DEL.ICIO.USPublished on: 06/03/07
Denver — After a crucial meeting where health authorities advised Andrew Speaker not to travel because he had drug-resistant tuberculosis, the man changed his Air France plane ticket and left the country two days ahead of schedule, a health official said Saturday.
Kim Speaker of Atlanta, the man's sister, in an interview Saturday with The Atlanta Journal-Constitution said her brother wasn't in any way trying to flee the country early. Rather, she said, the stress of being diagnosed with a potentially deadly disease and the prospect of two years of treatment had caused Andrew Speaker so much anxiety and sleepless nights that his fiancée urged him to head out early for their wedding in Greece.
 "Good Morning America" |
| In this image made from television and released by ABC News, Andrew Speaker speaks through a face mask from National Jewish Medical and Research Center in Denver, Colo during a 'Good Morning America' |
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| In this image made from television and released by ABC News, Andrew Speaker, right and his wife Sarah are interviewed at National Jewish Medical and Research Center |
"She [then fiancée Sarah Cooksey] said: 'You know what, you're not sleeping here, you're stressed out, just go, get there and get some peace and quiet,' " Kim Speaker said, noting that her brother "loves traveling" and that it helps him relax.
This latest twist in an already bizarre story raises further questions about the ability of health and homeland security officials to react swiftly and protect the United States not only in a potentially dangerous health threat, but from people who might be wanted in a bioterrorism event.
Congressional hearing
The case, which has sparked investigations in the United States, Canada, Italy and Greece, will be the subject of a hearing in Congress next week as the House Homeland Security Committee probes how the couple managed to elude local, state and federal health authorities, bypass a no-fly order and drive across the U.S.-Canadian border even after their passports set off an alarm alerting the border guard to detain them.
Speaker's change in flight plans contributed to Fulton County health officials being unable to serve him with a medical directive, an official written advisory not to travel. Under Georgia law, health officials have said they can't obtain a court order restricting a patient's movements until there is a violation of a written directive.
Without referring to Andrew Speaker by name, in deference to patient confidentiality, Fulton County Health Director Steven Katkowsky said the man changed flight plans after health officials advised him not to travel during a May 10 family care conference.
During that key meeting, Andrew Speaker has said he was never told he had to cancel his long-planned wedding in Greece and honeymoon traveling around Europe. What was said at the meeting, which included Fulton County health officials, Speaker's fiancée, Sarah, and his father, Ted, is a major point of controversy. Andrew Speaker has told the AJC that his father, who is an attorney, recorded the meeting with a device that was in his pocket. So far, the family has not released the recording.
Andrew Speaker, also an attorney, has maintained that health officials knew he was leaving the country for his wedding and that they told him he was at no risk of spreading TB to his family or anyone else. He says he would have canceled his wedding if he had been told to do so.
The day after the meeting, May 11, Fulton County health authorities wrote up a synopsis of the previous day's meeting in the form of a medical directive that again advised Speaker against traveling.
Katkowsky said a county disease investigator attempted to hand-deliver the letter to Speaker's home and business on May 11 and 12 but he wasn't in either location.
On May 12, the investigator learned that Speaker had already left the country, Katkowsky said, even though Speaker had told county officials his flight was scheduled for May 14.
"Yes, it was moved up from the 14th to the 12th," Katkowsky said. "We were advised by him that his plans were to leave on May 14. He actually moved up his plans to May 12."
According to a source close to the investigation, Speaker called Air France on May 12 and asked to be put on a flight earlier than his scheduled May 14 departure. During the call, the airline changed his ticket so he could leave that same day on Air France Flight 385.
On May 17, Katkowsky said, health officials learned that Speaker's TB wasn't just multidrug-resistant — the serious diagnosis that was known before he left the United States. The tests had found his TB to be the rare and most difficult-to-treat form of TB, called extensively drug-resistant TB, or XDR TB.
While local, state and federal health officials in Atlanta grappled with this new diagnosis, Speaker and his bride tied the knot May 18 in Santorini, a picturesque Greek island perched high over the Aegean Sea. Known around the world for its gorgeous sunsets and bleached-white buildings, it is a popular wedding destination. It's a place where tourists tool around town on motorcycles, taking in panoramic views of cliffs and volcanoes.
Both sets of parents attended the Speakers' wedding, said a person who attended but did not want to be named. Wedding sites on the island are difficult to wrangle, and planners say couples often have to book at least a year in advance.
