Note: Clarification was provided by General Rodriguez, following the briefing:
"In response to comments I made today about U.S. military personnel potentially coming in direct contact with Ebola infected individuals, specific to lab testing, I want to clarify my remarks. U.S. military personnel working in the labs are not interacting with patients, only samples. The testing labs are manned by highly skilled and trained personnel from the U.S. Naval Medical Research Center. These labs provide 24-hour turnaround results on samples received from area clinics and healthcare providers, with the capability to process up to 100 samples per day."
REAR ADMIRAL JOHN KIRBY: Afternoon, everybody. I'm proud to welcome into the briefing room General David Rodriguez, commander of Africa Command. He's here to give you an update on U.S. contributions to the effort against Ebola -- U.S. military contributions to the effort against Ebola in West Africa. And with that, sir, I'll turn it over to you.
GENERAL DAVID RODRIGUEZ: Thank you.
REAR ADM. KIRBY: By the way, I'll moderate, and so I'll just let you know, we've got 30 minutes total.
GEN. RODRIGUEZ: OK, well good morning. Good to see you all again. I'm glad to have the opportunity to talk to you about how U.S. Africa Command is supporting the comprehensive U.S. government effort to help contain the outbreak of Ebola in West Africa.
As you know, the president considers containing the spread of Ebola to be a national security priority that requires mobilizing our collective resources to enable the success of the international effort.
Recently, I discussed the progress of the response with the president, who underscored the pivotal role of American leadership in containing the epidemic at its source. In support of U.S. government effort, the military focus is on providing logistics, training, and engineering support in conjunction with the greater interagency effort.
We stood up the headquarters, joint force command, United Assistance in Monrovia, Liberia, to provide regional coordination of U.S. military support to the U.S. and international relief efforts.
Finally, we placed two additional mobile medical labs into operation last week, significantly increasing the capacity for rapidly diagnosing Ebola. We are also establishing a facility capable of training health care support workers, enabling health care workers to safely provide direct medical care to patients.
Now, this is very important, and I want you to help us to tell our families and the American public the health and safety of the team supporting this mission is our priority. Let me assure you, by providing pre-deployment training, adhering to strict medical protocols while deployed, and carrying out carefully planned reintegration measures based on risk and exposure, I am confident that we can ensure our service members' safety and the safety of their families and the American people.
As we deploy America's sons and daughters to support this comprehensive effort, we will do everything in our power to address and mitigate the potential risk to our service members, civilian employees, contractors, and their families.
Preventing the spread of Ebola is the core task of this effort. This is a key requirement in everything that we do in this operation, and this applies both to our support efforts and the protection of our own people.
The professionals at Doctors Without Borders have a remarkable record of safe operation in their fight against the spread of Ebola. We have looked at their procedures and consulted with the U.S. Agency for International Development, the Centers for Disease Control, the World Health Organization, and others, to develop our protocols based on known risks and prudent planning.
We are taking the following steps to ensure the safety of our people. We are implementing procedures to reduce or eliminate the risk of transmission to service members as they go about their daily missions while deployed, including the use of personal protective equipment, hygiene protocols and constant monitoring.
So, again, let me assure you, by providing the pre-deployment training, adhering to strict medical protocols while deployed, and carrying out carefully planned reintegration measures based on risks and exposure, I am confident that we can ensure our service members' safety and the safety of the American people.
In the end, our equipment, training, procedures, and most of all, the discipline of our leaders and our force will help us to ensure that our team accomplishes the mission without putting our nation and fellow citizens at risk. And as I said before, stopping the spread of this disease is the core mission here.
We are all focused our effort -- we are focused in all of our efforts to accomplish this both by supporting the international effort and by keeping our own people as safe as we can.
And with that, I'll take your questions. Thank you.
Q: There's been some questions about whether the response to the overall crisis has been too slow. Do the troops that you have now, will they -- are they enough to get the job done, do you think? Or do you think, in order to move things along more rapidly and construct some of the facilities more quickly, do you think you're going to need more troops there? And, secondly, do you have a cost estimate yet on the military response?
GEN. RODRIGUEZ: Well, first of all, one of the challenges, as you can imagine here, is continuing to gain and grow situational understanding over time because of the -- some of the isolated places that is creating problems. So we're supporting the USAID efforts to do that.
And right now, the leadership has approved up to, you know, almost 4,000 people, as Admiral Kirby talked to you about. And we have a lot of flexibility to put people in there as they're needed and who's needed.
