Scott Gottlieb and Tevi Troy explain for Wall Street Journal readers why the problems associated with the government response to the Ebola threat involve much more than poor messaging.
Much public skepticism about the government’s response to Ebola stems from the dogmatic pronouncements of Obama administration officials. In a video message early last month on stopping the virus, for example, President Obama asserted that “we know how to do it.” He was wrong.
The world has learned that dealing with Ebola in remote African villages is a very different challenge from confronting an unfamiliar virus in large cities and modern hospitals.
The Centers for Disease Control and Prevention, despite a rocky beginning, now recognizes that containing Ebola presents unexpected challenges of technique and execution. The White House, for its part, apparently thinks it is a messaging problem.
To fix his messaging problem, President Obama has appointed political fixer Ron Klain as its new Ebola response “czar.” Mr. Klain’s most significant contribution to public-health spin control came when he was Vice President Joe Biden’s chief of staff during one of the worst public-health communications missteps of recent memory. During the 2009 H1N1 pandemic, Mr. Biden said on NBC’s “Today” show that “I wouldn’t go anywhere in confined places now.” The White House press office scrambled to walk back Mr. Biden’s words, which threatened to disrupt public transportation and air travel.
The CDC’s lapses—such as failing to intensify the recommended protective gear for medical workers or tighten techniques for handling hospital waste—may have contributed to the unnecessary secondary spread of the virus to two nurses. Misstatements by its director, Thomas Frieden, about the risk to U.S. citizens and hospital personnel, have rightly fueled some of the criticism directed his way. But Dr. Frieden deserves credit for chasing down the agency’s errors and readily acknowledging its bad decisions.
One insight about the Ebola epidemic has already emerged: Health-care workers inside a modern U.S. hospital, paradoxically, may be at greater risk for contamination and infection than those in West Africa’s spartan clinics. That’s because of the comprehensive way that critical care is delivered in the U.S., reflecting the health-care system’s greater sophistication. Dr. Frieden has cited kidney dialysis and intubation with a breathing tube as two such high-risk procedures. But many other seemingly routine services in an intensive-care unit—including frequent blood draws and bedding changes, and the use of feeding tubes and IVs—can be sources of contamination.
As a result, the CDC is changing its approach. Initially the CDC’s plan was to let patients be treated in place at major hospitals. The idea was that these institutions would gain experience that would be essential in the event of a larger outbreak. Now the CDC seems to be moving toward a model of expert referral centers, where a smaller network of hospitals can be specially equipped and trained to handle Ebola, and where the CDC can exert tighter controls. …
… The broad, early assurances from Mr. Obama prove that the best political messages don’t make for good public health. The public won’t be spooked by an admission that we don’t have all the answers, as long as people sense that they are being spoken to honestly and believe that officials are pursuing key uncertainties.
