our interests around the world and maybe even eventually here in our homeland.  And that is why the President has laid out a strategy for degrading and ultimately destroying this organization.

Q    So the point is to convey it’s going to take a long time. 

MR. EARNEST:  I think -- well, again, in terms of the name, you’d have to check with the Department of Defense.  They may have a more cogent explanation than I do.  Based on my reading of it, I do think that it is an intent to convey that all the members of our coalition have a -- are resolved to confront this threat and to ensure that this extremist organization is not able to establish a safe haven inside the power vacuum that currently exists in Syria right now.

MR. EARNEST:  Let’s move around.  Justin.

Q    I just had a quick one on the consultations with Congress.  One thing that many lawmakers -- dozens of lawmakers, including some Democrats, have mentioned is the travel ban.  And I know you’ve explained why you guys oppose it, but Republicans have said that they’re going to introduce language when they get back.  Ted Cruz has even said that Congress should be called back immediately to address that type of legislation.  If it were to come up and pass, is it something you guys would veto?

MR. EARNEST:  You’re talking about a piece of legislation that hasn’t even been introduced yet, so I won’t at this point convey our position on it beyond what I’ve already explained about how putting in place a travel ban would actually increase the risk to the American public.  And because the President’s focus is on trying to reduce the risk, we want to leave those travel channels open so that we can screen those individuals when they enter this country, and we can do more to ensure the safety of the American public.

Q    And then really quickly, I know yesterday you explained why a kind of czar, an Ebola czar might not be necessary because everybody has got their distinct channels and understands their responsibilities, but I’m wondering if that was something that came up in the meeting with the President.  Was that idea floated or discussed?  And do you guys still feel like it’s not something that you’re going to go for?

MR. EARNEST:  Well, what we continue to believe is that the clear lines of responsibility have been established, and they continue to exists; that it is the clear responsibility of the Department of Defense, for example, to leverage their logistical expertise in West Africa to improve the response to the outbreak in that region of the world.

For example, CDC and HHS have important responsibilities here at home.  DHS and CBP have responsibilities for monitoring ports of entry, including airports; that everybody does have a clear line of responsibility.  And the President is holding those agencies and the leadership of those agencies to a high standard for executing on their line of responsibility.

Everybody who is responsible for some aspect of this response was -- participated in that meeting in the Cabinet Room, and I think all of them walked away with clear direction they’d received from the President for ensuring that we are at the top of our game here.


Q    I wanted to follow up back on this notion of are there designated hospitals or anything.  Because one thing that is true is -- you keep pointing to these examples of success -- Emory University, certainly NIH.  But these are hospitals different than Presbyterian in Dallas.  I mean, these are state-of-the-art facilities.  Now the President says, well, if there’s an Ebola case, we want to get one of these SWAT teams in place.  When the first patients, Dr. Brantly and Ms. Writebol were treated, the question was asked then, can people go to any hospital?  And the answer from both Emory University and the Centers for Disease Control was, yes, any hospital in America is able to handle one of these cases.  Does the President still believe that is true?

MR. EARNEST:  The President does still believe that that’s true.  The goal here -- and this is indicative of the kind of response that we have deployed to the situation in Texas -- we want to make sure that the best practices that have been learned and successfully deployed in the Nebraska Medical Center, at NIH, and at Emory, that those best practices are shared with health care professionals across the country.

And there is more that the CDC believes can and should be done to support hospitals in the unlikely event that they are dealing with an Ebola patient in their facility.  So what Dr. Frieden expressed was the importance of having medical experts on standby who are ready to travel on very short notice, that they can be at a hospital within hours of an Ebola diagnosis; that these experts can be on the ground, standing next to hospital administrators, doctors and nurses as they're trying to meet the medical needs of this patient.  And we believe that that is an effective template for managing the situation.

Q    But that wasn’t the template initially in Dallas.  The CDC has said as much that --

MR. EARNEST:  That's correct.

Q    -- maybe they should have responded quicker.

MR. EARNEST:  That's correct.

Q    Was that slowness, or just the misreading of how quickly they should respond because there was a belief that is now maybe in doubt that any hospital in America had the proper procedures and protocols in place at that time?