The couple headed off on their honeymoon and were in Rome on May 23 when they got a message that the CDC was looking for them. In a strange coincidence, bride Sarah Speaker's father — Robert Cooksey — is a Ph.D. microbiologist who works in CDC's tuberculosis labs.
Andrew Speaker has told the AJC that during phone calls between Rome and the CDC, he received mixed messages and little assurance of help from CDC's Dr. David Kim, the TB official who alerted him of the new XDR TB diagnosis and instructed him to voluntarily go into isolation at an Italian hospital.
Kim did not respond to requests for interviews Saturday made through the CDC press office and his e-mail.
Speaker said Kim, after initially indicating CDC would help the couple get back to the United States, told him that the agency couldn't help.
Speaker said he told Kim about his plans to have cutting-edge drug therapy and surgery at National Jewish Medical and Research Center in Denver following the honeymoon. Speaker explained that he'd been told he has just one shot at getting the right treatment.
'He has one chance'
Dr. Charles Daley, the Denver hospital's infectious diseases chief, confirmed in an interview Friday that the hospital officials had told Speaker this. "He has one chance. He was told that. We told him that," Daley said.
According to Speaker, Kim told the couple if they could raise up to $140,000 they could hire a private air ambulance to transport them home. When specifically asked whether the CDC's emergency jet could bring them home, Kim told him there was no money in the budget to transport them and that the decision was final.
"I'm appalled at the fact they were going to [wash] their hands of me in Italy. That's the most upsetting part. You think, naively, that the government is going to help you," he said, adding, "In the end, the people at the top [at CDC] decided to do that."
The CDC's leased Gulfstream III, which is on call 24 hours a day at a cost to taxpayers of $250,000 a month, was the subject of an article in the AJC on Memorial Day because it has rarely been used in the past year and was used for non-emergency flights the previous year.
Since the TB controversy became public, CDC Director Julie Gerberding has said that use of the jet to transport Speaker was one of several options being explored, but that international approvals take time.
But Speaker told the AJC that he was never told that the agency was still working on using the jet. That option has been completely ruled out, he said. Speaker said he asked Kim whether there was someone else at CDC he could appeal to. He said Kim told him no.
"He said, 'Why don't you walk around, get some fresh air, get some dinner before you come in the morning.' I thought: So it's OK to walk around, but you want me to voluntarily turn myself in for solitary confinement?"
In that same call on May 23, Kim told the couple that they had been put on the "no-fly" list and that their passports had been flagged, Speaker said.
It didn't make sense, Speaker said Tuesday. "They knew I was coming. They knew I was drug-resistant," he said. "It was OK to roam around Atlanta ... it was fine to put Rome at risk and go out to dinner."
"So I'm able to walk around before I leave, now it's an international incident," Speaker said. That's when Speaker and his bride decided to run — booking a flight from Rome to Prague then into Montreal. Speaker said they purposely flew to Canada to avoid the "no fly" order, which they assumed would only apply to U.S.-bound aircraft. They then rented a car and drove across the border without incident.
They contacted CDC officials once in the U.S., met them in New York and were ultimately flown from New York to Atlanta aboard the CDC jet on Memorial Day.
Disease experts say there is a significant difference between the risk of a person with TB walking around outdoors or briefly being in a restaurant, than the same person being in the confined space of an aircraft with air recirculating for eight hours or more.
Small risk still a risk
While the risk of TB transmission aboard an aircraft is still small — especially because tests show Speaker's disease at the time and currently is not very infective — it's not zero. That's why CDC issued an international health alert Tuesday and urged those seated in nearby seats and rows have a TB test as a precaution.
Speaker, who remains under a rare federal isolation order, began receiving a combination of drugs Friday that doctors at National Jewish Medical and Research Center hope will cure his infection. They've cautioned that many of the drugs, which they did not identify, have toxic side effects and will likely make Speaker fatigued. He's expected to remain hospitalized in a pressurized room for about two months, and will be taking a dozen pills or more a day for at least two years, the doctors have said.
Speaking briefly with the AJC by telephone Saturday morning from his hospital room, Speaker sounded groggy and said he was exhausted. He said the intensity of the media spotlight, the hounding of his family, and the angry and sometimes hateful e-mails, messages and TV talk show commentary have been overwhelming.
"I'm fighting for my life and now my personal and professional integrity is being questioned. They're even questioning whether I actually got married," he said.
A Greek official, in media reports, has questioned whether the Speakers' marriage is valid because of a paperwork issue. "We went over there, had a ceremony. We signed all the marriage papers," Speaker said.
While Speaker has spoken with the AJC several times since Tuesday, his televised appearance Friday on ABC's "Good Morning America" has helped shift some public sympathy in his direction, he said.
