What Ebola Says About Our Ability to Cope
Mistakes, cynical responses, and weak leadership portend scary outcomes for bigger threats.
Let me tell you a horrifically depressing story, then explain why it's important.
His body laced with a covert killer, Thomas Eric Duncan flew from Liberia to Dallas with connecting flights in Brussels and suburban Washington. He fell ill four days later and went to Texas Health Presbyterian Hospital. Doctors sent him home despite a high fever and his travel history, which he had disclosed.
Two days later, on Sept. 28, Duncan returned to the hospital with his family and said he might have Ebola. Within hours, according to medical records, Duncan was racked by severe diarrhea and projectile vomiting.
The sick man was left in an open area of the Presbyterian Hospital Emergency room.
The hospital lacked full biohazard protection. The doctors and nurses improvised. They used more-conventional protective gear and added extra layers, which made the clothing more difficult and dangerous to take off.
Two of the health care workers who treated Duncan are now sick with Ebola.
"We've been lied to in terms of the preparation in the hospitals," said RoseAnn DeMoro, executive director of National Nurses United. "What happened in Dallas can happen anywhere."
The Centers for Disease Control and Prevention did not send a team of experts to Dallas to contain the virus. CDC Director Thomas Frieden, a highly respected doctor, acknowledged that he should have immediately ordered a team to Dallas.
One of the sick nurses, 29-year-old Amber Joy Vinson, had scheduled a trip to Ohio to plan her wedding. Before boarding the flight, she called the CDC and said she was running a low fever.
She asked: Can I fly?
Yes, the CDC said.
Friedman said that was a mistake. Still, no worries. "She did not vomit, she was not bleeding, so the level of risk of people around her would be extremely low," he said.
Her fellow passengers aboard Frontier Airlines Flight 1143 were contacted by CDC and told: You've been exposed to Ebola. Frontier decontaminated the plane
Vinson visited three family members in Ohio who work at Kent State University. The school's president told them to stay home and monitor their health for 21 days.
Frieden accepted responsibility. "If a health care worker gets infected," he said, "that's on us, all of us."
Ebola became a political issue. President Obama summoned his Cabinet and spoke publicly about the situation Wednesday, promising "a much more aggressive" response. He called on foreign leaders to join the U.S. fight to contain the disease in Africa.
The president's spokesman struggled to tell reporters who was singularly in charge of the government's response. After listing an alphabet soup of agency leaders, Josh Earnest said Obama's homeland security adviser, Lisa Monaco, coordinates the bureaucracies. He added, "I think that is a completely reasonable management structure."
(The next time Earnest is asked, "Who's in charge?" he might just say, "The president.")
House Speaker John Boehner, Obama's chief rival in governing, called for a ban on travelers from nations affected by the outbreak. Some conservatives stretched to link the Ebola situation to lax immigration laws or to question Obama's patriotism. Rush Limbaugh suggested the outbreak may be a liberal plot to avenge slavery.
Many liberals dismissed concerns about government competence and said there was no reason to question Obama's leadership. Some mocked public fears.
The flu kills 36,000 people in the US every year. Feel free to panic now.— Markos Moulitsas (@markos) October 15, 2014
The Washington Post summed things up nicely:
As Wednesday ended, Americans had to be wondering when the U.S. outbreak will be contained, and whether public officials' measured language and repeated reassurances are a gloss on a desperate and sometimes improvisational battle against a disease that in West Africa has killed more than 4,000 people.
I took the time to catalogue the mistakes and cynical responses, because it's important. Not so much because we need to adjust quickly to prevent a major Ebola outbreak in the United States. While that is a concern, it still strikes me as a relatively minor one, compared with what this fiasco says about the nation's ability to deal with a truly knee-buckling crisis.
A nuclear attack. An earthquake that levels major cities. A pandemic flu. The Bush administration worked with health care systems across the country to prepare for a worst-case scenario: A flu strain evolves and quickly sickens a third of all Americans, killing nearly 2 million. Pick your poison, and ask yourself, "Could we cope?"
As I wrote last week, the Ebola crisis is a reminder of how much faith we've lost in our political and social institutions. The Ebola infections cause most Americans to wonder about the effectiveness of local, state, and federal agencies, as well as the private-sector health care systems. We must demand better.
If we don't hold our leaders accountable, especially those who share our ideology, we get irresponsible and unresponsive leadership.
If the nation's leadership class doesn't own up to its mistakes and learn from them, they lose the faith of their flocks.
The compact between The Leaders and The Led is fundamental to the survival of any tribe, community, or country. You could argue that radical connectivity and the democratization of the media makes it harder than ever to lead, and to be led. But that just makes stories like this horrific Ebola situation all the more maddening—and all the more important.