So I think right now we have the sufficient capacity and numbers to do that. The speed at which these things are done is -- it's not just one challenge with doing that. Part of it is the ability of the host nation to absorb it. As you can imagine, their infrastructure and their capacity to house people, to feed people and all that is limited. So it's all going to have to come in, in a very, very carefully orchestrated -- based on the demand out at the front.
At the same time, they're increasing their situational understanding over time. So just as an example of that, these mobile labs are very, very important because, as you can imagine, some people have malaria, some people have the flu, and it's really important to find out who you have to treat and who you don't. So we've already flown two more those in that are already having a major impact, and we have several more on the way to better adjust.
But, again, that wasn't what we expected when we got the first mission, so I think we have the right flexibility and ability to adjust as needed, ma'am.
GEN. RODRIGUEZ: The cost estimates right now are probably around $750 million for our efforts, and that's in about a six-month period. And, again, the challenge with doing that is that those labs, for example, were not in the current -- you know, in the initial plan, so it's going to have to be a free-flowing, flexible adjustment on all that, ma'am.
Q: General, will any U.S. military personnel be involved in the direct treatment of any Ebola patients or in the training that health care givers -- will they be -- come into contact with any Ebola patients?
GEN. RODRIGUEZ: No. Now, the mobile labs are different. But no for the majority of the force. The mobile labs are testing people, OK? And some of them will have the Ebola virus. Now, those are trained at the highest level of something like nuclear, biological and chemical. So they're all trained at a very, very high level. And they've been -- the one from Walter Reed has been operating there for many years, for example. And the two that we just deployed meet those standards of training.
Q: Do you have any numbers of those who will be involved in the lab operations? And what kind of protections or what kind of protocol will they observe? And if any U.S. military personnel should contract Ebola, what is the protocol there? What happens?
GEN. RODRIGUEZ: Yes. First, on the -- the numbers in the labs, they're between a three- and a four-person team. We have three labs deployed right now. We will probably deploy several others. So it'll add -- one lab adds three to four additional people.
And, again, those people are trained to the very highest level of operating in a nuclear, biological, and chemical arena, and they are tested continually, and they are the ones who are testing all the people. They will be the primary ones that come in contact with anybody.
On the second point, if somebody does contract Ebola and becomes symptomatic, they will be handled in -- just like you've seen on the recent ones who came back on an aircraft that was specially designed to bring them back, and they'll go back to one of the centers that is specially designed to handle the Ebola patients right now.
Q: So they'll be returned to the U.S.?
GEN. RODRIGUEZ: Yes, they will. Yes.
Q: Will U.S. armed forces personnel be working side-by-side with Liberian troops as they build these emergency treatment units? I thought we had been told that they would be separate from the Liberian forces. Is there a risk of contamination by working closely with the partner nation's troops? First question.
And are you -- do you have enough of the personal protective equipment that you need? Or is there a shortage of that? And have you stockpiled any of this ZMapp, the treatment that was given to the two missionaries that had been proven in case troops are exposed to the virus?
GEN. RODRIGUEZ: We are -- we have people that will be working with and observing the other people who are building the ETUs [Ebola treatment unit], whether it be the Armed Forces of Liberia or contractors, to ensure that they're meeting the standards and oversight.
All the people who are doing that are tested and meet all the medical protocols to ensure that they do not have the disease. And then the continual daily checks are also a part of it. So all the people that we're working with go through that -- those medical protocols.
On the last point, on the virus, we do not have that stockpiled. And right now, that is -- you'll have to get the expert opinion of the CDC, but that's still to be determined whether it's effective or not, and they have a date in the future when it -- they may be able to tell whether it's effective or not, so we are not stockpiling that.
And last, we have sufficient personal protective equipment for ourselves, and we will continue to make sure that that's the way throughout the process.
Q: Can you tell us a little bit about where these 3,000 or 4,000 service members will be housed? And can you give us a little bit more information about what kind of personal protective gear are we talking about? What kind of hygiene protocols are we talking about? And what kind of monitoring is going to be done on a daily basis?
GEN. RODRIGUEZ: Yes, for the -- for the majority of the people, they will be in places, like the Ministry of Defense, or some of the military posts that are out there. Some will be over at the airfields and the locations where people will be flowing in personnel and equipment. We will have trainers that are in a training facility. And most of these places that are in and around Monrovia are actually in buildings.
The people will either live in the Ministry of Defense areas or they will live in tent city-type procedures, where everything will be taken care of for them, to include their food and water and those things, because you have to watch all that, obviously, at these points.
And then on the -- the protocols that occur in a daily monitoring, mainly, it's built around the multiple washings that you have to do with your hands and feet and everything else. I mean, when you go in one of these Ebola treatment units, you're going to wash your hands and feet multiple times. You're going to get your temperature taken in and out. And then there is a checklist of things to ask each personnel based on the -- the virus or any other sickness, quite frankly, that could be coming up. OK, it's just like a self-questionnaire and a checklist.
