The PJ Tatler

CNN to CDC Director: Who's in Charge of the Ebola Response?

CNN’s Dr. Sanjay Gupta and Michaela Perierra flummoxed Centers for Disease Control Director Dr. Tom Frieden with a simple Ebola scenario last week involving three feet of distance and a cough or a sneeze.

Today, Gupta asked Frieden another simple question: Just who’s in charge of the Ebola response?

Frieden inspired about as much confidence this time as last time.

GUPTA: “Dr. Frieden, I’m curious about — I know you’ve had a very busy week. Who is in charge? And if you’re in charge — I mean, can you mandate things to happen? We know what’s going on in Dallas. Could you say, ‘Look, here’s what you absolutely need to do in Dallas, this is required, I’m enforcing this to happen?’And if you can’t do that, why can’t you do that? Somebody needs to have some leadership, it seems, over the whole situation.”
FRIEDEN: “Absolutely. And we work very closely with state and local governments. And when there’s an episode in a state or local government, they are in charge and we support them in every way. They assign an incident manager; they establish an emergency operations system; they outline every aspect and we work very closely with them. There’s a great collaboration. I think the issue that we’ve been challenged by is what do you do with the waste?”
GUPTA: “Is it necessary to have somebody who is absolutely in charge — sort of a czar, if you will, over this? Who doesn’t just provide guidance or recommendations, but provides mandates?”
FRIEDEN: “In every place, where Ebola is spreading, our number one recommendation is to establish what we call an incident management system, where one person is in charge and you break down the tasks into smaller tasks to make sure that everything gets done and followed up. And that’s been done in Texas. They’ve done exactly what we’ve recommended. They have an incident manager in place. We’re supporting that person. The state of Texas is supporting that person and I’m confident we’ll break the chain of transmission there.”

That all sounds sort of good from a federalism perspective, though a local official is far less likely to have a grip on the epidemiology of any particular disease than the CDC ought to have. In Dallas, the incident manager is Judge Clay Jenkins. And that’s a problem.

Judge Jenkins first tried “requesting” that the family of the Ebola-infected man stay home. They broke that request and Jenkins then, after they might possibly have exposed others, ordered them into quarantine. The apartment where they lived and Patient Zero came down with symptoms was not cleaned for several days, and residents of that complex only learned about their neighbor’s infection days later as well. All along, Jenkins has prioritized the family’s feelings over the safety of their neighbors and the Dallas area.

Over the weekend, Jenkins personally moved the family to a new home because the apartment they had been living in was a quarantine zone and needed cleaning. So Jenkins personally drove them to the new home. He was not wearing any gear to protect himself from hazardous materials when he entered the apartment. He later bragged to reporters that he was wearing the same shirt for a press conference later.

Jenkins is obviously trying to inspire confidence, but the fact is, it is possible for someone to become infected with Ebola without ever touching a person who is showing symptoms of the disease (which none of the family are). An NBC photographer appears to have contracted Ebola when he was sanitizing a car in Liberia. Evidently some fluids with the virus had gotten into that car, and onto that reporter. The apartment Jenkins visited may have had Ebola in any number of places.

The CDC, though, has Judge Jenkins in charge of the local Ebola response.