He said he's aware of people wishing he would die a painful death but is grateful for those who wish him recovery. "There are so many people sending messages saying you're in our prayers," he said.
Staff writer Andrea Jones contributed to this report.
country two days ahead of schedule, a health official said Saturday.Kim Speaker of Atlanta, the man's sister, in an interview Saturday with The Atlanta Journal-Constitution said her brother wasn't in any way trying to flee the country early. Rather, she said, the stress of being diagnosed with a potentially deadly disease and the prospect of two years of treatment had caused Andrew Speaker so much anxiety and sleepless nights that his fiancée urged him to head out early for their wedding in Greece.
"She [then fiancée Sarah Cooksey] said: 'You know what, you're not sleeping here, you're stressed out, just go, get there and get some peace and quiet,' " Kim Speaker said, noting that her brother "loves traveling" and that it helps him relax.
This latest twist in an already bizarre story raises further questions about the ability of health and homeland security officials to react swiftly and protect the United States not only in a potentially dangerous health threat, but from people who might be wanted in a bioterrorism event.
Congressional hearing
The case, which has sparked investigations in the United States, Canada, Italy and Greece, will be the subject of a hearing in Congress next week as the House Homeland Security Committee probes how the couple managed to elude local, state and federal health authorities, bypass a no-fly order and drive across the U.S.-Canadian border even after their passports set off an alarm alerting the border guard to detain them.
Speaker's change in flight plans contributed to Fulton County health officials being unable to serve him with a medical directive, an official written advisory not to travel. Under Georgia law, health officials have said they can't obtain a court order restricting a patient's movements until there is a violation of a written directive.
Without referring to Andrew Speaker by name, in deference to patient confidentiality, Fulton County Health Director Steven Katkowsky said the man changed flight plans after health officials advised him not to travel during a May 10 family care conference.
During that key meeting, Andrew Speaker has said he was never told he had to cancel his long-planned wedding in Greece and honeymoon traveling around Europe. What was said at the meeting, which included Fulton County health officials, Speaker's fiancée, Sarah, and his father, Ted, is a major point of controversy. Andrew Speaker has told the AJC that his father, who is an attorney, recorded the meeting with a device that was in his pocket. So far, the family has not released the recording.
Andrew Speaker, also an attorney, has maintained that health officials knew he was leaving the country for his wedding and that they told him he was at no risk of spreading TB to his family or anyone else. He says he would have canceled his wedding if he had been told to do so.
The day after the meeting, May 11, Fulton County health authorities wrote up a synopsis of the previous day's meeting in the form of a medical directive that again advised Speaker against traveling.
Katkowsky said a county disease investigator attempted to hand-deliver the letter to Speaker's home and business on May 11 and 12 but he wasn't in either location.
On May 12, the investigator learned that Speaker had already left the country, Katkowsky said, even though Speaker had told county officials his flight was scheduled for May 14.
"Yes, it was moved up from the 14th to the 12th," Katkowsky said. "We were advised by him that his plans were to leave on May 14. He actually moved up his plans to May 12."
According to a source close to the investigation, Speaker called Air France on May 12 and asked to be put on a flight earlier than his scheduled May 14 departure. During the call, the airline changed his ticket so he could leave that same day on Air France Flight 385.
On May 17, Katkowsky said, health officials learned that Speaker's TB wasn't just multidrug-resistant — the serious diagnosis that was known before he left the United States. The tests had found his TB to be the rare and most difficult-to-treat form of TB, called extensively drug-resistant TB, or XDR TB.
While local, state and federal health officials in Atlanta grappled with this new diagnosis, Speaker and his bride tied the knot May 18 in Santorini, a picturesque Greek island perched high over the Aegean Sea. Known around the world for its gorgeous sunsets and bleached-white buildings, it is a popular wedding destination. It's a place where tourists tool around town on motorcycles, taking in panoramic views of cliffs and volcanoes.
Both sets of parents attended the Speakers' wedding, said a person who attended but did not want to be named. Wedding sites on the island are difficult to wrangle, and planners say couples often have to book at least a year in advance.
The couple headed off on their honeymoon and were in Rome on May 23 when they got a message that the CDC was looking for them. In a strange coincidence, bride Sarah Speaker's father — Robert Cooksey — is a Ph.D. microbiologist who works in CDC's tuberculosis labs.