Q: And the personal protective gear?
GEN. RODRIGUEZ: The personal protective gear, the majority of the people will just deploy with personal protective gear that includes gloves and masks and things like that. They don't need the whole suit, as such, because they're not going to be in contact with any of the people.
Q: Understanding your point about the ability of Liberia to absorb all this stuff, you still -- you have the feeling that if, say, the American embassy were under attack in Liberia, it wouldn't take the 101st Airborne weeks to get there. So what is it that is -- what is it about this operation that makes it seem to be unrolling in a much slower pace than -- than sending U.S. troops to protect Americans first?
GEN. RODRIGUEZ: There's -- the protect the Americans piece is a small number. We already have about five times what we've sent in, for example, in Libya to protect the U.S. embassy in that situation, and that infrastructure was there as well as of the ability to sustain themselves.
The other challenge out there in -- in Liberia is, as you can imagine, their whole nation is overwhelmed. Their health facilities are overwhelmed. There -- there's -- that's all broken down. So, we have to bring in everything at the same time.
And again, they -- they -- right now, the ETUs, for example, aren't even located -- all the locations where they want them.
So, those are some of the challenges that we're being faced with that, you know, we just can't -- we just don't want to overwhelm them and press things in there that cannot -- they can't absorb at all.
The airfield is the same way, for example.
Q: Could you tell us how the decision was made to not have U.S. military medical personnel treat Ebola patients directly, and do you have any concerns about manning these Ebola Treatment Units? On the ground, there's been calls from Doctors Without Borders that more people are needed, not necessarily more facilities, although both are needed, so if you could answer one of those.
GEN. RODRIGUEZ: I'm not so sure about how the decision was made, but the bottom line is that's the position right now of the leadership. It's the international community's role right now, and that's where everybody is encouraging people to come forward to do that and -- and that's where -- where we stand until we move, you know, to some future thing that they'll -- they'll continue to relook the decision and continue to adapt to what's required on the ground.
Again, we're filling in the demands that the international community needs us to do. That's for command and control, it's for engineering support, it's for logistics, and those type of things. OK, so that's where we're focusing our effort, OK. And that's what they've asked us to do.
Q: Do you believe right now that there's a scenario that you can see that would push you past 3,900 or 4,000, and on the -- and the question of -- of security, do you think the concerns in Congress about the security of U.S. troops there, be it just contamination risks or force protection in a situation where people are trying to get into an area that was off-limits, do you think that those concerns are overblown?
GEN. RODRIGUEZ: I think that you know, we have -- our service members, wherever they go, they have the ability to defend themselves and protect themselves, and they'll have that here. And I think that that will, you know, we'll meet that standard no matter where we go anywhere in the world, and we're going to do that here, too.
Q: So, what are the rules of engagement if it's a contaminated person who's unarmed?
GEN. RODRIGUEZ: We have the same rules of engagement we have everywhere we go. It's the standard, chairman, SECDEF [Secretary of Defense] approved rules of engagement, and that's about protect themselves and self-defense. But I want to make sure that you also understand, when these people get infected and they -- they are not capable of, you know, doing a -- you know, a mounted attack or anything.
When they were coming -- the only ones that are getting the ETUs are the very -- the sickest ones, because you know -- because of a capacity problem, and they don't -- they don't have the ability to move or any of those things.
So, they have had zero problems that I know of in the Ebola Treatment Units right now handling people at the gates with a very small element. OK?
Q: The 4,000?
GEN. RODRIGUEZ: The 4,000, when you say, you know, I mean it depends how everything goes. I can't answer that question right now. But I mean, I don't -- I don't foresee more than that right now, but things can change. I mean, this is a -- a fastly changing situation. Again, we're still gaining situational understanding throughout the whole region, so I think that that will be the driving factor.
Q: Can you please give us your latest estimate about how long it's going to take to get all the treatment centers and do the other work you need to do up and running?
And can you give us a sense of how long large numbers of American troops are going to be on this mission and doing this deployment?
GEN. RODRIGUEZ: You know, the -- the treatment centers, to get the ones that we have been tasked to build right now will probably take until mid-November, right now. They are working on an effort over there to get more people to build some of those at different times, so we'll just have to see how it flexes out.
We will probably, you know, we'd be able to continue to improve the speed with which we build them. Because after you get one done, the second set goes faster. But that's the estimate right now, to get all of the 17 done.
And what was the second question, I'm sorry?