MR. EARNEST:  I think the concern that we have about what happened in Dallas is that experts weren’t on the ground right away to help those local officials maximize their capabilities to care for these patients in a way that didn't endanger the health care workers that were trying to render this lifesaving aid.

And so what we're talking about here is the kinds of best practices that now can be applied to other facilities -- again, in the unlikely event that they are responsible for treating an Ebola patient that shows up at their door.


Q    Josh, I want to follow up on that.  I have two questions related.  Jared, to follow up what he was asking -- 24 hours after the President endorsed the SWAT team approach, as Jared points out, the policy has switched to removing the patients to the most sophisticated health care facilities in the nation to handle infectious disease.  So if you are a hospital or a health care worker out there, you are now going to expect that you are going to get removed after being stabilized -- not that you will be treated until you recover at a health care facility.  Has the President confused the situation even more 24 hours after he endorsed the SWAT team approach?

MR. EARNEST:  No, Alexis, he has not.  The fact is this is does not reflect a policy change.  It reflects decisions that are being made by medical professionals about the proper course of treatment for specific patients.  That's obviously not something that I’m going to comment on from here.  It’s something that I’m not qualified to comment on.

But what we're going to do is we're going to make decisions that we believe are in the best interest of the patients and the best interest of those health care workers who are treating them.  We continue to believe that with the expert assistance of a SWAT team that's deployed on short notice, that hospitals across the country do have the capability for managing the situation in a way that doesn't pose a significant risk to their employees or to the community.

But in this case, these two individual patients were transferred in the last 24 hours.  But again, that does not reflect a policy change, it reflects a commitment to putting in place a treatment protocol for those that's best suited for those patients.

Q    The second question is, because yesterday and today you have many times emphasized that the CDC is in a position of offering guidance and monitoring and suggestions and best practices, but you have also indicated that nurse number two has been moved to a federal facility, NIH -- she is now in the care of the federal government.  So my question is, has the President considered using the Stafford Act or the National Emergencies Act or HHS’s power to declare a national health emergency to federalize all Ebola responses?

MR. EARNEST:  Well, let me correct one thing.  I believe that it’s actually health care worker number two, the woman who was more recently diagnosed, was yesterday transferred to the facility in Atlanta.  It’s the first health care worker that was diagnosed with contracting the Ebola virus that was transferred to the NIH facility today.

As it relates to the Stafford Act, I’m not aware of any consideration that currently is underway at is relates to the Stafford Act or any sort of national medical emergency.  I wouldn’t rule it out, but, frankly, I don't know what those sorts of -- the entirety of what those designations entail.  But that's not something that we're actively considering right now.

Q    And just to clarify -- the Dallas hospital had assured the nurse that you just described, that her care would be covered by the Dallas hospital.  But just to correct the record now, her care is being covered by the federal government?

MR. EARNEST:  When you say “covered by,” what do you mean?

Q    In other words, the hospital said that any costs incurred by the nurse for her health care or her family -- obviously her family nearby -- that it would be covered by the hospital in Dallas.  They made that offer.  But --

MR. EARNEST:  I’ll be honest with you, Alexis, I’m not aware of what arrangements -- what financial arrangements have been made for her care or what sort of insurance she’s covered by.  All I know is that she is currently being treated at a federal facility.  In terms of what the consequences are for her medical bills or for insurance coverage --

Q    So when nurse number one goes to NIH and the other goes to Emory, the actual cost, how it’s covered may differ?

MR. EARNEST:  I am not aware of what sort of financial arrangements are in place to cover the costs of the treatment of these two individuals.


Q    Josh, you spoke earlier about media coverage of the Ebola situation.  Do you think that some of the media coverage is over the top and might be contributing to needless alarm or even panic?

MR. EARNEST:  There are plenty of media critics out there, and even people who are amateur media critics will take their own opportunity to evaluate the quality of media coverage of this and other events.  But I’m smart enough not to do that.  (Laughter.)

Q    When did the number of forces needed in Africa, West Africa go from 3,000 to 4,000?

MR. EARNEST:  I think that all along the Department of Defense has described that as the range that they needed.  I think what they said was between 3,000 and 4,000.  I recognize that I’m confusing it by now describing as up to 4,000.  But those two things aren’t necessarily inconsistent.