Andrew Speaker has told the AJC that during phone calls between Rome and the CDC, he received mixed messages and little assurance of help from CDC's Dr. David Kim, the TB official who alerted him of the new XDR TB diagnosis and instructed him to voluntarily go into isolation at an Italian hospital.
Kim did not respond to requests for interviews Saturday made through the CDC press office and his e-mail.
Speaker said Kim, after initially indicating CDC would help the couple get back to the United States, told him that the agency couldn't help.
Speaker said he told Kim about his plans to have cutting-edge drug therapy and surgery at National Jewish Medical and Research Center in Denver following the honeymoon. Speaker explained that he'd been told he has just one shot at getting the right treatment.
'He has one chance'
Dr. Charles Daley, the Denver hospital's infectious diseases chief, confirmed in an interview Friday that the hospital officials had told Speaker this. "He has one chance. He was told that. We told him that," Daley said.
According to Speaker, Kim told the couple if they could raise up to $140,000 they could hire a private air ambulance to transport them home. When specifically asked whether the CDC's emergency jet could bring them home, Kim told him there was no money in the budget to transport them and that the decision was final.
"I'm appalled at the fact they were going to [wash] their hands of me in Italy. That's the most upsetting part. You think, naively, that the government is going to help you," he said, adding, "In the end, the people at the top [at CDC] decided to do that."
The CDC's leased Gulfstream III, which is on call 24 hours a day at a cost to taxpayers of $250,000 a month, was the subject of an article in the AJC on Memorial Day because it has rarely been used in the past year and was used for non-emergency flights the previous year.
Since the TB controversy became public, CDC Director Julie Gerberding has said that use of the jet to transport Speaker was one of several options being explored, but that international approvals take time.
But Speaker told the AJC that he was never told that the agency was still working on using the jet. That option has been completely ruled out, he said. Speaker said he asked Kim whether there was someone else at CDC he could appeal to. He said Kim told him no.
"He said, 'Why don't you walk around, get some fresh air, get some dinner before you come in the morning.' I thought: So it's OK to walk around, but you want me to voluntarily turn myself in for solitary confinement?"
In that same call on May 23, Kim told the couple that they had been put on the "no-fly" list and that their passports had been flagged, Speaker said.
It didn't make sense, Speaker said Tuesday. "They knew I was coming. They knew I was drug-resistant," he said. "It was OK to roam around Atlanta ... it was fine to put Rome at risk and go out to dinner."
"So I'm able to walk around before I leave, now it's an international incident," Speaker said. That's when Speaker and his bride decided to run — booking a flight from Rome to Prague then into Montreal. Speaker said they purposely flew to Canada to avoid the "no fly" order, which they assumed would only apply to U.S.-bound aircraft. They then rented a car and drove across the border without incident.
They contacted CDC officials once in the U.S., met them in New York and were ultimately flown from New York to Atlanta aboard the CDC jet on Memorial Day.
Disease experts say there is a significant difference between the risk of a person with TB walking around outdoors or briefly being in a restaurant, than the same person being in the confined space of an aircraft with air recirculating for eight hours or more.
Small risk still a risk
While the risk of TB transmission aboard an aircraft is still small — especially because tests show Speaker's disease at the time and currently is not very infective — it's not zero. That's why CDC issued an international health alert Tuesday and urged those seated in nearby seats and rows have a TB test as a precaution.
Speaker, who remains under a rare federal isolation order, began receiving a combination of drugs Friday that doctors at National Jewish Medical and Research Center hope will cure his infection. They've cautioned that many of the drugs, which they did not identify, have toxic side effects and will likely make Speaker fatigued. He's expected to remain hospitalized in a pressurized room for about two months, and will be taking a dozen pills or more a day for at least two years, the doctors have said.
Speaking briefly with the AJC by telephone Saturday morning from his hospital room, Speaker sounded groggy and said he was exhausted. He said the intensity of the media spotlight, the hounding of his family, and the angry and sometimes hateful e-mails, messages and TV talk show commentary have been overwhelming.
"I'm fighting for my life and now my personal and professional integrity is being questioned. They're even questioning whether I actually got married," he said.
A Greek official, in media reports, has questioned whether the Speakers' marriage is valid because of a paperwork issue. "We went over there, had a ceremony. We signed all the marriage papers," Speaker said.
While Speaker has spoken with the AJC several times since Tuesday, his televised appearance Friday on ABC's "Good Morning America" has helped shift some public sympathy in his direction, he said.
He said he's aware of people wishing he would die a painful death but is grateful for those who wish him recovery. "There are so many people sending messages saying you're in our prayers," he said.
Staff writer Andrea Jones contributed to this report.
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