Q: How long are significant numbers of U.S. troops going to be doing this?
GEN. RODRIGUEZ: The real critical thing to this, based on USAID and the CDC is to get about 70 percent of the personnel that are infected into a treatment facility. And then at that point, they believe the curve will start going down. And then it will be based on how fast and how effectively, one, the curve turns down and, two, the international community can then pick up all the requirements. So we're going to stay as long as we're needed, but not longer than we're needed.
Q: Do you have a sense that that's six months, a year longer?
GEN. RODRIGUEZ: No, I do not at this point. I mean, I'm sure it'll be about a year, you know, at this point, but that's just a guess. And, again, we'll have to play that by ear, because it's all about the function of the transmission rates and when that curve starts going down.
Q: Could you give us a sense about the -- your cooperation with regional countries in West Africa? And do you think other countries other than Liberia are safe now from the Ebola outbreak?
GEN. RODRIGUEZ: No. As you know, both Sierra Leone and Guinea are also threatened by this. We are working just in -- for the military with both the French and the U.K. who are also doing some things, like putting the hospital up, like our 25-person hospital. And -- but most of those efforts are being run and controlled by the United Nations and international community, so we just, you know, coordinate with them and communicate with them, but not -- we don't direct them or anything.
Q: Thank you. About the cost. Can you tell us where the $750 million is coming from? Is that coming from OCO out of the continuing resolution? And do you anticipate the Pentagon needing to request more money in 2015 for the response?
GEN. RODRIGUEZ: You'd have to ask the comptrollers for that. But the bottom line is, it's a reprogramming effort, and I don't know where that's coming from, but they're working that on the Hill. And OSD Policy is leading that effort. So they'd be the ones who could tell you exactly where it's coming from. OK?
REAR ADM. KIRBY: I think we have time for two more.
Q: Thank you. General, I just wanted to clarify one thing. It is, in fact, troops who would -- and servicemembers who will be operating these testing labs in the field, correct?
GEN. RODRIGUEZ: That's correct.
Q: And so we've been told repeatedly up to this point from this podium that, in fact, servicemembers are not going to come in contact with patients, and now we're being told that that's changing.
GEN. RODRIGUEZ: The lab -- the labs are a separate specialty element of the force. So that's -- that's probably where that has come. As far as the general population, they won't be coming in contact. These are -- like I said, these labs are trained to a specialty skill -- level four, it's called -- but the bottom line, it's the highest level. I mean, they can operate in a nuclear, biological and chemical environment. They are specifically trained to do that, and that's their primary skill set, OK?
And we had one in there that has been operating for several years in the country that works on infectious diseases. We have the -- both the Navy and the Army have medical labs in many countries doing just that, to monitor these things. OK?
Q: And how many do you expect -- how many troops will be running these labs?
GEN. RODRIGUEZ: As I mentioned, there will be three or four per lab. It's a testing facility, OK? And they test it in a full-up biological -- suited up. I mean, these people -- like I said -- meet the highest level of standards of operating in the environment. OK?
Q: Just a clarification on that, please. Will they be in contact with individuals or just specimens?
GEN. RODRIGUEZ: They come in contact with the individuals and they do that. And they're -- like I said, it's a -- it's a very, very high standard that these people have operated in all their lives, and this is their primary skill. This is not a -- you know, just medical guys trained to do this. This is what they do for a living.
Q: And how many labs total would be...
GEN. RODRIGUEZ: There are three labs deployed right now and operating, and there's been a request for four more labs, and we're working to generate that right now, because as I mentioned, that's -- the testing really focuses who you need to treat and who you don't need to treat, because, like I said, malaria shows a similar problem with the symptoms. So that's -- they have already had a major impact, and the more the better for the effectiveness of the effort.
REAR ADM. KIRBY: Last question.
Q: General, when do you expect General Volesky to be on the ground? And why is he replacing General Williams?
GEN. RODRIGUEZ: The -- the way that the command and control is set for the component for USARAF [United States Army Africa] is that it has the ability to do small humanitarian things for a very short period of time. OK? And then that is -- again, this is not a small effort, and it's not a short period of time. So then we'll get a headquarters from the United States out there to do that, and then General Williams also has a significant job doing lots of other things every single day that we need him working on in the rest of Africa. And that's the way the design structure of the command and control is set up.
Q: Sir, when will General Volesky get there?
GEN. RODRIGUEZ: He'll be there in the next three weeks.
REAR ADM. KIRBY: Thanks, everybody. Appreciate you coming.
Q: Thank you, General.
Q: Thank you.
GEN. RODRIGUEZ: Thank you.