For the precise evaluation or assessment that the Department of Defense has reached, I’d refer you to them.

Fred, I’ll give you the last one.

Q    Thanks, Josh.  Just on the flights, we have two patients now.  Would there possibly be any kind of trigger or threshold that would make you reconsider your views on flight restrictions or some variation of flight restrictions even if it’s not a total travel ban?

MR. EARNEST:  Can you tell me -- what was the first part of your question again?

Q    Well, I said, like, maybe a trigger or a threshold.  I mean, if there are more patients, if there are increased concerns, would there be -- would that cause the administration to rethink if not a travel ban then some sort of variation of a restriction?

MR. EARNEST:  At this point, we're not considering a travel ban at this point.  Does that mean that it could change?  I suppose that it does.  But again, based on the circumstances as we are aware of them now, it’s not something that we're considering.

You do raise a good point, though, which is that this Ebola outbreak occurred seven months ago.  And so far there is one individual over the course of that seven months that has traveled to this country from West Africa and started exhibiting symptoms of Ebola after they arrived.  That's only happened once.  And so I think that is a relevant statistic as people evaluate the wisdom of a travel ban that in a different circumstance and could actually have the perverse effect of giving individuals an incentive to evade monitoring.

I guess the other thing I should mention in the context of your question is that the screening doesn't just occur in this country when individuals from West Africa are seeking to enter the country.  It does occur if we know that they’ve been in those countries recently.  But it also occurs on the ground in West Africa in the three countries where the Ebola outbreak currently exists.

We also know that there are dozens of individuals that were exhibiting symptoms of Ebola who were denied boarding from those planes.  And so again, if we put in place a travel ban from West Africa, those individuals could go to other countries and try to travel here and disguise their original destination.

Now, the thing that's important for people to understand is that when those individuals who were denied boarding were tested, they were not found to have Ebola.  But it indicates how important it is for us to have those kinds of screening measures in place to protect the American public.

And again, that is the bottom line for the President.  If we're trying to protect the American public, we should not put in place a travel ban.

Q    And just to follow up on that -- when the President spoke to the world leaders yesterday, did this topic ever come up about what other governments would be doing or what they might be considering?

MR. EARNEST:  I know that the focal point of the President’s conversations with them on this topic are related to the need for other members of the international community to ramp up the assistance that they are providing to the response in West Africa.  I frankly don't know whether or not they had a discussion about a travel ban.

Chris, I’ll actually give you the last one.  You seemed very disappointed when I told Fred he was getting the last one.

Q    I was, because I have a set of questions, actually.  They’re a little bit different, as usual.

MR. EARNEST:  All right.  Good.

Q    On Monday, a forum is taking place here in D.C. featuring transgender members of the armed forces who are unable to serve in the government openly because of government regulation.  It’s been five months since the White House has said it backed Secretary Hagel’s efforts to review the policy, but there hasn’t been any movement.  Has this potential review come up at all in conversations between the President and the Secretary?

MR. EARNEST:  I know the President is meeting with the Secretary today.  I don't know if this is on the agenda for that meeting.  I guess it occurred earlier, so I don't know if it was on the agenda for that meeting.  But I’d refer you to the Department of Defense who should be able to give you an update in terms of the status of that report and when you can expect it to be finalized.

Q    The President has spoken numerous times though about the success of “don't ask, don't tell” repeal under his administration.  If the President is going to take the lead in allowing openly gay people to serve in the military, why not do the same -- why isn’t he taking the lead for openly transgender people?

MR. EARNEST:  Well, I do think that the President’s commitment to equality is one that he has articulated many times.  He also believes that commitment to equality makes our country stronger, and he believes that it makes our armed forces stronger.  So his commitment to that principle is unwavering.  But as it relates to how it is implemented in the armed forces, that's the subject of an ongoing review and I’d refer you to the Department of Defense for a status update on it.

Q    Will the President himself call for openly transgender (inaudible) before the end of his administration?

MR. EARNEST:  I don't know the answer to that, Chris.  We’ll have to get back to you on that.  Okay? 

Thanks, everybody.  Have a good afternoon.

2:19 P.M. EDT

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